Waist: Hip ratio is a more reliable risk assessment tool for acute myocardial infarction: A hospital based case – control study among rural Maharashtra, India

Abstract

Background: Worldwide, incidence of Acute Myocardial Infarction (AMI) has been increasing over the years and now reflected as the leading cause of death universally. Aims and Objectives: To determine the strength and degree of association between obesity indices and serum lipid profile with incidence of AMI in rural Indian population. Materials and Methods: Hospital based case-control study was conducted among newly diagnosed cases of AMI and matched controls. A total of 40 patients admitted in ICCU at rural tertiary care centre and equal number of healthy age/sex controls were enrolled in the study. Over the period of three months, by employing personal interview, anthropometric, clinical and laboratory examination information was obtained. Data were analysed by using SPSS version17 and results were expressed on Mean ± SD, Chi-Square test and Odds ratio. Results: Mean age of cases and controls was 58.5 and 60 yrs respectively with mean difference of 1.5 years. Maximum, 47.5% cases were in age 60-69 yrs and shown 1.5 times risk of getting AMI. The Overweight, Waist-Hip ratio and hyperlipidemia (cholesterol, H:L ratio and triglycerides) were significantly associated with AMI (p < 0.05 at 95% CI) and risk predicted by odd's was of 9.3, 3.4, 2.4, 4.8, and 9.4 respectively. Every unit rise in overweight, Waist:Hip ratio, serum cholesterol, LDL and triglycerides; the risk of occurrence of AMI increases by 1.7, 2.8, 1.02, 1.01 and 1.03 times respectively. Conclusion: Study demonstrated, W:H ratio is a more valid, single, reliable risk assessment tool for AMI could be practiced at health care institutions as well as community surveillance. 20% and 7-12% of coronary artery disease respectively. 3,4Diabetes mellitus, hypertension, dyslipidemia and obesity (body mass index or waist-hip ratio) have all been linked to AMI. 5,6 The incidence of AMI in India was 27,040,912 cases in year 2002 which increased to 46,968,695 cases by 2010. Incidence toll of AMI in urban and rural Indian population was 54.37% and 45.48% respectively in year 2000; however in year 2010, incidence toll of AMI was higher in rural Indian population (52.56%) as compared to urban (47.43%) indicating AMI is now public health threats to rural Indian. 7,8 The study aimed to determine the strength of association between obesity and hyperlipidemia indices with incidence of AMI in rural Indian population. It is known that BMI and W/H ratio is routinely used to assess the risk of AMI however, it is not yet described which is best and unit rise leads to what folds the risk increases. Study can provide new information to health professionals, physical fitness trainers and general people about risk of getting AMI in context to anthropometric and laboratory parameters for necessary information and practical application to reduce the problem of AMI in Indian population by utilizing cost effective, easily accessible, affordable, applicable, acceptable and scientific sound tool. MATERIAL AND METHODSA hospital based case-control study was conducted among newly diagnos...