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Impact of Adiposity Measures on Heart Disease Risk Alike

BMI, waist size, and waist-to-hip ratio are of limited value when other information is available

FRIDAY, March 11 (HealthDay News) -- Body mass index (BMI), waist circumference, and waist-to-hip ratio all have a similar strength of association with cardiovascular disease, but do not significantly improve risk prediction when information on blood pressure, diabetes, and lipid levels is available, according to a study published online March 11 in The Lancet.

David Wormser, of the University of Cambridge in the United Kingdom, and colleagues from the Emerging Risk Factors Collaboration, a consortium of 200 scientists from 17 countries, investigated the association of adiposity measures (BMI, waist circumference, and waist-to-hip ratio) with the risk of first-onset cardiovascular disease. Individual records from 58 cohorts, totaling 221,934 people, were studied to calculate hazard ratios (HRs) per one standard deviation increase in adiposity values.

The researchers found that, in people with BMI 20 kg/m² or higher, the risk of a cardiovascular event was increased (HRs, 1.23 with BMI, 1.27 with waist circumference, and 1.25 with waist-to-hip ratio) after adjusting for age, gender, and smoking status. After adjustment for risk factors, including systolic blood pressure, history of diabetes, and lipid levels, HRs were 1.07 with BMI, 1.10 with waist circumference, and 1.12 with waist-to-hip ratio. Adding information about these three measures in a risk prediction model using conventional cardiovascular disease risk factors had minimal impact on its accuracy.

"BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not importantly improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids," the authors write.

Several authors disclosed financial ties with the pharmaceutical industry.

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