title: Waist circumference but not body mass index predicts long-term mortality in elderly subjects with chronic heart failure.
abstract: OBJECTIVE
  To examine whether waist circumference (WC) and body-mass index (BMI) can predict long-term mortality in elderly subjects with and without chronic heart failure (CHF).
  
  
  METHODS
  Longitudinal evaluation with a 12-year follow-up.
  
  
  METHODS
  Campania, a region of southern Italy.
  
  
  METHODS
  One thousand three hundred thirty-two subjects aged 65 and older selected from the electoral rolls of Campania.
  
  
  METHODS
  The relationship between WC or BMI and mortality during a 12-year follow-up in 125 subjects with and 1,143 subjects without CHF.
  
  
  RESULTS
  Mortality increased as WC increased in elderly subjects without CHF (from 47.8% to 56.7%, P=.01), and the increase was even greater in patients with CHF (from 58.1% to 82.0%, P=.01). In contrast, mortality decreased as BMI increased in elderly subjects without CHF (from 53.8% to 46.1%, P0=.046) but not in those with CHF. According to Cox regression analysis, BMI protected against long-term mortality in the absence but not in the presence of CHF. In the absence of CHF, WC was associated with a 2% increased risk of long-term mortality for each 1-cm greater WC (Hazard Ratio (HR)=1.02, 95% confidence interval (CI)=1.01-1.03; P<.001), versus 5% increased in the presence of CHF (HR=1.06, 95% CI=1.02-1.10; P<.001).
  
  
  CONCLUSIONS
  WC, but not BMI, is predictive of long-term mortality in elderly individuals with CHF and to a lesser extent in those without CHF.
authors.affiliation: Department of Clinical Medicine, Cardiovascular Science and Immunology, Cattedra di Geriatria, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Testa
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Galizia
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.forename: Francesca
authors.initials: F
authors.lastname: Mazzella
authors.forename: Assunta
authors.initials: A
authors.lastname: Langellotto
authors.forename: Salvatore
authors.initials: S
authors.lastname: Russo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Domenico
authors.initials: D
authors.lastname: De Santis
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
authors.forename: Franco
authors.initials: F
authors.lastname: Rengo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology; D012944:Social Support; D055105:Waist Circumference