Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample

Han, Thang S.; Leer, E.M. van; Seidell, Jacob C.; Lean, Michael E. J.

doi:10.1136/bmj.311.7017.1401

Cited by 824 publications

(679 citation statements)

References 16 publications

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“…BMI was not independently associated with hypertension and diabetes mellitus. A study by Han et al (1995) showed clear associations between WC and hypertension and other cardiovascular risk factors but did not adjust for the overall body fatness. WC was a better predictor of diabetes mellitus (NIDDM) compared to BMI and WHR in Mexican Americans in a prospective study (Wei et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

et al. 2004

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Objectives: To evaluate waist circumference (WC) as a screening tool for obesity in a Caribbean population. To identify risk groups with a high prevalence of (central) obesity in a Caribbean population, and to evaluate associations between (central) obesity and self-reported hypertension and diabetes mellitus. Design: Cross-sectional. Setting: Population-based study. Subjects: A random sample of adults (18 y or older) was selected from the Population Registries of three islands of the Netherlands Antilles. Response was over 80%. Complete data were available for 2025 subjects. Intervention: A questionnaire and measurements of weight, height, waist and hip. Main outcome measurement: Central obesity indicator (WC Z102 cm men, Z88 cm women). Results: WC was positively associated with age (65-74 y vs 18-24 y) in men (OR ¼ 7.7, 95% CI 3.4-17.4) and women (OR ¼ 6.4, 95% CI 3.2-12.7). Women with a low education had a higher prevalence of central obesity than women with a high education (OR ¼ 0.5, 95% CI 0.3-0.7). However, men with a high income had a higher prevalence of a central obesity than men with a low income (OR ¼ 1.7, 95% CI ¼ 1.1-2.6). WC was the strongest independent obesity indicator associated with self-reported hypertension (OR ¼ 1.7, 95% CI 1.4-2.0) and diabetes mellitus (OR ¼ 1.6, 95% CI 1.3-1.9). Conclusions: The identified risk groups were women aged 55-74 y, women with a low educational level and men with a high income. WC appears to be the major obesity indicator associated with hypertension and diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

et al. 2004

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“…Height, weight, and WC were measured by a trained nurse during the physical examination at a primary care unit or hospital clinic in charge of the national health examination programs. WC was measured between the lower margin of the last palpable rib and the top of the iliac crest, at the level of maximum circumference, using a flexible inelastic fiberglass tape with the tape parallel to the floor 22. BMI is defined as the body weight divided by the square of the body height (kg/m 2 ).…”

Section: Methodsmentioning

confidence: 99%

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Baek

Yang

Kim

et al. 2017

JAHA

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BackgroundHigher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.Methods and ResultsWe studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow‐up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01–1.45, P=0.043), 14% (95% confidence interval, 1.06–1.23, P<0.001), and 52% (95% confidence interval, 1.30–1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder‐adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10–1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new‐onset AF, particularly in participants without comorbidities.ConclusionsAbdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

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“…The average of the two measurements was used in the analysis. Large waist circumference, indicative of increased CVD risk, was defined as exceeding 102 cm in men and 88 cm in women (Han et al, 1995).…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Early signs of atherosclerosis and CVD risk are detectable in childhood as fatty streaks in the aorta and are related to fat mass (body mass index, BMI, kg/m 2 ), blood pressure, plasma cholesterol and triacylglycerol levels (Berenson et al, 1998). These risk factors for CVD tend to track into adulthood (Boulton, 1996), as do other modifiable risk factors such as waist circumference, Lp a concentration, hyperinsulinaemia and glucose intolerance (Han et al, 1995;Sattar et al, 1998;Clarke et al, 2002), and can be influenced by diet. As such, the diet in childhood as well as in adulthood may be a modulator of adult CVD.…”

Section: Introductionmentioning

confidence: 99%

Childhood and adult dietary vitamin E intake and cardiovascular risk factors in mid-life in the 1946 British Birth Cohort

et al. 2003

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Objectives: To determine whether dietary vitamin E intake in childhood or mid-life was predictive of adult hypertension and high waist circumference, as two important risk factors for cardiovascular disease. Design: Longitudinal study of a social class stratified random sample of all the legitimate, singleton births in the week of 3-9 March 1946. Settings: England, Scotland and Wales. Subjects: The 2980 survey members who provided information on diet, health and sociodemographic information at two time points; age 4 y in 1950 (24-h dietary recall) and 43 y in 1989 (48-h dietary recall). Main outcome measures: Outcomes were adjusted odds ratios (ORs) for hypertension and high waist circumference at age 43 y by thirds of vitamin E intake, relative to the highest intake thirds at both ages. Results: The lowest consumers of vitamin E in both childhood and adulthood were more likely to be hypertensive (OR 1.8, 95% confidence interval (CI): 1.03-3.08) and have high waist circumference (OR 1.6, 95% CI: 1.02-2.43) than those consuming high levels at both ages. A low intake of vitamin E at just one time point was not associated with a statistically significant increased risk of hypertension or high waist circumference. Social class was also an independent and equally strong predictor of these coronary risk factors, indicating that the relation between social class and cardiovascular risks was not mediated solely by the current measures of diet and lifestyle. Conclusions: Unique data on vitamin E intake from foods in both childhood and adulthood have indicated that relatively low intake of vitamin E at both ages predicted hypertension and high waist circumference at age 43 y.

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Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample

Abstract: Larger waist circumference identifies people at increased cardiovascular risks.

Cited by 824 publications

References 16 publications

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Childhood and adult dietary vitamin E intake and cardiovascular risk factors in mid-life in the 1946 British Birth Cohort

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