Body mass index and mortality of cardiovascular disease by smoking and age at menopause among postmenopausal women : a Kangwha cohort study

Abstract

[한글]

[영문]Background and Purpose-The association between body mass index (BMI) and mortality caused by subtypes of stroke among postmenopausal women by smoking status and age at menopause remained controversial. Methods-The data were derived from a cohort study of 3,321 with 17.8 years of follow-up (1985-2002). Hazard ratios and 95% confidence intervals for strokes as related to BMI were estimated by Cox proportional hazard models adjusted for age, hypertension, smoking, drinking, occupation, education, self-reported health, and age at menopause. A stratified analysis was conducted by age at menopause and smoking status. Results-The obese group (BMI ≥27.5 kg/m2) had higher risks of total stroke mortality (hazard ratio [HR] =1.59; 95% confidence interval [CI], 1.05-2.42) and hemorrhagic stroke mortality (HR=2.91; 95% CI, 1.37-6.19) than the normal weight group (18.5≤BMI<23.0). Among ever smokers, the obese group showed significantly increased risks of total stroke mortality (HR=2.33; 95% CI, 1.00-5.43) and ischemic stroke mortality (HR=7.21; 95% CI, 1.18-44.3). Obesity had more effect on stroke mortality among women who experienced menopause at age <50 than women with age ≥50. For the obese group of the none smoker, the hazard ratio of total stroke was 2.04 (95% CI, 1.25-3.34) and that of hemorrhagic stroke 6.46 (95% CI, 2.42-17.25).Conclusions-In this prospective study, obesity raised the risks of total stroke mortality and hemorrhagic stroke mortality among Korean menopausal women. It was more evident with women who experienced menopause at age <50. The obese group of ever smokers was at an increased risk of ischemic stroke mortality.