Key result
Baseline waist-to-height ratio was significantly associated with increased cardiovascular disease incidence in hypertensive adults, with a 1-SD increase yielding an adjusted HR of 1.16.
Why the study?
It remained unclear which obesity index best predicts cardiovascular disease in hypertensive individuals.
Does waist-to-height ratio predict cardiovascular disease incidence better than other obesity indices in hypertensive adults?
Cohort (n=4,244)
Does waist-to-height ratio predict cardiovascular disease incidence better than other obesity indices in hypertensive adults?
Effect estimate: HR 1.16 (95% CI 1.03-1.31)
p-value: p=0.017
Waist-to-height ratio is a simple, low-cost, and superior predictor of cardiovascular disease incidence compared to BMI, waist circumference, and waist-to-hip ratio in hypertensive adults.
WHtR may aid CVD risk stratification in hypertension; leaves open superiority to other obesity indices in prospective studies.
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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Sun et al. (2021) conducted a cohort in Hypertension (n=4,244). Waist-to-height ratio (WHtR) vs. 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 a 1-SD increase yielding an adjusted HR of 1.16.
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