ArticleCirculation2026
Prospective Associations of Obesity and Obesity Severity With 9 Cardiovascular Outcomes: The Cross-Cohort Collaboration.
Abstract read
In one paragraph
Article in Circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Association between body mass index and cardiopulmonary function in patients with chronic coronary syndrome.Annals of medicine · 2026Article
- Obesity, metabolic health status, and adverse outcomes in men and women.American journal of preventive cardiology · 2026Article
- Obesity trajectories based on the European association for the study diagnostic framework and their associations with cardiovascular disease: evidence from two longitudinal cohorts.BMC public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
34 authors.
Zeina A DardariJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.A.D., Z.Y., Y.J., S.B., K.M., M.J.B.).ORCID 0000-0001-6026-3329
Zhiqi YaoJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.A.D., Z.Y., Y.J., S.B., K.M., M.J.B.).ORCID 0000-0001-6356-1524
Jianjun ZhangDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University Indianapolis, IN (Z.A.D., J.Z., G.B., H.N., L.K.S.).ORCID 0000-0003-2179-2388
Giorgos BakoyannisDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University Indianapolis, IN (Z.A.D., J.Z., G.B., H.N., L.K.S.).
Hongmei NanDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University Indianapolis, IN (Z.A.D., J.Z., G.B., H.N., L.K.S.).
Lisa K StatenDepartment of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University Indianapolis, IN (Z.A.D., J.Z., G.B., H.N., L.K.S.).ORCID 0000-0002-6056-4153
Kunal K JhaDivision of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, KY (K.K.J.).ORCID 0000-0002-3166-9335
Erfan TasdighiDepartment of Medicine, Rutgers New Jersey Medical School, Newark, NJ (E.T.).
Yara JelwanJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.A.D., Z.Y., Y.J., S.B., K.M., M.J.B.).ORCID 0009-0003-9269-7377
Semenawit BurkaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.A.D., Z.Y., Y.J., S.B., K.M., M.J.B.).ORCID 0009-0000-4313-3071
Kunihiro MatsushitaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.A.D., Z.Y., Y.J., S.B., K.M., M.J.B.).ORCID 0000-0002-7179-718X
Eleanor M SimonsickIntramural Research Program, National Institute on Aging, Baltimore, MD (E.M.S.).ORCID 0000-0002-5460-3494
Joao A C LimaDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD (J.A.C.L.).ORCID 0000-0001-8756-6995
Bruce M PsatyCardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, WA (B.M.P.).ORCID 0000-0002-7278-2190
Debbie L CohenRenal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (D.L.C.).ORCID 0000-0002-1325-315X
Lawrence J AppelDepartment of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (K.M., L.J.A.).ORCID 0000-0002-0673-6823
Amit KheraUniversity of Texas Southwestern, Division of Cardiology, Dallas, TX (A.K., A.M.S.).ORCID 0000-0001-7255-6874
Amil M ShahUniversity of Texas Southwestern, Division of Cardiology, Dallas, TX (A.K., A.M.S.).ORCID 0000-0003-1056-4451
Michael E HallDepartment of Medicine, University of Mississippi Medical Center, Jackson, MS (M.E.H.).ORCID 0000-0002-5733-1025
Suzanne E JuddDepartment of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL (S.E.J.).ORCID 0000-0001-7594-6587
Shelley A ColePopulation Health Program, Texas Biomedical Research Institute, San Antonio, TX (S.A.C.).ORCID 0000-0002-2651-0127
Ramachandran S VasanUniversity of Texas School of Public Health, San Antonio, TX (R.S.V.).ORCID 0000-0001-7357-5970
Emelia J BenjaminThe American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (M.E.H., E.J.B., M.J.B.).ORCID 0000-0003-4076-2336
Peggy M CawthonCalifornia Pacific Medical Center Research Institute, San Francisco and Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (P.M.C.).
Eric OrwollDivision of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University, Portland, OR (E.O.).ORCID 0000-0002-8520-7355
Michael J LaMonteDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY (M.J.L.).ORCID 0000-0002-6669-5242
Charles B EatonCenter for Primary Care and Prevention, Department of Family Medicine, Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, RI (C.B.E.).ORCID 0000-0002-7723-9461
Samar R El KhoudaryUniversity of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA (S.R.E.).ORCID 0000-0003-2913-0821
Rebecca C ThurstonDepartments of Psychiatry, University of Pittsburgh School of Medicine, PA (R.C.T.).ORCID 0000-0001-6580-1202
Carol A DerbyDepartments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (C.A.D.).ORCID 0000-0002-5657-4519
Paulo A LotufoCenter for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil (P.A.L., I.M.B., M.S.B.).ORCID 0000-0002-4856-8450
Isabela M BensenorCenter for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil (P.A.L., I.M.B., M.S.B.).ORCID 0000-0002-6723-5678
Márcio Sommer BittencourtCenter for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil (P.A.L., I.M.B., M.S.B.).ORCID 0000-0002-3711-1754
Michael J BlahaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.A.D., Z.Y., Y.J., S.B., K.M., M.J.B.).ORCID 0000-0001-5138-9683
Funding
UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2MVCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0MOregon Clinical and Translational Research Institute - The National COVID Cohort Collaborative (N3C)UL1TR002369 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Cynthia D Morris, Christopher G. Slatore · 2017 to 2026
$78.4MThe Study of Women's Health Across the Nation (SWAN): The Impact of Midlife and the Menopause Transition on Health and Functioning in Early Old AgeU19AG063720 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REBECCA C THURSTON · 2020 to 2026
$61.3MInstitute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1MScientific and Data Coordinating Center(SDCC) for the P*U01DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI FELDMAN, HAROLD I · 2001 to 2017
$50.1MClinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0MMichigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9MRURAL: Risk Underlying Rural Areas Longitudinal Cohort StudyU01HL146382 · NHLBI · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI JUDD, SUZANNE E, RAMACHANDRAN, VASAN · 2019 to 2025
$42.5MInstitutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9MWOMENS HEALTH ACROSS THE NATION--COORDINATING CENTERU01AG012553 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BROOKS, MARIA MORI · 1994 to 2019
$37.7MWake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3MNCATS NIH HHS UL1 TR000003NCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1 TR000424NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1 TR001079NCATS NIH HHS UL1 TR001105NCATS NIH HHS UL1 TR001420NCATS NIH HHS UL1 TR002369NCRR NIH HHS M01 RR016500NCRR NIH HHS UL1 RR024131NCRR NIH HHS UL1 RR029879NHLBI NIH HHS 75N92019D00027NHLBI NIH HHS 75N92019D00028NHLBI NIH HHS 75N92019D00029NHLBI NIH HHS 75N92019D00030NHLBI NIH HHS 75N92019D00031NHLBI NIH HHS 75N92020D00001NHLBI NIH HHS 75N92020D00002NHLBI NIH HHS 75N92020D00003NHLBI NIH HHS 75N92020D00004NHLBI NIH HHS 75N92020D00005NHLBI NIH HHS 75N92020D00006NHLBI NIH HHS 75N92020D00007NHLBI NIH HHS 75N92021D00006NHLBI NIH HHS 75N92022D00001NHLBI NIH HHS 75N92022D00002NHLBI NIH HHS 75N92022D00003NHLBI NIH HHS 75N92022D00004NHLBI NIH HHS 75N92022D00005NHLBI NIH HHS 75N92023D00002NHLBI NIH HHS 75N92023D00003NHLBI NIH HHS 75N92023D00004NHLBI NIH HHS 75N92023D00005NHLBI NIH HHS 75N92023D00006NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HHSN268201500001CNHLBI NIH HHS HHSN268201500001INHLBI NIH HHS HHSN268201500003CNHLBI NIH HHS HHSN268201500003INHLBI NIH HHS HHSN268201600001CNHLBI NIH HHS HHSN268201600002CNHLBI NIH HHS HHSN268201600003CNHLBI NIH HHS HHSN268201600004CNHLBI NIH HHS HHSN268201600018CNHLBI NIH HHS HHSN268201800001CNHLBI NIH HHS HHSN268201800010INHLBI NIH HHS HHSN268201800011CNHLBI NIH