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Association of multiple anthropometrics of overweight and obesity with incident heart failure: the Atherosclerosis Risk in Communities study.

TitleAssociation of multiple anthropometrics of overweight and obesity with incident heart failure: the Atherosclerosis Risk in Communities study.
Publication TypeJournal Article
Year of Publication2009
AuthorsLoehr LR, Rosamond WD, Poole C, McNeill A M, Chang PP, Folsom AR, Chambless LE, Heiss G
JournalCirc Heart Fail
Volume2
Issue1
Pagination18-24
Date Published2009 Jan
ISSN1941-3297
KeywordsAtherosclerosis, Body Mass Index, Female, Follow-Up Studies, Heart Failure, Humans, Incidence, Male, Middle Aged, Obesity, Overweight, Proportional Hazards Models, Retrospective Studies, Risk Factors, Survival Rate, Time Factors, United States, Waist-Hip Ratio
Abstract

BACKGROUND: The association of central adiposity with incident heart failure (HF) has yet to be studied in a large population-based study.

METHODS AND RESULTS: The Atherosclerosis Risk in Communities study is an ongoing biracial population-based cohort of those aged 45 to 64 years from 4 US communities with 16 years' median follow-up for incident, hospitalized, or fatal HF. Waist-hip ratio, waist circumference, and body mass index (BMI) were measured at baseline (1987-1989). After exclusions, the sample size was 14 641. BMI was categorized as or=30 kg/m(2). Waist circumference and waist-hip ratio were divided into gender-specific tertiles. A first occurrence of International Classification of Diseases, 9th Revision, Clinical Modification, codes of HF, either hospital discharge (428.0 to 428.9; n=1451) or on a death certificate (428.0 to 428.9 or I50.0 to I50.9; n=77) was considered an HF event. Cox models were adjusted for alcohol use, smoking, age, center, and educational level. The adjusted hazard ratios for the highest category (obese) compared with the lowest were well above 1.0 for all 3 anthropometric measures (hazard ratio for 3rd versus 1st tertile of waist-hip ratio: 2.27 [1.71, 3.02] for white women; 3.24 [2.25, 4.65] for black women; 2.46 [1.95, 3.09] for white men; and 2.63 [1.90, 3.65] for black men). Hazard ratios for overweight were lower in magnitude, suggesting a graded response between body size and HF.

CONCLUSIONS: Obesity and overweight, as measured by 3 different anthropometrics, were associated with incident HF in the Atherosclerosis Risk in Communities cohort. The current study does not support the superiority of waist-hip ratio and waist circumference over BMI for the prediction of incident HF.

DOI10.1161/CIRCHEARTFAILURE.108.813782
Alternate JournalCirc Heart Fail
PubMed ID19808311
PubMed Central IDPMC2748859
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
NIH0014140325 / / PHS HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
NIH0014140325 / / Intramural NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States