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Normal weight with central obesity increases CV risk

Issue: September 2018

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SANTA ANA PUEBLO, N.M. — Patients who had normal weight and central obesity had an increased CV risk compared with those with normal BMI without central fat distribution, according to data presented at the American Society for Preventive Cardiology Congress on CVD.

Jose R. Medina-Inojosa, MD, MSc, senior research fellow in preventive cardiology at Mayo Clinic and International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic, and colleagues analyzed data from 1,692 patients (mean age, 61 years; 48% men). Those with HF, CAD, COPD, underweight or death from cancer within 5 years were excluded. Patients underwent a clinical examination and anthropometric measurements between 1997 and 2000, where BMI was calculated and central obesity was determined by waist-to-hip ratio (at least 0.85 for women and at least 0.9 for men).

Data from the Rochester Epidemiology Project was also analyzed for the composite outcome of major adverse CV outcomes, defined as coronary revascularization, acute MI, death or stroke.

After a median follow-up of 16.1 years, 22.6% of patients had a major adverse CV event, including MI (n = 93), PCI (n = 32), CABG (n = 25), all-cause death (n = 66) or stroke (n = 129).

Patients with normal weight central obesity had an elevated risk for major adverse CV events (HR = 1.79; 95% CI, 1.23-5.56). After adjusting for age and sex, the relationship remained constant (HR = 1.87; 95% CI, 1.16-3.08). Further adjustment for diabetes, hypertension and dyslipidemia attenuated the association, but it remained statistically significant (HR = 1.52; 95% CI, 1.04-2.39).

“These findings have significant implications in clinical practice, as it is important to identify normal weight individuals with central obesity, which is currently not recommended in obesity guidelines,” Medina-Inojosa said. – by Darlene Dobkowski

Reference:

Medina-Inojosa JR, et al. Poster #125. Presented at: American Society for Preventive Cardiology Congress on CVD; July 27-29, 2018; Santa Ana Pueblo, New Mexico.

Disclosure: Medina-Inojosa reports no relevant financial disclosures.