Both BMI and Waist Circumference Are Associated with Coronary Vasoreactivity in Overweight and Obese Men

OBJECTIVE: Guidelines differ about the value of assessment of adiposity measures for cardiovascular disease risk prediction. Reduced coronary vasoreactivity appears to be one of the earliest abnormalities in the development of coronary artery disease. We studied the associations of BMI, waist circumference, waist-to-hip ratio (WHR) and percentage of fat with coronary vasoreactivity. METHODS: Myocardial blood flow was quantitated in 14 overweight or obese non-smoking men (age 32 ± 7 years, BMI 32 ± 3 kg/m², waist circumference 106 ± 9 cm, WHR 0.96 ± 0.04, %fat 27.2 ± 3.7) using positron emission tomography and oxygen-15-labelled water. The measurements were performed basally and during adenosine infusion (140 µg/kg/min) to measure coronary vasoreactivity. RESULTS: Adenosine infusion induced significant increase in myocardial blood flow (from 0.8 ± 0.2 to 3.5 ± 0.9 ml/g/min). After adjustment for LDL-cholesterol, HbA(1c), systolic blood pressure and age, hyperaemic myocardial blood flow was inversely associated with BMI (r = -0.87, p = 0.001), waist circumference (r = -0.84, p = 0.003), WHR (r = -0.79, p = 0.007) and %fat (r = -0.65, p = 0.04). CONCLUSIONS: Both BMI and waist circumference are associated with coronary vasoreactivity in overweight and obese men.