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Wait and hip measurement better indicator of heart attack risk than obesity

Waist and hip size more strongly associated with heart attack risk than obesity, especially among women

Ingrid Torjesen

Wednesday, 28 February 2018

Higher waist and hip size are more strongly associated with heart attack risk than overall obesity, especially among women, according to research* published in Journal of the American Heart Association.

Findings from the study of nearly 500,000 adults (aged 40-69) participating in the UK Biobank suggest that while general obesity and obesity specifically around the abdomen each have profound harmful effects on heart attack risk in both sexes, women are more negatively impacted by higher waist circumference and waist-to-hip ratio than men.

During seven years of follow-up, 5710 cases of myocardial infarction (28% women) were recorded among 265,988 women and 213,622 men without a history of cardiovascular disease at baseline. Cox regression models showed there was a relationship between measures of general and central adiposity and the risk of myocardial infarction (MI) in both sexes. A 1-SD higher in body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio, respectively, were associated with hazard ratios for myocardial infarction of 1.22, 1.35, 1.49, and 1.34 in women and of 1.28, 1.28, 1.36 and 1.33 in men. The corresponding women-to-men ratios of hazard ratios were 0.96, 1.07, 1.15 and 1.03.

“Although general and central adiposity measures each have profound deleterious effects on the risk of MI in both sexes, a higher waist circumference and waist-to-hip ratio conferred a greater excess risk of MI in women than in men,” the researchers said.

“Waist-to-hip ratio was more strongly associated with the risk of MI than body mass index in both sexes, especially in women.”

The findings suggest that differences in the quantity and distribution of fat tissue not only results in differences in body shape between women and men, but may also have differential implications for the risk of heart attack in later life, the researchers said.

"Our findings support the notion that having proportionally more fat around the abdomen (a characteristic of the apple shape) appears to be more hazardous than more visceral fat which is generally stored around the hips (i.e., the pear shape)," said lead author Sanne Peters, research fellow in Epidemiology at the George Institute for Global Health at the University of Oxford.


*Peters S, Bots S, Woodward M. Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results From the UK Biobank. Journal of the American Heart Association. 2018;7:e008507, originally published February 28, 2018. Doi: 10.1161/JAHA.117.008507.

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