Sex, BMI, waist-hip ratio & cardiovascular disease

[Guest guest]

Hi All,

It seems that, only in the men who are too heavy, is

the risk of heart disease and stroke associated with

their waist-to-hip ratio. The below paper is not

pdf-availed.

Sex differences in the relationships between BMI, WHR

and incidence of cardiovascular disease: a

population-based cohort study

C Li, G Engström, B Hedblad, S Calling, G Berglund and

L Janzon

Int J Obes 2006 30: 1775-1781

Objective: Body mass index (BMI) is associated with

increased incidence of cardiovascular disease (CVD).

However, the risk could be very different for

individuals with the same body mass. The present study

explored whether regional fat distribution, as

measured by waist–hip ratio (WHR), could modify the

impact of BMI on the risk of CVD in men and women.

Design: Prospective population-based study.

Subjects: A total of 10 369 men and 16 638 women,

45–73 years old, from general population in Malmö,

Sweden.

Measurements: All subjects were followed over 7 years

for the incidences of first-ever cardiac event (CE)

and ischemic stroke in relation to BMI category

(<25.0, 25.0–29.9, 30.0) and WHR.

Results: The prevalence of overweight and obesity was

39.4 and 13.0%, respectively. During follow-up, 1280

subjects suffered a CVD event (750 CE, 530 ischemic

stroke). The risk of CVD in women increased with

increasing levels of WHR, irrespective of BMI

category. In men, WHR (per 1 s.d. increase) was

associated with increased incidence of CVD in those

with normal weight (relative risk (RR)=1.24; 95% CI:

1.13–1.37) after adjustments for confounding factors.

However, WHR was not related to CVD in overweight men

(RR=1.06; 95%CI: 0.94–1.20) or obese men (RR=1.04;

95%CI: 0.87–1.24). A significant interaction was

observed between sex and WHR on the CVD risk.

Conclusion: The effect of WHR on incidence of CVD is

modified by the overall body weight and by gender. WHR

adds prognostic information on the cardiovascular risk

in women at all levels of BMI, and in men with normal

weight.

-- Al Pater, alpater@...

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