Normal-Weight Central Obesity and Mortality Risk in Older Adults With Coronary Artery Disease

To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR...

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Published in:Mayo Clinic proceedings Vol. 91; no. 3; pp. 343 - 351
Main Authors: Sharma, Saurabh, Batsis, John A., Coutinho, Thais, Somers, Virend K., Hodge, David O., Carter, Rickey E., Sochor, Ondrej, Kragelund, Charlotte, Kanaya, Alka M., Zeller, Marianne, Park, Jong-Seon, Køber, Lars, Torp-Pedersen, Christian, Lopez-Jimenez, Francisco
Format: Journal Article
Language:English
Published: England Elsevier Inc 01.03.2016
Frontline Medical Communications Inc
Elsevier Limited
Elsevier
Subjects:
Age Factors
Aged
Aged, 80 and over
Analysis
Body Mass Index
Care and treatment
Cause of Death
Cohort Studies
Complications and side effects
Coronary Artery Disease - epidemiology
Coronary Artery Disease - mortality
Coronary heart disease
Denmark - epidemiology
Female
France - epidemiology
Health aspects
Human health and pathology
Humans
Internal Medicine
Life Sciences
Male
Obesity
Obesity, Abdominal - epidemiology
Obesity, Abdominal - mortality
Proportional Hazards Models
Risk Factors
Sex Factors
United States - epidemiology
Denmark
France
United States
WHR
NWCO
CV
CAD
HR
WC
BMI
coronary artery disease
waist-hip ratio
waist circumference
body mass index
cardiovascular
hazard ratio
normal-weight central obesity
Acute Myocardial-Infarction
Body-Mass Index
Cardiorespiratory Fitness
Sarcopenic Obesity
3rd National-Health
Cardiovascular-Disease
Nutrition Examination Survey
Waist-Hip Ratio
Heart-Disease
All-Cause Mortality
ISSN:0025-6196, 1942-5546, 1942-5546
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Summary:To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.
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ISSN:0025-6196
1942-5546
1942-5546
DOI:10.1016/j.mayocp.2015.12.007