Diabetes, Heart and Cardiovascular Diseases News Chronicle.  Diabetes, Cardiovascular and Heart Diseases
 Article 328
    Published on April 29, 2018

 

Larger waist and hips may increase the risk of heart attack

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Men more likely to store fat around the abdomen. In women before menopause, estrogen hormone causes excess fat to be stored as subcutaneous fat in the buttocks, thighs and hips. After menopause, as the production of estrogen hormone declines, fat migrates from subcutaneous locations to the waist and finally to the abdomen.



A higher risk of heart attack in women with a higher waist-to-hip ratio (WHR) and higher waist circumference (apple shape body).

The abdominal or visceral fat (also known as intra-abdominal or organ fat) is a fat stored in deeper layers. This fat wraps around important organs such as stomach, liver, intestines, kidneys, etc. This fat is closely linked to the development of insulin resistance, heart disease and metabolic disorders. Earlier studies show high-intensity exercise is effective in reducing the total abdominal fat.


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The Centers for Disease Control and Prevention (CDC) say about 34 percent of men, and about 38 percent of women in the United States are obese. An earlier study shows a higher risk of myocardial infarction (heart attack. MI) in men and women with a higher body mass index (BMI). But the BMI does not differentiate the location of fat deposits in the human body such as abdominal fat (visceral fat), subcutaneous fat (fat stored under the skin), fat stored in body organs (such as stomach, liver, intestines, kidneys, etc.) and fat stored in thighs, buttocks and hips.

A current study by the researchers from the United Kingdom shows the waist size and the waist-to-hip ratio (WHR) of a woman are the best indicators for the risk of heart attack. The study also shows the waist-to-hip ratio (WHR) is a better predictor of heart health than body mass index (BMI).



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To find out the risk of heart attack associated with the location of fat deposits in the body, researchers conducted a seven-year follow-up study with a focus on the body size and shape. The study was conducted on 479,610 adults, aged between 40 and 69 with an average age of 56 years, from the UK Biobank, United Kingdom. About 55 percent of them were women.

Researchers used Cox regression models to calculate the risk of heart attack (or myocardial infarction) associated with body mass index (BMI). They also calculated the risk of heart attack with other heart attack risk factors associated with body fat such as waist circumference, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) (also known as the waist-to-stature ratio. WSR). The follow-up study shows 5,710 individuals had a heart attack in the study group and 28 percent of them in women. The study has found.


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  • A higher risk of heart attack in women than in men with a higher waist circumference and with a higher waist-to-hip ratio (WHR).
  • In both men and women, the association between the waist-to-hip ratio (WHR) and the heart attack is stronger when compared to the association between the body mass index (BMI) and the heart attack.
  • The excess body fat stored in the abdomen (apple shape body) can cause more risk of heart attack when compared to excess fat stored around the hips (pear shape body), in both men and women.
  • The risk of heart attack with excess belly fat (or belly weight - apple shape body) is more than the risk of heart attack with overall obesity among women compared with men.

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The study shows a 15 percent higher risk of heart attack with a higher waist-to-hip ratio among women when compared to men. Similarly, there is a seven percent higher risk of heart attack with the waist circumference among women when compared to men. When compared with body mass index (BMI), the study shows 18 percent stronger prediction of heart attack with waist-to-hip ratio in women and six percent stronger prediction in men.


The World Health Organization (WHO) says a waist-to-hip ratio (WHR) of over 0.9 in men and over 0.85 in women is an indicator of abdominal obesity. Researchers say the risk of heart attack increases by 50 percent among women and by 36 percent among men with a just 0.09 increase in waist-to-hip ratio (WHR). This study shows the risk of heart attack with a higher fat in the waist is more in women when compared to men. Researchers suggest that the women can reduce the risk of heart attack by quickly reducing the weight around the waist.


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In the study, researchers excluded people with a history of cardiovascular diseases or individuals with a body mass index (BMI) less than 15 kg/m2. As this study was done with the white population, a larger study with more diverse populations by including all racial and ethnic populations is required. Researchers say further studies are required to find out how the excess fat is being stored in our body and how the location of fat deposits in the body are associated with heart health.

Lead author of the study was Dr. Sanne A.E. Peters, Ph.D., a research fellow in Epidemiology, The George Institute for Global Health, University of Oxford, United Kingdom. The study was published February 28, 2018, in the Journal of the American Heart Association. Title of the article was "Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results From the UK Biobank." DOI : dx.doi.org/10.1161/JAHA.117.008507



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