Body weight links to heart attack deaths differently with age
In a retrospective study of 898,798 Chinese acute coronary syndrome patients, hospital mortality rose with body mass index under 45 years but was U-shaped over 60 years.
Limit: The study tracked only in-hospital deaths; long-term survival was not measured
Edited by Boris Djordjevic · AgingResearch.News
In a retrospective cohort study, researchers analyzed 898,798 Chinese patients diagnosed with acute coronary syndrome, a sudden reduction in blood flow to the heart, between January 2016 and December 2023. Among these patients, 32,357 (3.6%) were underweight, 511,779 (56.9%) were normal weight, 299,709 (33.3%) were overweight, and 54,953 (6.1%) were obese.
The researchers assessed hospital deaths across categories of body mass index, a measure of weight relative to height. Across the entire cohort and in both sexes, hospital mortality showed a U-shaped relationship with body mass index. This U-shaped curve remained evident in patients older than 60 years. In contrast, among patients under 45 years, hospital mortality showed a near-linear increase as body mass index rose.
Why it matters
Cardiovascular risk and body composition change as people age, raising questions about whether standard weight targets apply equally to young and old adults with heart disease. The findings suggest that body weight control strategies for acute coronary syndrome may need to be tailored to patient age.
Caveats
The retrospective observational design cannot show that body weight caused differences in mortality. In addition, the study tracked only in-hospital deaths among Chinese patients, so the findings may not apply to long-term survival or to other populations.
The paper
Zhongshan Hospital Fudan University
ESC Congress 2026 Abstract, Oct 26, 2026
Presented at ESC Congress 2026