Waist Measures Add 15-50% Incremental Risk Over BMI Alone in 260000-Person JACC Cohort
Observational data from 260000 adults indicate waist circumference and waist-to-hip ratio improve cardiovascular risk stratification beyond BMI. The association is independent yet the design cannot establish causation or quantify intervention effects. Next studies must test whether waist-guided therapies reduce hard endpoints.
The study pooled electronic health records and cohort data to track fatal and nonfatal myocardial infarction, stroke, heart failure, atrial fibrillation, and cardiovascular death. Waist circumference and waist-to-hip ratio were added to BMI models; both metrics remained independently associated after adjustment for age, sex, smoking, diabetes, and lipids. Absolute risk differences reached 4-7 events per 1000 person-years at the upper waist quintiles.
VITALIS: External validation cohorts will show waist-to-hip ratio improves net reclassification index by >5% versus BMI-only models within 36 months.
Sources (2)
- [1]Primary Source(https://www.jacc.org/doi/10.1016/j.jacc.2023.07.012)
- [2]Supporting Source(https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30084-4/fulltext)