Registry data provide no evidence of stroke mortality ‘obesity paradox’

Some studies have suggested that overweight and obese patients have a survival advantage following stroke, but no evidence of this "obesity paradox" was found in an analysis of registry data.

Of 71,617 patients in the Danish Stroke Register, 7,878 (11%) died within a month of the index stroke, with 5,512 of the deaths (70%) attributable to the stroke. The largest proportion of deaths (39%) were among normal-weight patients, while 9.7% were underweight, 34.5% were overweight, and 16.8% were obese. The hazard ratios for stroke mortality for overweight and obese patients, compared with normal weight patients, were 0.96 and 1.0, respectively, Christian Dehlendorff, Ph.D., of the Danish Cancer Society Research Center, Copenhagen, and associates reported online June 2 in JAMA Neurology.

Of note, BMI was inversely related to average age of stroke onset, the investigators found (JAMA Neurol. 2014 June 2 [doi:10.1001/jamaneurol.2014.1017]).

The findings suggest that the "obesity paradox" identified in some earlier studies was an artifact related to selection bias, and that overweight and obese individuals with stroke should continue to aim for normal weight, the investigators concluded.

This study was funded by Jascha Foundation. The authors reported having no disclosures.

Some studies have suggested that overweight and obese patients have a survival advantage following stroke, but no evidence of this "obesity paradox" was found in an analysis of registry data.

Of 71,617 patients in the Danish Stroke Register, 7,878 (11%) died within a month of the index stroke, with 5,512 of the deaths (70%) attributable to the stroke. The largest proportion of deaths (39%) were among normal-weight patients, while 9.7% were underweight, 34.5% were overweight, and 16.8% were obese. The hazard ratios for stroke mortality for overweight and obese patients, compared with normal weight patients, were 0.96 and 1.0, respectively, Christian Dehlendorff, Ph.D., of the Danish Cancer Society Research Center, Copenhagen, and associates reported online June 2 in JAMA Neurology.

Of note, BMI was inversely related to average age of stroke onset, the investigators found (JAMA Neurol. 2014 June 2 [doi:10.1001/jamaneurol.2014.1017]).

The findings suggest that the "obesity paradox" identified in some earlier studies was an artifact related to selection bias, and that overweight and obese individuals with stroke should continue to aim for normal weight, the investigators concluded.

This study was funded by Jascha Foundation. The authors reported having no disclosures.

Some studies have suggested that overweight and obese patients have a survival advantage following stroke, but no evidence of this "obesity paradox" was found in an analysis of registry data.

Of 71,617 patients in the Danish Stroke Register, 7,878 (11%) died within a month of the index stroke, with 5,512 of the deaths (70%) attributable to the stroke. The largest proportion of deaths (39%) were among normal-weight patients, while 9.7% were underweight, 34.5% were overweight, and 16.8% were obese. The hazard ratios for stroke mortality for overweight and obese patients, compared with normal weight patients, were 0.96 and 1.0, respectively, Christian Dehlendorff, Ph.D., of the Danish Cancer Society Research Center, Copenhagen, and associates reported online June 2 in JAMA Neurology.

Of note, BMI was inversely related to average age of stroke onset, the investigators found (JAMA Neurol. 2014 June 2 [doi:10.1001/jamaneurol.2014.1017]).

The findings suggest that the "obesity paradox" identified in some earlier studies was an artifact related to selection bias, and that overweight and obese individuals with stroke should continue to aim for normal weight, the investigators concluded.

This study was funded by Jascha Foundation. The authors reported having no disclosures.