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Background: Obesity contributes significantly to increased risk of cardiovascular disease (CVD) and particularly heart failure (HF). However, an elevated body mass index (BMI) in older adults might not fully reflect the additional risk associated with excess weight at a younger age. We determined the prognostic value of self-reported weights from early- and mid-adulthood, after accounting for current weight, with incident HF and CVD.Methods: We studied 6,437 MESA participants (aged 45-84 years) with self-reported weights at ages 20 and 40 (by questionnaire) and measured weight at the baseline exam (2000-2002). BMI was calculated using measured height at baseline. Cox hazard models assessed relationships between BMI at each age with HF and CVD.Results: Participant mean age was 62±10 years and 53% were women. Over a median follow-up of 13 years, 290 HF and 828 CVD events occurred. Elevated BMI at each age point (age 20, age 40, and MESA baseline) was independently associated with HF, and to lesser extent with CVD (Figure). After adjustment for demographics, CVD risk factors, and baseline BMI, higher self-reported BMIs at ages 20 and 40 years were independently associated with increased risk of incident HF with hazard ratios (HR) 1.18 (95% CI 1.05-1.32) and 1.30 (1.15-1.46), respectively, per 1 SD higher BMI. Participants with self-reported obesity (BMI≥30) at age 20 [HR 3.20 (1.93-5.32)] and age 40 [HR 1.92 (1.31-2.83)] had greater HF risk, even after accounting for current BMI. For incident CVD, only higher self-reported BMI at age 20 (per 1 SD) was associated after accounting for current BMI [HR 1.09 (1.01-1.17)].Conclusions: Assessment of self-reported lifetime weights is a simple tool utilized in any clinical encounter. Although subject to recall bias, self-reported weights provide prognostic information about future HF risk, incremental to current BMI, in a multi-ethnic cohort of middle-aged to older adults.