Measures of adiposity and future risk of ischemic stroke and coronary heart disease in older men and women.

Abstract:

:The relation between measures of general and central adiposity and individual cardiovascular endpoints remains understudied in older adults. This study investigated the association of measures of body size and composition with incident ischemic stroke or coronary heart disease (1989-2007) in 3,754 community-dwelling US adults aged 65-100 years. Standardized anthropometry and bioelectric impedance measurements were obtained at baseline. Body mass index at age 50 years (BMI50) was calculated on the basis of recalled weight. Although only waist/hip ratio was significantly associated with ischemic stroke in quintile analysis in women, dichotomized body mass index (BMI) (≥ 30 kg/m²) was the only significant predictor in men. For coronary heart disease, there were significant positive adjusted associations for all adiposity measures, without interaction by sex. This was true for both quintiles and conventional cutpoints for obesity, although BMI-defined overweight (25-29.9 kg/m² was significant at midlife but not at baseline. Strengths of association for extreme quintiles (quintile 5 vs. quintile 1) were broadly comparable, but the highest effect estimates were for waist/hip ratio (hazard ratio = 1.56, 95% confidence interval: 1.25, 1.94) and BMI50 (hazard ratio = 1.71, 95% confidence interval: 1.37, 2.14), both of which remained significant after adjustment for mediators, BMI, or each other. Whether these differences translate to better risk prediction will require meta-analytical approaches, as will determination of prognostic cutpoints.

journal_name

Am J Epidemiol

authors

Kizer JR,Biggs ML,Ix JH,Mukamal KJ,Zieman SJ,de Boer IH,Mozaffarian D,Barzilay JI,Strotmeyer ES,Luchsinger JA,Elkind MS,Longstreth WT Jr,Kuller LH,Siscovick DS

doi

10.1093/aje/kwq311

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

10-25

issue

1

eissn

0002-9262

issn

1476-6256

pii

kwq311

journal_volume

173

pub_type

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