Large waistlines associated with stroke risk
NEW YORK (Reuters Health) - A large waist circumference, which is known to raise the risk of cardiovascular disease, may also increase the risk of strokes and transient ischemic attacks (TIAs), a brief episode of mild stroke symptoms, according to a study from Germany published Thursday in Stroke: Journal of the American Heart Association.
In an AHA statement, study leader Dr. Tobias Back of Saxon Hospital Arnsdorf in Arnsdorf/Dresden suggests that physicians "measure patients' waistlines and use the waist-to-hip ratio to estimate stroke risk. World Health Organization-defined categories of waist-to-hip ratio or waist circumference should be used."
Back also emphasized the importance of considering "the whole vascular risk profile to minimize or modify all possible factors contributing to coronary heart disease, stroke and peripheral artery disease."
The study team evaluated the contribution of obesity and abdominal fat mass to the risk of stroke or TIA recurrence in 379 adults and a comparison group of 758 sex- and age-matched subjects.
Several markers of abdominal obesity correlated strongly with the risk of stroke or TIA, they report. For example, individuals with the highest waist-to-hip ratio had 7.69-times the risk of these two events compared with those with the lowest waist-to-hip ratio.
"If the waist-to-hip ratio values were greater than 0.97 for men and 0.84 for women, then individuals faced almost eight times increased risk for stroke compared to individuals with a waist-to-hip ratio less than 0.92 in men or less than 0.78 in women," Back stated.
Increased waist circumference also showed a strong association with stroke and TIA. If the waist circumference was greater than 40.2 inches for men or 34.6 inches for women, the risk of stroke increased more than four times compared with individuals with normal waistline measurements, according to the researchers.
The findings also suggest that the waist-to-stature ratio (waist circumference divided by height) "is an appropriate measure to assess the risk of stroke and TIA comparable to waist circumference."
The current study, the investigators note, also shows that markers of abdominal fat are better predictors of stroke and TIA than body mass index. "By using different statistical approaches, it was confirmed that waist-to-hip ratio appeared to be the strongest predictor of stroke and TIA risk," Back said.
SOURCE: Stroke 2008.
