Las medidas de la cintura y de la cadera contribuyen a la evaluación de riesgo cardiovascular

Título: The influence of hip circumference on the relationship between abdominal obesity and mortality

Resumen :

Abstract: Background Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction.

Methods In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of > 25% and a decrease of > 20% after waist and hip circumference were added to the model was calculated.

Results Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by > 25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by > 20% for 4.5% of those who died and 14.8% of those censored.

Conclusions The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models.

Autores : Cameron, A.J.; Magliano, D.J.; Shaw, J.E.; Zimmet, P.Z.; Carstensen, B.; Alberti, K.G.M.M.; Tuomilehto, J.; Barr, E.L.M.; Pauvaday, V.K.; Kowlessur, S.; Soderberg, S.

Direcciones :

1. Deakin University, Ctr Phys Act & Nutr Res (Australia)

2. Baker IDI Heart & Diabet Institute (Australia)

3. Monash University, Dept Epidemiol & Prevent Med (Australia)

4. Steno Diabet Ctr (Denmark)

5. Univ London Imperial Coll Sci Technol & Med, Dept Endocrinol & Metab (Inglaterra)

6. Univ Helsinki, Dept Publ Hlth (Finlandia)

7. S Ostrobothnia Cent Hosp (Finlandia)

8. Hospital de la Paz, Universidad de La Paz, Red RECAVA (España)

9. Minist Hlth & Qual Life (Mauricio)

10. Umea Univ, Med & Heart Ctr, Dept Publ Hlth & Clin Med (Suecia)