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23 July 2010

Waistline and blood fat level predict heart risk

Checking people's waist circumference and level of fat (triglycerides) in their blood could help to identify those at risk of coronary artery disease, according to new research.

The study, published in the Canadian Medical Association Journal, looked at more than 20,000 people aged between 45 and 79, who took part in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Waist circumference is often used by doctors as a measure of abdominal fat - the type of fat known to increase the risk of coronary artery disease. However, this isn't always very accurate as fat located under the skin, which isn't so dangerous for health, can also contribute to a large waistline. Looking at levels of fats in the blood known as triglycerides is thought to be a good way of identifying whether a large waistline is due to the more dangerous abdominal fat.

The people taking part in the study had their waist circumference, triglyceride level and a number of other risk factors for heart disease measured. They were classified depending on whether they had what was considered to be a large waist circumference, a high triglyceride level or both.

 The message is clear that it's better to look at a number of these factors when assessing someone's risk of heart disease, rather than just one or two.

Dr Peter Mace, Assistant Medical Director, Bupa

A total of 2,109 people developed coronary artery disease during the study. The researchers adjusted the results to take into account other risk factors for coronary artery disease, such as cholesterol level, blood pressure and whether or not people smoked. After adjustment, those with both a waist circumference and triglyceride level above the threshold values were significantly more likely to develop coronary artery disease than those with a healthy waist circumference and triglyceride level. Waist circumference and triglyceride level together had a greater effect on risk of coronary artery disease than either factor alone.

The authors propose that checking people's waist circumference and triglyceride level in addition to other traditional risk factors - such as blood pressure and cholesterol - is a good way to identify those people who have abdominal obesity, and so are at greater risk of coronary artery disease.

Commenting on the study, Dr Peter Mace, Assistant Medical Director for Bupa, said: "This study adds to the understanding of how the numerous risk factors for coronary artery disease may interact. However, the message is clear that it's better to look at a number of these factors when assessing someone's risk of heart disease, rather than just one or two.

"At Bupa, all of our health assessments include tests for cholesterol and triglyceride levels, as well as a number of other factors including blood pressure and waist-to-hip ratio. We keep a close eye on latest research to make sure our services are based on best available evidence."

Key facts
  • Coronary artery disease (also referred to as coronary heart disease) is caused by fatty deposits building up in the arteries that supply blood to the heart.
  • It can lead to angina (chest pain), heart attack and other heart problems.
  • A waist circumference of 94cm or more in men and 80cm or more in women is associated with an increased risk of health problems.
  • A blood level of triglycerides of more than 1.7 mmol/L is associated with increased risk of heart disease.
  • Waist-to-hip ratio is another way of measuring abdominal fat. Although it's just as helpful as waist circumference, it can be harder to measure, so it's better to get it done by a health professional.

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How Bupa can help

Read the study

Arsenault BJ, Lemieux I, Despres JP, et al. The hypertriglyceridemic-waist phenotype and the risk of coronary artery disease: results from the EPIC-Norfolk Prospective Population Study. CMAJ 2010. doi: 10.1503/cmaj.091276

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