{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T18:37:40Z","timestamp":1775673460500,"version":"3.50.1"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obesity at a given point in time is a known cardiovascular risk factor. However, the contribution of long-term excess weight exposure to cardiovascular risk has not been well established. We therefore conducted a study to evaluate the relationship between long-term excess weight exposure and incidence of cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This secondary analysis of a prospective cohort study analyzed data from adult participants in Nurses\u2019 Health Study and Health Professionals Follow-Up Study with a BMI\u2009&gt;\u200925 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      between 01\/01\/1990 and 12\/31\/1999. We investigated the relationship between cumulative exposure to body mass index (BMI) &gt; 25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      between 1990 and 1999 and time to the composite primary outcome of fatal and non-fatal myocardial infarction (MI) and stroke beginning in 2000.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean baseline BMI of 136,498 study participants was 27.2 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and the mean annualized cumulative excess BMI exposure was 3.9 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . In multivariable analysis having annualized cumulative excess BMI in the 4\n                      <jats:sup>th<\/jats:sup>\n                      vs. 1\n                      <jats:sup>st<\/jats:sup>\n                      quartiles was associated with an increased cardiovascular risk for women aged\u2009&lt;\u200935 (HR 1.60; 95% CI 1.05\u20132.44) and 35\u221250 years (HR 1.27; 95% CI 1.01\u20131.58); and for men aged 35\u221250 (HR 1.57; 95% CI 1.22\u20132.03) and 50\u221265 (HR 1.23; 95% CI 1.02\u20131.48). There was no increase in cardiovascular risk with greater excess BMI exposure for women older than 50 and for men older than 65. Baseline BMI (in 1990) was not associated with cardiovascular risk in models adjusted for cumulative excess BMI exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Long-term excess weight exposure plays a greater role in cardiovascular risk than weight at a single point in time. This risk is strongest in younger individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0344620","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T17:21:39Z","timestamp":1775668899000},"page":"e0344620","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cumulative excess weight exposure over time and cardiovascular risk: A prospective cohort study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8609-564X","authenticated-orcid":true,"given":"Alexander","family":"Turchin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Shubina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fritha J.","family":"Morrison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia N.","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Neff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Kan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"issue":"10026","key":"pone.0344620.ref001","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/S0140-6736(16)30054-X","article-title":"Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19\u00b72 million participants","volume":"387","author":"NCD Risk Factor Collaboration (NCD-RisC)","year":"2016","journal-title":"Lancet"},{"key":"pone.0344620.ref002","author":"CDC"},{"issue":"16","key":"pone.0344620.ref003","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1001\/jama.2018.3060","article-title":"Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016","volume":"319","author":"CM Hales","year":"2018","journal-title":"JAMA"},{"issue":"39","key":"pone.0344620.ref004","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.15585\/mmwr.mm6639e1","article-title":"Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity - 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