Central obesity no worse than other types for cardiovascular risk

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The long held view that central obesity, where fat is deposited mainly around the abdomen, is more harmful in terms of cardiovascular risk than other types of obesity has been challenged by a new study led by British researchers.

The study, published online in The Lancet on March 11th, 2011, was conducted by the Emerging Risk Factors Collaboration led by Dr John Danesh, (University of Cambridge). They analysed individual data from 221,934 participants from 17 countries in 58 prospective studies to produce reliable estimates of associations of body mass index (BMI), waist circumference, and waist-to-hip ratio with first-onset cardiovascular-disease outcomes. They found that in people with a BMI of 20 kg/m2 or higher, the risks of cardiovascular disease were similar based on measurements of BMI, waist circumference, or
waist-to-hip ratio.

Is obesity an independent risk factor?

The Emerging Risk Factors Collaboration also found that if other risk factors are considered – such as diabetes, cholesterol, and blood pressure, family history, age, and gender − BMI (or any other measure of obesity) does not add much extra to risk prediction scores. But they add that: “The main finding of this study does not, of course, diminish the importance of adiposity as a major modifiable determinant of cardiovascular disease.”

But a new analysis of WOSCOPS (West of Scotland Coronary Prevention Study) suggests that obesity is an independent risk factor for coronary heart disease death. In a paper, published online on February 14th 2011, in Heart, the authors of the Scottish study report that the risk of fatal coronary heart disease (CHD) events was increased in men with a BMI over
30 kg/m2 after adjusting for other risk factors. “Our analysis suggests that white men with an increased BMI may have an increased risk of fatal CHD events beyond that mediated by classical risk factors,” they say. Non-fatal events, however, were not increased.

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