Appendix: Definition of variables in the studies included in the meta-analysis

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1 Appendix: Definition of variables in the studies included in the meta-analysis Belonging to the article: Bogers RP, BemelmansWJE, Hoogenveen RT, Boshuizen HC, Woodward M, Knekt P, van Dam RM, Hu FB, Visscher TLS, Menotti A, Thorpe RJ Jr, Jamrozik K, Calling S, Strand BH, Shipley MJ, for the BMI-CHD collaboration investigators. Overweight is associated with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including over 300,000 persons. Arch Int Med 1

2 Definition of variables in the studies included in the meta-analysis Ref. BMI BMI continuous normal or weight categories category Australian National Heart Foundation Risk Factor Prevalence Caerphilly cohort Dubbo study of Australian elderly Finnish Mobile Clinic Health Examination Survey Fletcher Challenge Italian Rural Areas Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Malmö Preventive Project (MPP) Melbourne Collaborative Cohort 1 2, Smoking Physical activity Blood pressure Cholesterol con + cat 20- not current / current yes, not con never, ex, current leisure-time physical activity diastolic con never, ex, current 2 categorical variables: walking (from daily to less frequently) and gardening (daily to less frequently) cat never, ex, current (pipe, cigar or 1-14 cigarettes/day), current (15+ cigarettes/day) yes, not 4 categories: SBP<140 and DBP<90, SBP or DBP 90-94, SBP or DBP 95-99, SBP200 or DBP100; + drugs (y/n) definitely hypertensive ((SBP 170 and DBP 100) or use of antihypertensive drugs); mild hypertension (SBP 160 and DBP 95); borderline hypertensive (not included in any of the three other categories); normotensive (SBP < 140 and DBP < 90) con + cat 20- not current / current yes, not sedentary, moderate, heavy cat 20- pack years continuous as duration of conditioning physical activity cat <25 never, ex, current Sedentary leisure time physical activity in 3 categories: no, yes, missing con + cat 20- not current / current yes, not 2

3 Definition of variables in the studies included in the meta-analysis (continued) Ref. BMI BMI continuous normal or weight categories category Multifactor Primary Prevention (MPPS) Göteborg NHANES I Epidemiologic Followup (NHEFS) Nijmegen Cohort Norwegian Counties Nurses Health PRIME study Rome Railroad Cohort Scottish Heart Health US Railroad cohort Ventimiglia di Sicilia Heart (VHS) Whitehall Zutphen Elderly , Smoking Physical activity Blood pressure Cholesterol cat never, ex, current leisure time physical activity: sedentary, moderately acitive, regular exercise cat cat never, ex, current regular exercise vs. otherwise and diastolic 20- yes (=current and quit < 1 y ago), no (=never or quit >1 y ago) moderate/vigorous, light cat 20- never, ex, current low, high con + cat never, ex, current (1-14,15-24, 25 cigs/d) 5 categories self-reported hypertension (y/n) elevated chol. (y/n) con never, ex, current no/low, intense sedentary, moderate, heavy con + cat 20- never, ex, current physical activity at work: inactive, average, active; leisure physical activity: inactive, average, active sedentary, moderate cat <27 never, ex, current physical activity at work and leisure time physical activity in 4 categories con + cat never, ex cig smk, current cig smk adj. for no. cigs/d, current pipe or cigar smk. leisure time activity: low, moderate, vigorous; travel activity: none, 1-9 mins, mins, 20 mins. and diastolic, LDL, HDL con + cat 20- never, ex, current minutes activity 3

4 References 1. Welborn TA, Dhaliwal SS, Bennett SA. Waist-hip ratio is the dominant risk factor predicting cardiovascular death in Australia. Med J Aust. 2003;179: Yarnell JW, Patterson CC, Sweetnam PM, Lowe GD. Haemostatic/inflammatory markers predict 10-year risk of IHD at least as well as lipids: the Caerphilly collaborative studies. Eur Heart J. 2004;25: Yu S, Yarnell JW, Sweetnam PM, Murray L. What level of physical activity protects against premature cardiovascular death? The Caerphilly study. Heart. 2003;89: Simons LA, Friedlander Y, McCallum J, Simons J. Risk factors for coronary heart disease in the prospective Dubbo of Australian elderly. Atherosclerosis. 1995;117: Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliovaara M, Aromaa A. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994;139: MacMahon S, Norton R, Jackson R, et al. Fletcher Challenge-University of Auckland Heart & Health : design and baseline findings. N Z Med J. 1995;108: Menotti A, Lanti M. Coronary risk factors predicting early and late coronary deaths. Heart. 2003;89: Lakka HM, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J. 2002;23: Jonsson S, Hedblad B, Engstrom G, Nilsson P, Berglund G, Janzon L. Influence of obesity on cardiovascular risk. Twenty-three-year follow-up of 22,025 men from an urban Swedish population. Int J Obes Relat Metab Disord. 2002;26: Giles GG, English DR. The Melbourne Collaborative Cohort. IARC Sci Publ. 2002;156: Rosengren A, Wedel H, Wilhelmsen L. Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality. A prospective population study. Eur Heart J. 1999;20: Thorpe RJ, Jr., Ferraro KF. Aging, obesity, and mortality. Misplaced concern about obese older people? Research on Aging. 2004;26: Bakx JC, Veldstra MI, van den Hoogen HM, et al. Blood pressure and cardiovascular morbidity and mortality in a Dutch population: the Nijmegen cohort study. Prev Med. 2001;32: Strand BH, Tverdal A. Can cardiovascular risk factors and lifestyle explain the educational inequalities in mortality from ischaemic heart disease and from other heart diseases? 26 year follow up of 50,000 Norwegian men and women. J Epidemiol Community Health. 2004;58: Li TY, Rana JS, Manson JE, et al. Obesity as Compared with Physical Activity in Predicting Risk of Coronary Heart Disease in Women. Circulation. 2006;113: Mahamat A, Richard F, Arveiler D, et al. Body mass index, hypertension and 5-year coronary heart disease incidence in middle aged men: the PRIME study. J Hypertens. 2003;21: Menotti A, Seccareccia F, Blackburn H, Keys A. Coronary mortality and its prediction in samples of US and Italian railroad employees in 25 years within the Seven Countries of cardiovascular diseases. Int J Epidemiol. 1995;24: Tunstall-Pedoe H, Woodward M, Tavendale R, A'Brook R, McCluskey MK. Comparison of the prediction by 27 different factors of coronary heart disease and death in men and women of the Scottish Heart Health : cohort study. BMJ. 1997;315: Barbagallo CM, Cavera G, Sapienza M, et al. Prevalence of overweight and obesity in a rural southern Italy population and relationships with and cardiovascular 4

5 mortality: the Ventimiglia di Sicilia project. Int J Obes Relat Metab Disord. 2001;25: Jarrett RJ, Shipley MJ, Rose G. Weight and mortality in the Whitehall. Br Med J (Clin Res Ed). 1982;285: Batty GD, Shipley MJ, Jarrett RJ, Breeze E, Marmot MG, Davey Smith G. Obesity and overweight in relation to disease-specific mortality in men with and without existing coronary heart disease in London: the original Whitehall study. Heart. 2006;92: Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly. Arch Intern Med. 2006;166:

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