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ludc webb

Hanna Markstad

Doctoral student

ludc webb

Obesity is associated with coronary artery stenosis independently of metabolic risk factors : The population-based SCAPIS study


  • Lars Lind
  • Hanna Markstad
  • Håkan Ahlström
  • Oskar Angerås
  • John Brandberg
  • Mattias Brunström
  • Gunnar Engström
  • Jan E. Engvall
  • Maria J. Eriksson
  • Mats Eriksson
  • Anders Gottsäter
  • Emil Hagström
  • Benno Krachler
  • Erik Lampa
  • Maria Mannila
  • Peter M. Nilsson
  • Fredrik H. Nyström
  • Anders Persson
  • Björn Redfors
  • Anette Sandström
  • Raquel Themudo
  • Sebastian Völz
  • Johan Ärnlöv
  • Carl Johan Östgren
  • Göran Bergström

Summary, in English

Background and aims: Previous studies reported divergent results on whether metabolically healthy obesity is associated with increased coronary artery calcium and carotid plaques. We investigated this in a cross-sectional fashion in a large, well-defined, middle-aged population using coronary CT angiography (CCTA) and carotid ultrasound. Methods: In the SCAPIS study (50–65 years, 51% female), CCTA and carotid artery ultrasound were performed in 23,674 individuals without clinical atherosclerotic disease. These subjects were divided into six groups according to BMI (normal weight, overweight, obese) and the presence of metabolic syndrome (MetS) according to the NCEP consensus criteria. Results: The severity of coronary artery stenosis was increased in individuals with obesity without MetS compared to normal-weight individuals without MetS (OR 1.47, 95%CI 1.34–1.62; p < 0.0001), even after adjusting for non-HDL-cholesterol and several lifestyle factors. Such difference was not observed for the presence of carotid artery plaques (OR 0.94, 95%CI 0.87–1.02; p = 0.11). Obese or overweight individuals without any MetS criteria (except the waist criterion) showed significantly more pronounced stenosis in the coronary arteries as compared to the normal-weight individuals, while one criterion was needed to show increased plaque prevalence in the carotid arteries. High blood pressure was the most important single criterion for increased atherosclerosis in this respect. Conclusions: Individuals with obesity without MetS showed increased severity of coronary artery stenosis, but no increased occurrence of carotid artery plaques compared to normal-weight individuals without MetS, further emphasizing that obesity is not a benign condition even in the absence of MetS.


  • Cardiovascular Research - Epidemiology
  • Cardiovascular Research - Translational Studies
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Internal Medicine - Epidemiology

Publishing year










Document type

Journal article




  • Cardiac and Cardiovascular Systems


  • Atherosclerosis
  • Carotid artery
  • Coronary arteries
  • Epidemiology
  • Metabolic syndrome
  • Obesity



Research group

  • Cardiovascular Research - Epidemiology
  • Cardiovascular Research - Translational Studies
  • Internal Medicine - Epidemiology


  • ISSN: 0021-9150