Skip to main content
Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women
UMass Worcester Prevention Research Center Publications
  • Kathleen M. McTigue, University of Pittsburgh
  • Yue-Fang Chang, University of Pittsburgh
  • Charles B. Eaton, Brown University
  • Lorena Garcia, University of California - Davis
  • Karen C. Johnson, University of Tennessee
  • Cora E. Lewis, University of Alabama - Birmingham
  • Simin Liu, University of California at Los Angeles
  • Rachel H. Mackey, University of Pittsburgh - Main Campus
  • Jennifer Robinson, University of Iowa College of Public Health
  • Milagros C. Rosal, University of Massachusetts Medical School
  • Linda G. Snetselaar, University of Iowa
  • Alice Valoski, University of Pittsburgh
  • Lewis H. Kuller, University of Pittsburgh - Main Campus
UMMS Affiliation
Department of Medicine, Division of Preventive and Behavioral Medicine
Publication Date
Document Type
OBJECTIVE: To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI >/= 40), and examine heterogeneity in weight-related CHD risk. DESIGN AND METHODS: Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). RESULTS: Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. CONCLUSIONS: Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity.
  • cardiovascular diseases/epidemiology,
  • cardiovascular diseases/etiology,
  • longitudinal studies,
  • obesity,
  • morbid/complications,
  • obesity,
  • morbid/epidemiology,
  • obesity/epidemiology,
  • obesity/complications
DOI of Published Version
McTigue KM, Chang YF, Eaton C, Garcia L, Johnson KC, Lewis CE, Liu S, Mackey RH, Robinson J, Rosal MC, Snetselaar L, Valoski A, Kuller LH. Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women. Obesity (Silver Spring). 2012 Dec 12. doi:10.1002/oby.20224. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Kathleen M. McTigue, Yue-Fang Chang, Charles B. Eaton, Lorena Garcia, et al.. "Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women" (2014) ISSN: 1930-7381 (Linking)
Available at: