Obesity Epidemiology

OBESITY AND CARDIOVASCULAR DISEASE 187In the largest study conducted so far, Song et al. 51 followed 234,863 Korean men aged40 to 64 years for approximately 10 years and documented 7,444 total strokes, 3,981 ischemicstrokes, and 1,806 hemorrhagic strokes (including 412 subarachnoid hemorrhages).Compared to men with BMI 22.0 to 23.9, the age-adjusted RRs of total stroke were 1.2(95% CI: 1.1 to 1.2) for BMI 24.0 to 25.9; 1.4 (1.3 to 1.5) for BMI 26.0 to 27.9; 1.6 (1.3 to2.1) for BMI 28.0 to 29.9; and 1.6 (1.3 to 2.1) for BMI ≥ 30 kg/m 2 . Adjustment for intermediatevariables, including blood pressure, glucose, and cholesterol, substantially attenuatedthese RRs, but the test for linear trend remained statistically significant. Of note, theelevated RR in the obese group was stronger for hemorrhagic stroke (age-adjusted RR =2.5, 1.7 to 3.7) than for ischemic stroke (age-adjusted RR = 1.4, 1.0 to 1.9). In lower BMIcategories (