Research

Mixed

In individuals with ideal cardiovascular health (high CVHS), elevated BMI (≥35.0 kg/m²) does not significantly increase the risk of incident atherosclerotic cardiovascular disease (ASCVD) compared to normal BMI, whereas low cardiovascular health strongly predicts ASCVD regardless of BMI.

If you have ideal cardiovascular health (normal blood pressure, lipids, glucose, no smoking, active, healthy diet, good sleep), your risk of heart disease is low even if your BMI is high (≥35). Focus on maintaining these healthy habits rather than trying to lose weight. If your cardiovascular health score is low, your risk is high regardless of your BMI, so prioritize improving lifestyle and metabolic markers.

GoodRefutesHIGH confidence
In participants with a high CVHS (8-10), those with a BMI ≥35.0 kg/m2 had a nonsignificant higher ASCVD risk (HR=1.20 [95% CI, 0.84-1.70], p=0.32) compared to those with a BMI of 18.5-24.9 kg/m2.
Audrey Paulin et al. · Journal of the American Heart Association · 2023

Why this rating

Large prospective cohort (n=319,866) with long follow-up (median 12.5 years), though observational design limits causal inference.

Source

Sex‐Specific Impact of Body Weight on Atherosclerotic Cardiovascular Disease Incidence in Individuals With and Without Ideal Cardiovascular Health

Audrey Paulin et al. · Journal of the American Heart Association · 2023

DOI 10.1161/jaha.122.028502

preprint · n=319866Cited 3×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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