December 1, 2010American Journal of Epidemiology
Measures of Adiposity and Future Risk of Ischemic Stroke and Coronary Heart Disease in Older Men and Women
Key result
High waist/hip ratio and midlife BMI (quintile 5 vs 1) were significantly associated with increased risk of coronary heart disease (HR 1.56, 95% CI 1.25-1.94 and HR 1.71, 95% CI 1.37-2.14).
Why the study?
Do measures of adiposity increase the risk of incident ischemic stroke and coronary heart disease in older adults?
Population
3,754 community-dwelling US adults aged 65-100 years
Comparison
Measures of general and central adiposity vs Lower quintiles or conventional cutpoints for…
Design
Cohort
Follow-up
1989-2007
Authors
Discussion
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Implication
Supports adiposity metrics for CHD risk stratification in older adults; leaves open causality and stroke associations.
Study Design
Type
Cohort (n=3,754)
Structured PICO
Do measures of adiposity increase the risk of incident ischemic stroke and coronary heart disease in older adults?
P
Population
3,754 community-dwelling US adults aged 65-100 years followed from 1989 to 2007 for incident ischemic stroke or coronary heart disease.
E
Exposure
Measures of general and central adiposity (including BMI, waist/hip ratio, and BMI at age 50)
C
Comparator
Lower quintiles or conventional cutpoints for normal weight/adiposity
O
Outcome
Incident ischemic stroke or coronary heart diseasehard clinical
Main Result
Hazard Ratio: 1.56 (95% CI 1.25–1.94)
Measures of central adiposity and midlife BMI are strong predictors of incident coronary heart disease in older adults, highlighting the importance of these metrics beyond baseline BMI.
Limitations
- Requires meta-analytical approaches to determine if differences translate to better risk prediction
- Requires determination of prognostic cutpoints
Cite This Study
Kizer et al. (2010) conducted a cohort in Community-dwelling older adults (n=3,754). Adiposity measures (waist/hip ratio and BMI) vs. Lowest quintile of adiposity (quintile 1) was evaluated on Incident ischemic stroke or coronary heart disease (HR 1.56, 95% CI 1.25-1.94). High waist/hip ratio and midlife BMI (quintile 5 vs 1) were significantly associated with increased risk of coronary heart disease (HR 1.56, 95% CI 1.25-1.94 and HR 1.71, 95% CI 1.37-2.14).