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Senior Citizen Health & Medicine
Study Verifies Heart Disease Danger with Obese
Stomach but Finds Big Hips Help
Big waist with big hips not as worrisome as big
waist with small hips
J an. 14, 2008 Using the waist-to-hip ratio is a
better predictor of heart disease risk among both older men and older
women than is using just the waist measurement, says new research, which
also verifies that obesity in the abdomen area is a strong independent
risk factor for heart disease.
In the study, published in Circulation: Journal of
the American Heart Association, researchers looked at whether the
association between fat distribution and heart disease risk was
independent of body mass index (BMI), which assesses body weight
relative to height, as well as other heart disease risk factors, such as
high blood pressure and high cholesterol.
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The size of the hips seems to predict a protective
effect, said Dexter Canoy, M.Phil., M.D., Ph.D., lead author of the
study and a research fellow in epidemiology and public health at the
University of Manchester in the United Kingdom.
In other words, a big
waist with comparably big hips does not appear to be as worrisome as a
big waist with small hips.
The research was based on 24,508 men and women ages
45 to 79 in the United Kingdom who participated in the European
Prospective Investigation into Cancer cohort study (EPIC-Norfolk) which
is based at the University of Cambridge in the UK.
Researchers measured participants weight, height,
waist circumference, hip circumference and other heart disease risk
factors from 1993 to 1997. They then followed up with participants for
an average 9.1 years.
During the follow-up, 1,708 men and 892 women
developed coronary heart disease. When they divided the men and women
into five groups, according to waist-hip ratio, researchers found that
those with the highest waist-to-hip ratio had the highest heart disease
risk.
Among the findings:
● Men in the top one-fifth of the distribution
(those with the biggest waists in relation to their hips) had a 55% higher risk of developing coronary heart disease compared to men
in the bottom one-fifth of the distribution (those with the smallest
waists in relation to their hips).
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● Women in the top one-fifth, or the highest
waist-to-hip ratio group, were 91 percent more likely to develop heart
disease than women with the smallest waists in relation to their hips.
● Waist-only measurements underestimated heart
disease risk by 10 percent to 18 percent when compared to risk estimates
for waist measurements when hip is considered (waist-to-hip ratio).
● When waist-only, body mass index and coronary
heart disease risk factors are considered, for every 6.4 centimeter
(cm) increase in hip circumference in men and for every 9.2 cm hip
circumference increase in women, there is a 20 percent lower risk for
developing heart disease.
The studys results are definitive for predicting
risk in relatively healthy men and women in the general population,
Canoy said. More research is needed on whether abdominal fat
distribution is an independent risk factor for heart disease among
people who have chronic and other diseases at baseline.
People whose abdominal fat puts them at higher
risk for heart disease do not always appear overweight or obese, Canoy
said.
However, the overriding message from this and
other studies about heart disease risk is that, despite the different
measures and risk estimates, the bottom line is that many of us need to
lose excess weight. Doctors should start looking beyond weight, height,
simple waist circumference and BMI to assess heart disease. A simple
waist-hip ratio measurement is a strong predictor of heart disease.
The EPIC/Norfolk study is funded by the Cancer
Research UK, Medical Research Council, Stroke Association, British Heart
Foundation, Department of Health, Europe against Cancer Programme
Commission of the European Union, Food Standards Agency and Wellcome
Trust. Canoy was funded by Cambridge Commonwealth Trust/Cambridge
Overseas Trust and Christs College.
Canoy worked with collaborators from
Cambridge University. Co-authors are: S. Matthijs Boekholdt, M.D.,
Ph.D.; Nicholas Wareham, M.B.B.S., FRCP; Robert Luben, B.Sc.; Ailsa
Welch, Ph.D.; Sheila Bingham, Ph.D.; Iain Buchan, M.D., F.F.P.H.;
Nicholas Day, Ph.D., F.R.S.; and Kay-Tee Khaw, M.B.B.Chir., FRCP.
Statements and conclusions of study authors that
are published in the American Heart Association scientific journals are
solely those of the study authors and do not necessarily reflect
association policy or position. The American Heart Association makes no
representation or warranty as to their accuracy or reliability.
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