November 20, 2009European Journal of Cardiovascular Prevention & Rehabilitation122 citationsOpen Access
View Full PaperBody mass index and waist circumference predict both 10-year nonfatal and fatal cardiovascular disease risk: study conducted in 20 000 Dutch men and women aged 20–65 years
Key Result
Obesity (BMI ≥30 kg/m2) was associated with a four-fold higher risk of fatal CVD (HR 4.0; 95% CI 2.4-6.6) and a two-fold higher risk of nonfatal CVD compared to normal weight.
Study Design
Type
Cohort (n=20,000)
Structured PICO
Do high BMI and waist circumference predict nonfatal and fatal cardiovascular disease risk in the general population?
P
Population
Over 20,000 men and women aged 20-65 years from the general Dutch population, followed for an average of 10 years to assess cardiovascular disease risk.
E
Exposure
High Body Mass Index (BMI ≥30 kg/m2 or ≥25 kg/m2) and high waist circumference (≥88 cm in women, ≥102 cm in men)
C
Comparator
Normal weight (BMI <25 kg/m2) and normal waist circumference (<80 cm in women, <94 cm in men)
O
Outcome
Nonfatal and fatal cardiovascular diseasehard clinical
Overweight and obesity are strong predictors of cardiovascular disease, with a substantially greater impact on fatal CVD than nonfatal CVD.
Main Result
Hazard Ratio: 4 (95% CI 2.4–6.6)
Abstract
AIMS: Body mass index (BMI) and waist circumference (WC) are both predictors of cardiovascular diseases (CVD). We compared absolute risk, hazard ratio (HR), and population attributable risk of nonfatal and fatal CVD for BMI and WC in a large prospective cohort study with an average follow-up of 10 years. METHODS AND RESULTS: Anthropometric data were measured between 1993 and 1997 in a general population sample of over 20,000 men and women aged 20-65 years in the Netherlands. All risks were adjusted for age and sex. Absolute risk of nonfatal CVD was on average 10 times higher than that of fatal CVD. In obese respondents (BMI >or=30 kg/m2), relative risk of fatal CVD was four-fold higher HR=4.0 95% confidence interval (CI)=2.4-6.6, whereas risk of nonfatal CVD was two-fold higher (HR=1.8 95% CI=1.6-2.2) than in normal-weight respondents. Similar associations were observed for WC (>or=88 vs. or=102 vs. 94 cm in men). In persons with overweight or obesity (BMI >or=25 kg/m2), half of all fatal CVD (attributable risk=54%, 95% CI=30-70) and a quarter of nonfatal CVD was ascribed to their overweight. On the population level, one-third of all fatal CVD cases could be attributed to overweight and obesity (population attributable risk=35%, 95% CI=14-52), and about one in seven of nonfatal CVD cases. CONCLUSION: The associations of BMI and WC with CVD risk were equally strong. Overweight and obesity had a stronger impact on fatal CVD than on nonfatal CVD.