Overview
Obesity is a well-known cardiovascular risk factor. BMI has traditionally been used to determine obesity (BMI  30). A clear association between BMI and atherosclerosis has been shown in men but not in women.81,82 In recent years, it has become increasingly believed that abdominal fat has a stronger association with heart disease risk than fat in other areas.37
Waist-Hip Ratio vs. BMI
It has recently been recommended that obesity be redefined by waist-hip ratio (WHR) rather than BMI.39
- In older women, WHR offers prognostic information beyond BMI and waist circumference.38
- WHR has been shown to be a strong predictor of mortality in women38 and has a highly significant association with myocardial infarction (MI) risk.39
- Increasing BMI was associated with increasing MI risk, but after adjusting for WHR and other risk factors, the association vanished.39
- The association between increasing WHR and increasing MI risk remained highly significant (P<.0001) after adjusting for BMI and other risk factors.
Fat Distribution and Cardiovascular Risk
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Lipid metabolism appears to be influenced by regional fat distribution.81,83 Higher WHR has been shown to correlate with increased total and LDL cholesterol and decreased HDL cholesterol.83
- Lower body fat in postmenopausal women may actually be protective against cardiovascular risk, having positive effects on serum triglycerides and HDL cholesterol as well as insulin and glucose measures.37
- Central adiposity has been associated with cardiovascular risk factors even in children and adolescents, with fat distribution being a more important influence on risk factors than overall adiposity.84
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Diabetes
Obesity
Metabolic Syndrome
Race/Ethnicity
Defining Risk in Women
Exercise Capacity in Women
C-Reactive Protein
Atrial Fibrillation
Heart Failure
Fat Distribution and Heart Disease in Women
Fitness Levels
Rheumatoid Arthritis
Aging
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