Waist circumference but not body mass index predicts long-term mortality in elderly subjects with chronic heart failure.
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.
Testa
Gianluca
G
Department of Clinical Medicine, Cardiovascular Science and Immunology, Cattedra di Geriatria, Università degli Studi di Napoli Federico II, Naples, Italy.
Cacciatore
Francesco
F
Galizia
Gianluigi
G
Della-Morte
David
D
Mazzella
Francesca
F
Langellotto
Assunta
A
Russo
Salvatore
S
Gargiulo
Gaetano
G
De Santis
Domenico
D
Ferrara
Nicola
N
Rengo
Franco
F
Abete
Pasquale
P
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