Adiposity and incident heart failure in older adults: the cardiovascular health study.
While several studies have reported a positive association between overall adiposity and heart failure (HF) risk, limited and inconsistent data are available on the relation between central adiposity and incident HF in older adults. We sought to examine the association between waist circumference (WC) and incident HF and assess whether sex modifies the relation between WC and HF. Prospective study using data on 4,861 participants of the Cardiovascular Health Study (1989-2007). HF was adjudicated by a committee using information from medical records and medications. We used Cox proportional hazard models to compute hazard ratio (HR). The mean age was 73.0 years for men and 72.3 years for women; 42.5% were men and 15.3% were African Americans. WC was positively associated with an increased risk of HF: each standard deviation of WC was associated with a 14% increased risk of HF (95% CI: 3%-26%) in a multivariable model. There was not a statistically significant sex-by-WC interaction (P = 0.081). BMI was positively associated with incident HF (HR: 1.22 (95% CI: 1.15-1.29) per standard deviation increase of BMI); however, this association was attenuated and became nonstatistically significant upon additional adjustment for WC (HR: 1.09 (95% CI: 0.99-1.21)). In conclusion, a higher WC is associated with an increased risk of HF independent of BMI in community-living older men and women.
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. ldjousse@rics.bwh.harvard.edu
Luc
L
Djoussé
Traci M
TM
Bartz
Joachim H
JH
Ix
Susan J
SJ
Zieman
Joseph A
JA
Delaney
Kenneth J
KJ
Mukamal
John S
JS
Gottdiener
David S
DS
Siscovick
Jorge R
JR
Kizer
D050154:Adiposity; D000368:Aged; D000375:Aging; D050218:Body Fat Distribution; D015992:Body Mass Index; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference