SAN DIEGO — Waist to height ratio is more strongly linked to cardiovascular risk than body mass index (BMI), particularly in middle age, according to a large European study that was presented at the annual meeting of the Endocrine Society.
Harald J. Schneider, M.D., of the Max Planck Institute of Psychiatry in Munich, and associates in Germany and Austria, examined weight, height, and waist and hip circumference and 18 single or combined cardiovascular risk factors in 48,353 primary care patients.
Waist to height ratio was most predictive of risk in the entire cohort in both men and women, followed by waist circumference and BMI.
Overall cardiovascular risk was highest at or above a waist to height ratio of 0.53 for women and 0.55 for men.
When investigators examined specific age groups, they found that waist to height ratio was linked most strongly to cardiovascular risk in men aged 35–54 years and women aged 55–64 years—pivotal ages for the development of cardiovascular disease.
In the other age groups, the BMI had a better association, Dr. Schneider told this newspaper following the meeting.
These findings, however, should be interpreted cautiously because not all differences are significant in the single age groups. Moreover, it should be born in mind that this is a cross-sectional study; therefore, we cannot say which anthropometric parameter best predicts the future occurrence of cardiovascular risk factors and events, he continued.
He suggested that the cutoffs be considered an orientation rather than a strict definition of risk.
That said, study investigators have recommended using the waist to height ratio to define treatment goals for abdominal obesity in middle-aged men and women.
The study was conducted as part of the Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment (the DETECT study), a very large, nationally representative epidemiological study in Germany.
The DETECT study involved the examination of 55,518 patients in 3,795 primary care settings to assess prevalence of cardiovascular disease.
Dr. Schneider's study was supported by an unrestricted educational grant by Pfizer Inc.