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06-10-2009 | Cardiometabolic | Article

High BMI and waist circumference predict fatal and nonfatal CVD



MedWire News: High body mass index (BMI) and waist circumference both predict fatal and nonfatal cardiovascular disease (CVD), show results from the MORGEN study.

“Data on the associations of overweight and obesity with nonfatal CVD are mainly obtained from large prospective cohorts in which height and weight were self-reported and circumference was self-measured,” explain Ineke van Dis (Netherlands Heart Foundation, The Hague) and colleagues, who add that “self-reported BMI data underestimate the true prevalence of obesity by at least 25%.”

They say: “For a correct estimation of the strength of the associations of BMI and waist circumference with nonfatal and fatal CVD, anthropometric data measured by trained staff are needed.”

van Dis and team analyzed data from 20,000 participants of the MORGEN (Monitoring Project on Chronic Disease Risk Factors) study, aged 20–65 years, who were recruited between 1993 and 1997.

At baseline, the researchers measured various anthropometric and CV characteristics including BMI and waist circumference. The participants were then followed-up until 2006 for nonfatal CVD and until 2007 for fatal CVD, defined using International Classification of Diseases (ICD) codes (ICD 9: 401–414, 426–443, 798.1 and 798.2).

Overall, the absolute risk for nonfatal CVD was 10-fold higher than that for fatal CVD. In participants who were obese (BMI=30 kg/m2 or above) the relative risks for fatal and nonfatal CVD were four- and two-fold higher, respectively, than for normal weight (BMI=18.5–25.0 kg/m2) participants.

Similar associations with fatal and nonfatal CVD were observed for men and women with waist circumferences of at least 88 or 102 cm, respectively, compared with those with waist circumferences of less than 80 or 94 cm, respectively.

Overall, in overweight or obese participants (BMI over 25 kg/m2) 53% of all fatal CVD and 22–30% of all nonfatal CVD could be attributed to their excess weight.

“One out of three of fatal and one out of seven of nonfatal CVD cases can be attributed to overweight and obesity in the population,” conclude van Dis et al in the European Journal of Cardiovascular Prevention and Rehabilitation.

“This emphasizes the importance of overweight prevention in CVD prevention,” they say, adding that “measuring overweight has the advantage that it does not require medical investigations and can be based on self-identification by persons at risk.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Helen Albert