Waist Circumference but Not Body Mass Index Predicts Long‐Term Mortality in Elderly Subjects with Chronic Heart Failure

OBJECTIVES: 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). DESIGN: Longitudinal evaluation with a 12‐year follow‐up. SETTING: Campania, a region of southern Italy. PARTICIPANTS: One thousand three hundred thirty‐two subjects aged 65 and older selected from the electoral rolls of Campania. MEASUREMENTS: 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%, P 0 =.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). CONCLUSION: WC, but not BMI, is predictive of long‐term mortality in elderly individuals with CHF and to a lesser extent in those without CHF.