Supervisors info:
Δημήτριος Τούσουλης,Καθηγητής, Ιατρική,ΕΚΠΑ
Κωνσταντίνος Τσιούφης,Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Ελένη Κυρίτση, Καθηγήτρια,Νοσηλευτική, ΑΤΕΙ
Summary:
Introduction: Obesity has become an epidemic and is associated with cardiac conditions. However, the exclusive use of BMI as a measure for determining obesity is not the most accurate tool for assessing cardiovascular risk development. Measurements of central obesity and waist circumference are significantly associated with the presence of fatty tissue and heart events. However, there are insufficient and contradictory data in relation to any obesity measurement parameter you should use for predictive diagnosis of outgoing cardiac events
Aim of the study: This study aimed to assess the predictive role of body mass index (BMI), waist circumference (WC) and the waist-to-hip ratio (WHR) for the incidence of coronary artery disease (CAD) in a cohort of essential hypertensive patients.
Method: We followed up 2266 essential hypertensive individuals (mean age, 57.8 years; males, 1083; office blood pressure (BP), 143/89 mm Hg) who were free of cardiovascular disease for a mean period of 6 years. All subjects had at least one annual visit and, at baseline, underwent blood sampling and a complete echocardiographic study to determine the left ventricular (LV) mass index. CAD was defined as a history of myocardial infarction or significant coronary artery stenosis that was revealed by angiography or a coronary evascularization procedure.
Results: The incidence of CAD throughout the follow-up period was 2.33%. Hypertensive individuals who developed CAD (n=53) had a greater baseline WC (101.1±11.7 vs. 96.4±12 cm, P=0.005), WHR (0.94±0.07 vs. 0.89±0.08 cm, Po0.0001) and LV mass index (117±26.8 vs. 103.3±27 g m−2, Po0.0001) compared with those without CAD at follow-up (n=2213), whereas no difference was observed compared with the baseline office BP and BMI values (P=NS for all). Using a multivariate Cox regression model, WC (hazard ratio (HR) 1.037, P=0.002) and LV mass index (HR 1.010, P=0.044) were found to be independent predictors of CAD.
Conclusion: In essential hypertensive patients, WC could predict the future development of CAD, whereas BMI and WHR showed no independent prognostic value. These findings suggest that WC constitutes an easy clinical tool to assess risk in hypertension among individuals with obesity.
Keywords:
Coronary artery disease, Obesity, Waist circumference, Hypertension