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 heart attack risk

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 locations such as 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.

Abdominal or visceral fat (also known as intra-abdominal or organ fat) is a deeper fat. 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 exercises are effective in reducing total abdominal fat.

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. Earlier studies have indicated higher risk of myocardial infarction MI (or heart attack) in men and women with a higher body mass index BMI. But the body mass index does not differentiate the fat storage locations of the human body such as abdominal fat (visceral fat), subcutaneous fat (fat stored below 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 done by researchers from United Kingdom show a waist size and a waist-to-hip ratio (WHR) of a woman are the best indicators of their risk of heart attack. The study also shows a waist-to-hip ratio (WHR) is a better predictor of heart health than body mass index (BMI) or other obesity parameters.

To find out risk of heart attack associated with fat storage locations in the body, researchers have conducted a seven-year follow-up study focusing on the body size and shape. The study was conducted on 479,610 adult people, aged between 40 and 69 with an average age of 56 years, belonging to 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 risk of heart attack with other heart attack risk parameters associated with body fat such as waist circumference, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) (also known as waist-to-stature ratio WSR). Follow-up studies show 5,710 heart attack events in the study group and 28 percent of them in women. The study has found.

  • 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) causes 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.

The study show 15 percent higher risk of heart attack with a higher waist-to-hip ratio among women when compared to men. Similarly, there is 7 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 show 18 percent stronger prediction of heart attack with waist-to-hip ratio among women and 6 percent stronger prediction among 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 for abdominal obesity. Researchers say 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 among women when compared to men. Researchers suggest that the women can reduce their heart attack risk by quickly reducing their weight around the waist.

In the study, researchers excluded people having cardiovascular history or individuals with body mass index (BMI) less than 15 kg/m2. As this study was done primarily with a white population, a larger study with more diverse populations by including all racial and ethnic population is required. Researchers say further studies are required to find out how men and women are storing their excess fat and how fat storage locations are associated to heart health risks.

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

Lead author of the study was Dr Sanne A.E. Peters, PhD, a research fellow in Epidemiology, The George Institute for Global Health, University of Oxford, United Kingdom. The study findings were 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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