Waist size is likely a better predictor of heart disease than body mass index (BMI), a measure of body fat based on height and weight, according to a new study.
Reporting at the 2016 American College of Cardiology’s Scientific Session, researchers from the Intermountain Medical Center Heart Institute in Salt Lake City and John Hopkins Hospital in Baltimore say that being apple-shaped, carrying weight in the abdominal area, “is a strong predictor of serious heart disease in patients who have type 1 or type 2 diabetes, and haven't displayed any symptoms of heart disease.”
Having a pear-shaped body, meaning extra weight is carried in the hips, does not seem to be as predictive of heart disease.
The researchers said that apple-shaped people have already been shown to have higher rates of metabolic syndrome such as high blood pressure, high sugar levels and high cholesterol as well as coronary artery disease and heart failure, but the new findings show that “waist circumference is also a strong predictor of left ventricular dysfunction in patients.”
Increased body fat in the abdominal area can be caused by metabolic syndrome.
"This study confirms that having an apple-shaped body -- or a high waist circumference -- can lead to heart disease, and that reducing your waist size can reduce your risks," said Brent Muhlestein, co-director of research at the Intermountain Medical Center Heart Institute in Salt Lake City.
For the study, researchers looked at 200 diabetic men and women who showed no indications of heart disease.
The subjects were given CT scans to measure the function of their left ventricle, which is the part of the heart that pumps oxygenated blood to the body. Poor function of the left ventricle causes blood to back up in the lungs and legs, often leading to “heart failure and increases the risk of sudden cardiac arrest.”
What they found was that regardless of BMI, “abdominal obesity was strongly associated with regional left ventricular dysfunction, which is a common cause of heart disease, including congestive heart failure.”
"Our research examined patients with diabetes, who are considered high risk for developing heart disease already, and found that the shape of your body determined if you were at a greater risk to develop left ventricular dysfunction," said Muhlestein.
Researchers added that one in three people worldwide will have cardiovascular disease, with about one third of those dying from a heart attack or other heart-related condition before they are diagnosed.
"We specifically found that waist circumference appears to be a stronger predictor for left ventricle dysfunction than total body weight or body mass index," says Boaz D. Rosen, MD, of Johns Hopkins, who is the study's principal investigator.
Dr. Rosen said that further studies would be required “to see if these patients are indeed at risk of developing heart failure or coronary artery disease in the future."