No matter how healthy you are in other areas, being obese can significantly raise your risk of dying from heart disease. A new study reported that obese men were much more likely to die of heart disease, even when other major known risk factors were controlled for.

Even when many other risk factors, like high blood pressure, high cholesterol, and blood fats were controlled for, obese men still had a 60% elevated risk of dying from CHD compared to men with normal BMI.

The relationship between weight and heart disease risk is a tricky one, because there are so many other risk factors that accompany obesity, like high blood pressure and cholesterol. This makes the relationship hard to tease apart and difficult for researchers to understand fully. But the team behind the current study wanted to see if they could control for all the other risk factors, and home in on obesity alone.

In the study, over 6,000 men with high cholesterol were followed for an average of almost 15 years. In this time, over 1,241 of the men suffered heart attack or stroke, 214 of which were fatal. Men who had body mass indices (BMIs) between 30 and 39.9 – obese, by definition – had a 75% increased risk of dying from coronary heart disease (CHD) compared to normal weight men. Even when many other risk factors, like high blood pressure, high cholesterol, and blood fats were controlled for, obese men still had a 60% elevated risk of dying from CHD compared to men with normal BMI.

Oddly, obesity was not connected to an increased risk of non-fatal heart disease — only of fatal heart disease.

What explains the connection between obesity and heart disease-related death? The authors suggest that inflammation may be the culprit: Earlier evidence has shown that certain markers for inflammation are linked to fatal, rather than non-fatal, heart disease, which is very much in line with the current findings. Still, it’s unclear whether different mechanisms underlie fatal vs. non-fatal heart attacks, or it is just a question of the severity of the attack.

The authors do underline that treating obesity itself is clearly the way to go, rather treating than each individual risk factor for heart disease separately, which may not be enough. If you are overweight or obese, please speak to your doctor about the safest way to begin weight loss and keep your heart beating healthy for a long time to come.

The study was carried out by a research team at the University of Glasgow, and published in the February 14, 2011 issue of Heart. It can be accessed here.