Key result
Baseline waist-to-height ratio was significantly associated with increased cardiovascular disease incidence in hypertensive adults, with an adjusted HR of 1.16 per 1-SD increase.
Why the study?
It was unclear which obesity index best predicts cardiovascular disease in hypertensive individuals.
Does baseline waist-to-height ratio predict cardiovascular disease incidence better than other obesity indices in hypertensive adults without pre-existing CVD?
Cohort (n=4,244)
Does baseline waist-to-height ratio predict cardiovascular disease incidence better than other obesity indices in hypertensive adults without pre-existing CVD?
Effect estimate: HR 1.16 (95% CI 1.03-1.31)
p-value: p=0.017
Waist-to-height ratio is a simple, no-cost anthropometric index that predicts incident cardiovascular disease better than BMI or waist circumference in hypertensive adults.
May support WHtR for risk stratification in hypertension; leaves open whether it outperforms BMI or waist circumference in prospective validation.
Background Cardiovascular disease (CVD) brings high mortality and economic burden to patients, especially in rural areas. Simple, low-cost abdominal adiposity measures may help identify individuals with increased CVD risk. It is unclear that which obesity indice is the best to predict CVD in hypertensive people. Methods NCRCHS is a prospective cohort study in a general population in Northeast China. The study examined the cardiovascular health from 2013–2015, and follow-up captured the CVD incidence in 2018. Baseline waist-to-height ratio (WHtR), body mass index (BMI),waist-to-hip(WHR)and waist circumference (WC) were calculated and analyzed in relation to the CVD incidence. Results A total of 4244 hypertensive adults without pre-existing CVD at baseline were included in this analysis (age 35–92 years; 2108 men). Over a median follow-up of 4.66 years, a total of 290 CVD cases (6.83%) were documented during the follow-up. Baseline WHtR showed a significant positive association with CVD incidence, even after adjusting for age, sex, diabetes, drinking, smoking, SBP, DBP, Triglyceride, HDL-C, LDL-C, and TC (Hazard Ratios per SD of WHtR ranging from 1.03 to 1.31, p = 0.017). Reclassification and discrimination analyses indicated WHtR addition could improve the conventional model for predicting adverse outcomes within 4 years. Moreover, WHtR predicted the CVD incidence better than other obesity indices (BMI, WC, WHR). Conclusion These findings support a positive association between WHtR and CVD incidence in CVD-free hypertensive adults. WHtR may be useful in predicting CVD incidence in hypertensive adults.
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Zhang et al. (2021) conducted a cohort in Hypertension without pre-existing cardiovascular disease (n=4,244). Waist-to-height ratio (WHtR) vs. Lower WHtR or other anthropometric indices (BMI, WC, WHR) was evaluated on Cardiovascular disease incidence (stroke or coronary heart disease) (HR 1.16, 95% CI 1.03-1.31, p=0.017). Baseline waist-to-height ratio was significantly associated with increased cardiovascular disease incidence in hypertensive adults, with an adjusted HR of 1.16 per 1-SD increase.
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