Abdominal Adiposity and Coronary Heart Disease in Women

Abstract

OBESITY is well recognized as a major risk factor for coronary heart disease (CHD) in men and women.^1-3 However, since Vague's⁴ description of the association between upper body obesity and cardiovascular disease, the relative importance of total and regional obesity has been debated. Abdominal adiposity has been linked to significant metabolic abnormalities, including insulin resistance, hyperinsulinemia, and elevated triglyceride levels, as well as increased incidence of hypertension,⁵ glucose intolerance,⁶ and diabetes mellitus.⁷ Several studies suggest that abdominal adiposity, as measured by waist-hip ratio (WHR), is an independent risk factor for CHD in men^8,9 and perhaps also in women.^10,11 Waist circumference has also been associated with increased risk of CHD^9,12 and has been advocated by some as a simpler measure of abdominal obesity.¹³ However, whether regional obesity remains a risk factor after taking total adiposity into account remains controversial. The purpose of this study was to determine the risk of CHD associated with abdominal adiposity in women and to compare the effects of WHR and waist circumference.