Key result
Larger neck circumference linked to ~8% greater incident CHF risk per unit increase.
Why the study?
The relationship between neck circumference and incidence of congestive heart failure or coronary heart disease mortality in populations with and without sleep-disordered breathing has not been clarified.
Is neck circumference associated with incident congestive heart failure and coronary heart disease mortality in a community-based population with or without sleep-disordered breathing?
Cohort (n=4,433)
Yes
Is neck circumference associated with incident congestive heart failure and coronary heart disease mortality in a community-based population with or without sleep-disordered breathing?
Hazard Ratio: 1.082 (95% CI 1.003–1.166)
p-value: p=0.040
Neck circumference is independently associated with incident congestive heart failure and coronary heart disease mortality in individuals without sleep-disordered breathing, suggesting its utility as a simple anthropometric marker for cardiovascular risk stratification.
May support neck circumference for CV risk stratification without SDB; hypothesis-generating and should not yet change practice.
BACKGROUND: Neck circumference (NC), representing upper body subcutaneous adipose tissue, may be correlated with increased risk of overweight/obesity, obstructive sleep apnoea, and metabolic and cardiovascular disease. However, the relationship between NC and the incidence of congestive heart failure (CHF) or mortality due to coronary heart disease (CHD) in a community-based population with and without sleep-disordered breathing (SDB) has not yet been clarified. METHODS: We performed a prospective study using the Sleep Heart Health Study (SHHS) cohort. Cox proportional hazards regression models were used to estimate the association of different levels of NC with CHF incidence or CHD mortality in 2234 individuals with SDB and 2199 without SDB, respectively. RESULTS: After adjusting for age, sex, and body mass index (BMI), NC was significantly associated with CHF when comparing the highest NC quartile group with the lowest (hazard ratio, HR, 2.265, 95% confidence interval, CI, 1.074-4.777) in the non-SDB population. This association diminished after further adjustment for other risk factors, but remained statistically significant, with an adjusted HR of 1.082 (95% CI 1.003-1.166) per unit increase in NC. Additionally, after adjustment for age, sex, and BMI, NC was also shown to be remarkably associated with CHD mortality (HR 1.141, 95% CI 1.014-1.282) per unit increase in NC in the non-SDB population but not in the SDB population. After adjustment for all the covariates, there was a significant association between NC and CHD death in those without SDB, with an adjusted HR of 1.134 (95% CI 1.001-1.284) per unit increase in NC. CONCLUSIONS: NC may correlate with CHF incidence and CHD mortality in population without SDB. NC measurement may help risk stratification for cardiovascular diseases. TRIAL REGISTRATION: NCT00005275 , January 1994.
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Zhang et al. (2018) conducted a cohort in Congestive heart failure and coronary heart disease mortality (n=4,433). Neck circumference vs. Lower neck circumference was evaluated on Incident congestive heart failure in the non-sleep-disordered breathing population (per unit increase in neck circumference) (HR 1.082, 95% CI 1.003-1.166, p=0.040). In adults without sleep-disordered breathing, each unit increase in neck circumference was significantly associated with an increased risk of incident congestive heart failure (HR 1.082) and coronary heart disease mortality (HR 1.134).
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