Thick waist ups risks for women

Staff Writer

Obesity is not a good indicator of which women have clogged arteries.

According to a team led by researchers at the University of Pittsburgh, a diagnosis of metabolic syndrome, which can include elevated blood pressure, high blood glucose, abnormal lipid levels and a thick waist, better predicts a woman’s heart disease risk than her weight does.

Doctors often presume an overweight or obese woman has a high risk of heart disease and that a thin woman is at minimal risk, said Dr. Oscar Marroquin, an interventional cardiologist at Pitt.

“This should make us take it a step further to look beyond what the scales tell us and be more inquisitive,” he said.

Dr. Lewis Kuller, of the Pitt Graduate School of Public Health, said the study underscores the importance of identifying the women who have the greatest risk of atherosclerosis and treating them aggressively, both with medication and lifestyle changes.

“There are a lot of women who are obese and who should lose weight for a variety of reasons, but they’re not all at risk for getting up in the morning and having a heart attack,” he said.

For the analysis, which will be published Wednesday in the journal Circulation, researchers collected information from the Women’s Ischemia Syndrome Evaluation study. The sites included Pitt, Allegheny General Hospital, the University of Alabama at Birmingham and the University of Florida in Gainesville.

The 780 participants ranged in age from 21 to 86. All had diagnostic tests to check for atherosclerosis because they had been having chest pain. They were followed annually.

The women were grouped according to their body mass index, called BMI, which takes height and weight into account. A normal BMI was lower than 25, overweight was 25 to 30 and obese was greater than 30.

Some experts think that metabolic syndrome is a precursor of diabetes, Marroquin said. At least three of five criteria must be met to make the diagnosis.

For women, the criteria are a waist circumference greater than 35 inches; a fasting triglyceride level greater than 150 milligrams per deciliter; an HDL or “good” cholesterol level below 50 milligrams per deciliter; high blood pressure or use of antihypertensive drugs; and a fasting blood sugar greater than 110 milligrams per deciliter.

The study found that women who were obese were more likely to have metabolic syndrome than those who had a normal BMI.

But BMI on its own did not indicate a higher likelihood of having coronary artery disease or of having a nonfatal heart attack, stroke, heart failure or of dying.

When the researchers plugged in the presence of metabolic syndrome, however, they could see some trends.

“People who are obese, overweight or normal with a normal metabolic status are the ones who do the best,” Marroquin said. “Anybody else who has the metabolic syndrome tends to do the worst, regardless of whether they are overweight, obese or normal.”

Compared with women who had normal BMIs and metabolisms, dysmetabolic women of normal weight had three times the risk of heart disease. The dysmetabolic, overweight group had 2.5 times the risk, and the dysmetabolic, obese women had almost twice the risk.

Survival rates were also lower among the dysmetabolic women.

The findings don’t mean that heavy people shouldn’t try to lose weight, Marroquin said.

“We don’t want to send the wrong message and say to obese people that they are off the hook if they don’t have metabolic syndrome,” he said. “If they don’t take care of themselves, they will eventually develop the abnormalities.”

(Distributed by Scripps Howard News Service, http://www.shns.com.)

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