Association Between Weight Change Since 20 Years of Age With Mortality From Myocardial Infarction and Chronic Heart Failure in the Japan Collaborative Cohort (JACC) Study

Background: Weight gain is an important risk factor of coronary artery disease, but there is limited evidence for an effect of weight change on heart failure (HF) mortality. Methods and Results: A total of 61,571 subjects aged 40-79 years were selected. Participants were already enrolled in the Japan Collaborative Cohort (JACC) study, for whom data regarding weight at the age of 20 years of age were available. The underlying causes of death were determined based on the International Classification of Diseases. During the median 19.3-year follow-up of the cohort, there were 640 deaths from myocardial infarction (MI) and 605 deaths from HF. Men and women who had gained weight had a higher risk of mortality from MI, whereas those who had lost weight had a higher risk of mortality from HF. Compared to subjects with no weight change (within +/- 5.0 kg), the multivariate hazard ratios (HR; 95% confidence interval [Cl]) of MI for weight change of +10.0 kg or more were 1.51 (1.11-2.06) for men and 1.80 (1.23-2.64) for women, whereas HRs of HF were 0.76 (0.51-1.13) and 0.94 (0.66-1.33), respectively. The corresponding HRs of MI for weight change of -10.0 kg or more were 0.86 (0.57-1.31) for men and 0.90 (0.54-1.53) for women, whereas those of HF were 1.33 (0.93-1.89) and 1.48 (1.04-2.12), respectively. Conclusions: High BMI and weight gain are associated with increased risk of mortality from MI, whereas low BMI and weight loss are associated with increased risk of mortality from HF.