Central adiposity and increased risk of coronary artery disease mortality in older women
Related Experiment Videos
R J Prineas1, A R Folsom, S A Kaye
1Department of Epidemiology and Public Health, School of Medicine, University of Miami, FL 33136.
Insights
Central adiposity, measured by waist/hip ratio (WHR), significantly increases coronary artery disease death risk in postmenopausal women. This risk is independent of body mass index, hypertension, and diabetes.
Area of Science:
- Cardiovascular Health
- Epidemiology
- Metabolic Health
Background:
- Central adiposity is a growing concern in postmenopausal women.
- The waist/hip circumference ratio (WHR) is a key indicator of central adiposity.
- Coronary artery disease (CAD) remains a leading cause of mortality in this demographic.
Purpose of the Study:
- To investigate the association between central adiposity (WHR) and the risk of fatal coronary artery disease.
- To determine if this association is independent of other known risk factors.
- To examine the role of body mass index (BMI) in relation to coronary death.
Main Methods:
- A large cohort study of 32,898 women aged 55-69 years was analyzed.
- The 4-year risk of fatal coronary artery disease was assessed.
- Statistical adjustments were made for age, body mass, lifestyle factors, and comorbidities.
Main Results:
- Women in the highest WHR tertile had a significantly higher risk of coronary death (RR 2.8) compared to the lowest tertile, even after extensive adjustments.
- Body mass index showed no independent association with coronary death.
- Hypertension, diabetes, smoking, estrogen nonuse, and being unmarried were also significant predictors of coronary death.
Conclusions:
- Increased waist/hip circumference ratio (central adiposity) is an independent risk factor for fatal coronary artery disease in postmenopausal women.
- The association between central adiposity and coronary death risk is largely independent of hypertension and diabetes.
- WHR is a valuable metric for assessing cardiovascular risk in this population.
Abstract:
The relation between central adiposity, measured by the waist/hip circumference ratio (WHR), and 4-year risk of fatal coronary artery disease was examined in a large cohort (n = 32,898) of women aged 55 to 69 years. The age-adjusted relative risk of death from coronary artery disease (115 deaths) was 3.3 for women in the highest tertile of WHR compared to the lowest tertile (95% confidence interval: 2.0, 5.6). After adjustment for age, body mass, smoking, physical activity, estrogen use, marital status, and alcohol intake, the relative risk of coronary death for women in the middle and highest tertiles versus those in the lowest tertile of WHR were 1.3 and 2.8, respectively (P for linear trend < 0.001). Further adjustment for hypertension and diabetes mellitus reduced the estimates slightly to 1.2 and 2.0, but the trend in relative risk remained statistically significant (P = 0.03). In contrast, body mass index showed no independent association with coronary death. Hypertension, diabetes mellitus, cigarette smoking, estrogen nonuse, and being unmarried were significant predictors of greater risk of coronary death in the multivariate model. These results indicate that central adiposity, reflected by an increased WHR, is an important risk factor for death from coronary artery disease in women, most of whom were postmenopausal. The association of central adiposity with risk of coronary death is independent, for the most part, of its association with hypertension and diabetes.