Study Links Central Obesity to Higher CV Mortality Risk

According to new research, patients who have a normal body mass index (BMI) but also have central obesity are at a greater risk for cardiovascular mortality.

In an effort to examine total and cardiovascular mortality risks associated with central obesity and normal (BMI), a team including researchers from the Mayo Clinic studied 15,184 adults, between the ages of 18 and 90, with BMIs greater than 18.5. Multivariable Cox proportional hazards models were used to evaluate the relationship of obesity patterns defined by BMI and waist-to-hip ratio (WHR) and total and cardiovascular mortality risk after adjustment for confounding factors.
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The mean follow-up time was 14 years, after which time waist-to-hip ratio (WHR), but not BMI, was connected to a higher overall mortality risk. Men with normal BMI and central obesity showed an 87% greater total mortality risk than those without central obesity. In addition, women with normal-weight central obesity demonstrated a 48% higher mortality risk in comparison to women with similar BMI but no central obesity.  Expected survival estimates were consistently lower for those with central obesity when age and BMI were controlled for, according to the authors.

Overall, the findings suggest that, especially for older adults, “just having a normal weight doesn’t mean they might not be at high cardiovascular risk,” says Michael Jensen, MD, a physician at the Mayo Clinic in Rochester, Minn., and a co-author of the study.

If physicians have the capacity to measure waist circumference, it will help them identify patients who need further screening,” says Jensen, adding that main risk factors—smoking, cholesterol, HDL-cholesterol, triglycerides, blood sugar, and blood pressure—still apply.

“It’s just that those with elevated waist circumferences are more likely to have abnormalities in these risk factors than those with low/normal waist circumferences,” he says. “We can be more efficient in deciding who to perform laboratory screening tests on if we measure waist circumference.”

—Mark McGraw

Reference:

Sahakyan K, Somers V, et al. mortality risk in persons with normal-weight central obesity. Ann Intern Med. 2015.