Carrying weight in your midsection adds to
obesity's dangers.
A "spare tire" around the
midsection raises the odds of sudden cardiac death in obese people, a new study
finds.
A
larger waist-to-hip ratio matters even more than body-mass index when it comes
to sudden cardiac death risk, said study researcher Dr. Selcuk
Adabag, an associate professor of medicine at the University of Minnesota in
Minneapolis. Body-mass index is a measure of weight relative to height used to
determine normal weight and obesity.
Obesity,
a moderate risk factor for sudden cardiac death, and apple-shaped
bodies often go hand in hand.
"The
significance of this study is that it shows that abdominal obesity is an independent risk
factor for
sudden cardiac death, even after accounting for factors such as diabetes, hypertension
and coronary heart
disease,"
said Adabag, who is also a cardiac electrophysiologist at the Veterans
Administration Medical Center in Minneapolis.
Adabag
was scheduled to present the findings Wednesday at the annual meeting of the
Heart Rhythm Society in Boston.
Sudden
cardiac death is responsible for more than 250,000 deaths in the United States
each year, according to the Centers for Disease
Control and Prevention. It is defined as death that occurs within an hour of
initial symptoms. Besides obesity, risk factors include coronary heart disease and heart
rhythm problems.
For the
study, Adabag looked at the records of more than 15,000 people with an average
age of 54 from four U.S. locales who were enrolled in the Atherosclerosis Risk
in Communities Study. Over 13 years, more than 300 of the participants
experienced sudden cardiac death.
After
Adabag took into account age, sex, race, education, smoking status and family history of
heart disease,
he found that body-mass index, waist circumference and
waist-to-hip ratio all were linked with sudden cardiac death.
"I
expected there would be some relationship with all [those factors] measured,"
he said.
But
when he factored in co-occurring conditions such as diabetes, high blood
pressure, heart failure and a high LDL, or ''bad," cholesterol, among
other problems, only the elevated waist-to-hip ratio still was linked with
sudden cardiac death.
Although
the reason people with apple-shaped bodies have higher risks than those with
pear-shaped bodies isn't clear-cut, Adabag speculates that where fat is stored
is important for heart risks.
"Fat
in the abdomen spews inflammatory substances," he said. Inflammation is
linked with heart problems.
Dr.
Suzanne Steinbaum, a preventive cardiologist and director of Women and Heart
Disease at Lenox Hill Hospital in New York City, said the findings are
interesting.
"We
have an understanding that an elevated waist-to-hip ratio is associated with
conditions like diabetes and high blood pressure," Steinbaum said.
"But what we never really appreciated before was the association
with sudden cardiac death."
A
waist-to-hip ratio of more than 0.8 for women and 0.95 for men is considered
unhealthy. A person with 35-inch hips and a 35-inch waist, for instance, would
have a ratio of 1, which is undesirable.
How do
you improve your waist-to-hip ratio? "The usual way that we prevent
obesity: exercise and diet -- a healthier lifestyle," Adabag said.
"Exercise
is so crucial," Steinbaum said. Those with a pot belly, she added, may be
eating too many simple carbohydrates, such as those found in processed sugary
foods.
In the
United States, two-thirds of adults and one-third of children reportedly are
overweight or obese, according to background information included in Adabag's
study.
While
the study uncovered a link between abdominal fat and heart risks, it didn't
prove a cause-and-effect relationship.
Data
and conclusions presented at meetings should be considered preliminary until
published in a peer-reviewed medical journal.
More
information: To
learn more about sudden cardiac death, visit the U.S. National Heart, Lung, and Blood Institute.
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