Coronary atherosclerosis associated with body structure and obesity in 599 women aged between 15 and 50 years

Abstract

OBJECTIVE: Few data are available on the actual degree of coronary atherosclerosis or its relationship to body composition in young women. The present study was carried out to identify, with the help of simple indicators of obesity and body structure, those women under 50 y of age who have the most advanced coronary lesions.

DESIGN: Autopsy reports were analysed including age, height, weight, abdominal subcutaneous fat thickness, heart weight, liver and kidney weights, coronary atherosclerosis, and ovarial status.

SUBJECTS: Female cases of sudden unexpected death (n=599) aged between 15 and 50 y autopsied in 1973–1995 were collected from the files of the Department of Forensic Medicine, University of Oulu, Finland.

RESULTS: The percentage of individuals with coronary lesions was 50% in women over 41 years of age, 32% in women from 31 to 40, 17% in women from 21 to 30, and 6% in women under 20 y of age. 2.1% of the women had died from manifestations of coronary heart disease (CHD). The most severe lesions were found in women with body mass index (BMI) between 24.2 and 27.2 when adjusted for age, and when abdominal subcutaneous fat thickness exceeded 35 mm when adjusted for age and BMI. Heart weight indexed to body size increased with BMI and abdominal fat and was positively correlated with the degree of coronary atherosclerosis, which was also associated with short stature and high liver and kidney weights when adjusted for body size.

CONCLUSION: Mild to moderate overweight, short stature, increased amounts of abdominal subcutaneous fat, increased components of fat free mass and myocardial hypertrophy are the physical characteristics that indicate more advanced coronary atherosclerosis in women under 50 y of age.