title: Waist circumference compared with other obesity parameters as determinants of coronary artery disease in essential hypertension: a 6-year follow-up study.
abstract: This study aimed to assess the predictive role of body mass index (BMI), waist circumference (WC) and the waist-to-hip ratio (WHR) for the incidence of coronary artery disease (CAD) in a cohort of essential hypertensive patients. We followed up 2266 essential hypertensive individuals (mean age, 57.8 years; males, 1083; office blood pressure (BP), 143/89 mm Hg) who were free of cardiovascular disease for a mean period of 6 years. All subjects had at least one annual visit and, at baseline, underwent blood sampling and a complete echocardiographic study to determine the left ventricular (LV) mass index. CAD was defined as a history of myocardial infarction or significant coronary artery stenosis that was revealed by angiography or a coronary revascularization procedure. The incidence of CAD throughout the follow-up period was 2.33%. Hypertensive individuals who developed CAD (n=53) had a greater baseline WC (101.1±11.7 vs. 96.4±12 cm, P=0.005), WHR (0.94±0.07 vs. 0.89±0.08 cm, P<0.0001) and LV mass index (117±26.8 vs. 103.3±27 g m(-)(2), P<0.0001) compared with those without CAD at follow-up (n=2213), whereas no difference was observed compared with the baseline office BP and BMI values (P=NS for all). Using a multivariate Cox regression model, WC (hazard ratio (HR) 1.037, P=0.002) and LV mass index (HR 1.010, P=0.044) were found to be independent predictors of CAD. In essential hypertensive patients, WC could predict the future development of CAD, whereas BMI and WHR showed no independent prognostic value. These findings suggest that WC constitutes an easy clinical tool to assess risk in hypertension among individuals with obesity.
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Kyriakos
authors: K
authors: Dimitriadis
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Costas
authors: C
authors: Tsioufis
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Anastasia
authors: A
authors: Mazaraki
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Ioannis
authors: I
authors: Liatakis
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Evaggelia
authors: E
authors: Koutra
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Athanasios
authors: A
authors: Kordalis
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Alexandros
authors: A
authors: Kasiakogias
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Dimitrios
authors: D
authors: Flessas
authors: First Department of Propaedeutic and Internal Medicine, Medical School, University of Athens, 'Laikon' Hospital, Athens, Greece.
authors: Nicholas
authors: N
authors: Tentolouris
authors: First Cardiology Clinic, University of Athens, Hippocration Hospital, Athens, Greece.
authors: Dimitris
authors: D
authors: Tousoulis
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D004452:Echocardiography; D000075222:Essential Hypertension; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D012737:Sex Factors; D055105:Waist Circumference / Q000502:physiology*