Obesity and Ideal Cardiovascular Health: Results from the My Research Legacy Study

Obesity is associated with increased risk for cardiovascular diseases compared to normal-weight and overweight status. We hypothesized that obese subjects would have lower ideal cardiovascular health than normal-weight and overweight subjects, but a subset among the obese would have a favorable cardiovascular health profile. Differences in ideal cardiovascular health between normal-weight (n = 523), overweight (n = 378), and obese (n = 660) subjects were examined using data from the Life’s Simple 7 survey and digital health devices. Obese participants were more likely to have prevalent cardiovascular disease, diabetes mellitus, hypertension, and hypercholesterolemia compared to normal weight and overweight (all p < 0.01). Life’s Simple 7 Health Scores, a measure of ideal cardiovascular health, were lower in obese than in normal-weight and overweight groups (5.6 ± 1.2 vs. 8.0 ± 1.1 vs. 6.8 ± 1.1, p < 0.01). A subset of obese with ideal cardiovascular health scores was identified (n = 103). Compared to obese with non-ideal health scores (n = 557), these individuals were more likely to have ideal cardiovascular risk factor status, diet, and exercise profiles. These findings indicate that there is heterogeneity among obese persons and suggest that an assessment of cardiovascular health factors and behaviors can identify areas for intervention beyond weight reduction alone to optimize cardiovascular health.