Greater Long-Term Weight Loss Linked to Increased ASCVD Risk

The study covered in this summary was published on as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Adults aged 60-79 years who lost more than 5% of weight over 10 years had a significantly increased predicted 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in an analysis based on National Health and Nutrition Examination Survey (NHANES) data.

Why This Matters

  • This study supports the benefits of stable weight in promoting cardiovascular health in the elderly.

Study Design

  • Data covering 1999-2018 were obtained from NHANES, a database intended to represent the noninstitutionalized, US civilian population.

  • Demographic, socioeconomic, and health-related data, including weight history, were collected at home interviews and separate examinations and laboratory screenings.

  • The analysis over the long-term interval of 10 years included 2322 persons; the short-term analysis over 1 year included 2543 persons. Their age range was 60-79 and all were self-reported to be free of ASCVD at baseline.

  • The primary outcome of 10-year ASCVD risk was defined as a first nonfatal myocardial infarction (MI), death from coronary heart disease (CHD), or fatal or nonfatal stroke over a 10-year period.

Key Results

  • The mean predicted 10-year ASCVD risk across the entire population (mean age 68, mean BMI 30.2 kg/m2, 42% female) was 23.6%.

  • Prevalences of 10-year weight change by degree of weight change was 28% for stable weight (±5.0%), 14.2% for moderate-to-large weight loss (≥10%), 9.9% for small weight loss (-5.1% to -9.9%), 14.4% for small weight gain (5.1% to 9.9%) and 33.5% for moderate-to-large weight gain (≥10%).

  • Compared with stable weight, both moderate-to-large and small weight loss were associated with significantly increased 10-year ASCVD risk in unadjusted models and models adjusted for age, sex, and race/ethnicity, BMI, income-poverty ratio, physical activity, education level, and marital status.

  • No significant association was observed between the weight gain categories and 10-year ASCVD risk in adjusted models, but moderate-to-large weight gain was associated with reduced ASCVD risk in the nonadjusted model.

  • There was a dose-response relationship between continuous 10-year weight change ±10% and 10-year ASCVD risk, with greater weight loss tracking with increased risk. No such relationship was seen for weight change over 1 year.


  • Weights were self-reported, which may have led to misclassification of weight change status.

  • Fluctuations in body weight over the 10-year intervals were not considered.

  • Weight measurements do not provide information on percentage body fat or lean mass.


  • This study was funded by the National Center of China for Clinical Medical Research on Cardiovascular Diseases.

  • The authors declare no competing interests.

This is a summary of a preprint research study, “Association between weight change and 10-Year Atherosclerotic Cardiovascular Disease Risk among U.S. older adults: data from National Health and Nutrition Examination Survey (NHANES) 1999–2018” written by Yuxuan Peng from the Beijing University of Chinese Medicine and colleagues on, provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on

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