HHS HHSN268201800011INHLBI NIH HHS HHSN268201800012CNHLBI NIH HHS HHSN268201800012INHLBI NIH HHS HHSN268201800014CNHLBI NIH HHS HHSN268201800014INHLBI NIH HHS HHSN268201800015INHLBI NIH HHS N01 HC025195NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS R01 HL043232NHLBI NIH HHS R01 HL068140NHLBI NIH HHS R01 HL087652NHLBI NIH HHS R01 HL103612NHLBI NIH HHS R01 HL105756NHLBI NIH HHS R01 HL109282NHLBI NIH HHS R01 HL109284NHLBI NIH HHS R01 HL109301NHLBI NIH HHS R01 HL109315NHLBI NIH HHS R01 HL109319NHLBI NIH HHS R01 HL120393NHLBI NIH HHS R01 HL172803NHLBI NIH HHS U01 HL041642NHLBI NIH HHS U01 HL041652NHLBI NIH HHS U01 HL041654NHLBI NIH HHS U01 HL065520NHLBI NIH HHS U01 HL065521NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NHLBI NIH HHS U01 HL146382NIAMS NIH HHS R01 AR035582NIAMS NIH HHS R01 AR035583NIAMS NIH HHS R01 AR035584NIAMS NIH HHS U01 AR066160NIA NIH HHS R01 AG005394NIA NIH HHS R01 AG005407NIA NIH HHS R01 AG007181NIA NIH HHS R01 AG023629NIA NIH HHS R01 AG027574NIA NIH HHS R01 AG027576NIA NIH HHS R01 AG028507NIA NIH HHS R01 AG066671NIA NIH HHS R37 AG007181NIA NIH HHS U01 AG012495NIA NIH HHS U01 AG012505NIA NIH HHS U01 AG012531NIA NIH HHS U01 AG012535NIA NIH HHS U01 AG012539NIA NIH HHS U01 AG012546NIA NIH HHS U01 AG012553NIA NIH HHS U01 AG012554NIA NIH HHS U01 AG017719NIA NIH HHS U01 AG027810NIA NIH HHS U01 AG042124NIA NIH HHS U01 AG042139NIA NIH HHS U01 AG042140NIA NIH HHS U01 AG042143NIA NIH HHS U01 AG042145NIA NIH HHS U01 AG042168NIA NIH HHS U19 AG063720NIDDK NIH HHS R01 DK031801NIDDK NIH HHS R01 DK119199NIDDK NIH HHS U01 DK060902NIDDK NIH HHS U01 DK060963NIDDK NIH HHS U01 DK060980NIDDK NIH HHS U01 DK060984NIDDK NIH HHS U01 DK060990NIDDK NIH HHS U01 DK061021NIDDK NIH HHS U01 DK061022NIDDK NIH HHS U01 DK061028NIDDK NIH HHS U24 DK060990NIGMS NIH HHS P20 GM109036NIMHD NIH HHS HHSN268201800013ININDS NIH HHS U01 NS041588NINR NIH HHS U01 NR004061
Abstract
backgroundObesity is an established risk factor for cardiovascular disease (CVD); however, the overall and sex-specific relationships across the full spectrum of body mass index (BMI), particularly severe obesity defined as class 2 (BMI 35 to <40.0 kg/m
methodsWe included 289 875 participants (mean age, 60.3 years; 79.2% women) from 21 cohorts of the Cross-Cohort Collaboration enrolled between 1948 and 2015 with harmonized BMI data, a BMI ≥18.5 kg/m
resultsOver 19.2 median years (25th, 11.6; 75th, 23.5 percentile) of follow-up, there were a total of 15 542 incident MI events, 15 467 incident stroke events, 14 172 incident HF events, 9066 diagnosed AF, and 113 918 total deaths, of which 14 647 were CHD-related and 28 879 were CVD-related. Overall, compared with individuals with normal weight, those with class 2 and class 3 obesity had the highest risk of HF (HR, 2.1, 95% CI, 2.0-2.3, and HR, 3.0, 95% CI, 2.7-3.2, respectively) and AF (HR, 1.8, 95% CI 1.7-2.0, and HR, 2.8, 95% CI, 2.5-3.1, respectively). Compared with men, women experienced higher relative increases in the risk associated with severe obesity for outcomes stroke, CVD, and all-cause mortality (P for interaction: <0.001, 0.003, and <0.001, respectively). Furthermore, in men, no increase in stroke risk was observed with higher BMI categories (P trend=0.49), whereas in women, the risk of stroke plateaued across obesity subclasses (compared with normal weight) yet remained significantly increased.
conclusionsHigher BMI was robustly associated with increased risk for most outcomes, particularly HF and AF, even after adjusting for traditional risk factors. Observed sex differences in the relative hazard of higher BMI categories and stroke, total CVD, and all-cause mortality suggest potential differences in underlying biological mechanisms.
Indexed as
Cardiovascular DiseasesObesityAgedBody Mass IndexFemaleHumansMaleMiddle AgedMyocardial InfarctionProspective StudiesRisk FactorsSeverity of Illness Indexcardiovascular diseasecross-cohort collaborationobesity
Identifiers
What Socratic holds
Textmetadata
LicenceTDM
Read underepoch 390
Registered trials
None linked
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.