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Waist-to-hip ratio best at predicting heart attack

New research suggests that the waist-to-hip ratio is a better predictor of heart attacks.

As the name implies, the waist-to-hip ratio is a calculation of a person's waist circumference divided by the hip circumference. A high ratio results in the so-called "apple-shaped body", whereas a low ratio indicates a "pear-shaped body".

Obesity is a known risk factor for heart attacks and it's usually determined by calculating a person's body mass index (BMI), which is based on their height and weight.

The findings, which appear in The Lancet, are based on a comparison of BMI and waist-to-hip ratio in predicting heart attacks in more than 26,000 subjects drawn from 52 countries and representing several major ethnic groups.

Consistent with previous reports, Dr. Salim Yusuf, from McMaster University in Hamilton, Ontario, and colleagues found that the risk of heart attack increased as BMI rose. However, after accounting for waist-to-hip ratio and other risk factors, the association was no longer statistically significant.

By contrast, waist-to-hip ratio predicted the heart attack risk, and the correlation remained significant even after accounting for other factors. The risk of heart attack increased progressively as waist-to-hip ratio climbed, with subjects in the highest ratio group being 75 percent more likely to experience an attack than those in the lowest ratio group.

The main message from this report is that BMI as the measure of obesity is not the most appropriate, and results in considerable under-estimation of the grave consequences of the overweight epidemic.


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