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Doctors don't need several obesity measures to predict heart failure

January 30, 2009

Doctors and other health care professionals are aware that a person's risk of heart failure increases as body weight goes up. However, they don't need to measure patients' waists or hips to help reduce the risk for heart failure, according to researchers from the University of North Carolina at Chapel Hill's Gillings School of Global Public Health.

Current procedures, which rely on body mass index tests, are effective predictors of risk without the additional measurements, according to the UNC study, published this month in Circulation: Heart Failure, a journal of the American Heart Association.

Dr. Laura Loehr

"We were surprised by the results," said lead study author Laura Loehr, MD, PhD, a 2008 graduate of the UNC doctoral program in epidemiology, now a postdoctoral fellow at the National Institute of Environmental Health Sciences in Research Triangle Park, N.C., and clinical assistant professor in UNC's department of medicine.

"We expected waist circumference or waist-to-hip ratio to be a better predictor of heart failure because excess adiposity (body fat) around the waist is a known risk factor for diabetes, which is itself an important risk factor for heart failure. What we found, though, is that the body mass index was an equal predictor of heart failure, and that's the test most clinicians are using now, anyway."

Loehr's research analyzes data collected through the Atherosclerosis Risk in Communities (ARIC) study, an epidemiologic study of 45- to 65-year-old residents of four U.S. communities, sponsored by the National Heart Lung and Blood Institute (NHLBI) and managed by the Collaborative Studies Coordinating Center at the UNC Gillings School of Global Public Health.

The current analysis includes nearly 14,600 people followed over 16 years by the ARIC study. Loehr said the findings were true for both men and women, and for African Americans and whites, all of whom had greater risk of heart failure if they were overweight (BMI = 25-29.9) or obese (BMI > 30). The risk increases with increasing BMI, she said.

Co-authors of the paper include, from the UNC department of epidemiology, Wayne D. Rosamond, PhD, professor; Charles Poole, ScD, associate professor; Gerardo Heiss, MD, PhD, Kenan Distinguished Professor; and Ann Marie McNeill, PhD, adjunct assistant professor of epidemiology at UNC and associate director of epidemiology at Merck Research Laboratories, Rahway, N.J.; Patricia P. Chang, MD, MHS, assistant professor of medicine in the UNC School of Medicine; Lloyd E. Chambless, PhD, research professor of biostatistics at UNC; and Aaron R. Folsom, MD, MPH, professor of epidemiology, University of Minnesota School of Public Health, Minneapolis, Minn.