Surgical outcomes researchEffect of diabetes and hypertension on obesity-related mortality
Section snippets
National Health Interview Survey database
The National Health Interview Survey (NHIS) is a population-based survey that is the principal device used by the US government to track disease prevalence. In continuous operation since 1957, the NHIS uses a complex multiscale design with oversampling of black and Hispanic individuals to acquire population-representative health-related information. Probability samples that are socioeconomically and racially representative of the entire US population are determined from the US census. Once
Results
The completed database, after ineligible cases were excluded, contained 662,443 records. Of these, there were 49,391 deaths in a patient cohort having a mean follow-up period of 74 months and ranging from 1 to 144 months, totaling 4,060,524 person-years.
Hazard ratios for age-adjusted mortality as a function of BMI and stratified for gender and race are presented in the Figure. BMI = 25.0-29.9 was associated with the lowest mortality. Compared with individuals with BMIs ranging from 18.5 to 25.0,
Discussion
Obesity unquestionably increases mortality; however, with two thirds of the American population being overweight or obese, it is impractical to provide treatment for all individuals at risk for early mortality. Current guidelines recommend maintenance of a healthy weight by dietary control and exercise.3., 31. For the extremely obese, pharmacological or surgical therapy may be used. Medical treatment of severe obesity generally results in modest, transient weight loss,32 with greater and more
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