Waist size a factor in heart failure risk

Larger waist circumference was linked to risk of heart failure in a study that analyzed data from two population-based prospective cohort studies in Sweden.

Researchers at Beth Israel Deaconess Medical Center in Boston reported that a higher waist circumference was associated with heart failure risk at all levels of body mass index in women, and both BMI and waist circumference were predictors in men.

The association between BMI and heart failure events declined with age, according to the Rapid Access Report of Circulation: Heart Failure, suggesting, the authors said, that the younger the person, the greater the impact of weight to heart health.

Collectively, the two cohorts included 36,873 women aged 48 to 83 and 43,487 men aged 45 to 79 who had submitted answers to questionnaires about their height, weight and waist circumference. Thirty-four percent of the women and 46% of the men were overweight, with a BMI of 25 or higher. Eleven percent of women and 10% of men were obese, with a BMI of 30 or above.

Central adiposity a risk in women

During the mean follow-up period of seven years, there were 382 first HF events among women and 718 among the men. These participants tended to be older, with a higher prevalence of diabetes, hypertension, high cholesterol levels and a personal and family history of myocardial infarction. People who had a HF event — whether hospitalization or death — had higher BMI, waist circumference, waist-hip ratio and waist-height ratio.

For women with a BMI of 25, a 10-cm higher waist circumference was linked with a 15% higher rate of HF events; for men, there was a 16% higher rate. When BMI was 30, there was an 18% increased HF rate in both women and men.

Emily Levitan, ScD, a research fellow in the Cardiovascular Epidemiology Research Unit at Beth Israel and one of the investigators, said that in women BMI was only associated with higher HF rates for those with the largest waists. Among men, each one-unit increase in BMI was associated with 4% higher HF rate regardless of waist size.

“This observation is consistent with studies suggesting that both BMI and waist circumference were risk factors for coronary heart disease in men, but that central adiposity was more important in women,” the researchers wrote.

In a press release, Levitan said that the study “reinforces the importance of maintaining a healthy weight. Previous research has looked at various types of heart disease and related health issues, and no matter the particulars of the study, they’ve all been pretty consistent in determining that excess body weight increases a person’s risk of heart disease.”

Circ Heart Fail. 2009;doi:10.1161/CIRCHEARTFAILURE.108.794099.