Is waist-to-height ratio the best parameter to predict CVD in hypertensive patients? Study sheds light
China: Findings from a recent study in the journal BMC Cardiovascular Disorders support a positive association between waist-to-height ratio (WHtR) and the risk of cardiovascular disease (CVD) in CVD-free hypertensive adults. This implies that WHtR can be used for predicting CVD incidence in patients with hypertension.
"WHtR may be a simple and accurate prognostic marker of CVD risk versus other obesity-related indices in hypertensive people," Xingang Zhang, The First Hospital of China Medical University, Shenyang, Liaoning, China, and colleagues wrote in their study.
Cardiovascular disease carries a high mortality and economic burden on patients, particularly in rural areas. Individuals with increased CVD risk can be identified with simple, low-cost abdominal adiposity measures. However, there is no clarity on which obesity indices are the best for predicting CVD in hypertensive patients.
Considering the above, the researcher's team from China aimed to determine the role of WHtR as a predictor of CVD incidence in the NCRCHS (the Northeast China Rural Cardiovascular Health Study) cohort of hypertensive people without previous CVD. They also compared its discriminating ability against other commonly anthropometric indices of central obesity (i.e., WC, WHR, and BMI).
NCRCHS is a prospective cohort study in a general population in Northeast China. The study examined cardiovascular health from 2013 to 2015, and follow-up captured the CVD incidence in 2018. Calculations of baseline waist-to-height ratio (WHtR), waist circumference (WC), waist-to-hip (WHR), and body mass index (BMI) was done and analyzed in relation to the CVD incidence.
The analysis included a total of 4244 hypertensive adults without pre-existing CVD at baseline (age 35–92 years; 2108 men).
Based on the study, the researchers reported the following findings:
- Over a median follow-up of 4.66 years, a total of 290 CVD cases (6.83%) were documented during the follow-up.
- Baseline WHtR showed a significant positive association with CVD incidence, even after adjusting for age, sex, diabetes, drinking, smoking, SBP, DBP, Triglyceride, HDL-C, LDL-C, and TC (Hazard Ratios per SD of WHtR ranging from 1.03 to 1.31).
- Reclassification and discrimination analyses indicated WHtR addition could improve the conventional model for predicting adverse outcomes within 4 years.
- WHtR predicted the CVD incidence better than other obesity indices (BMI, WC, WHR).
"The present findings offer new prospective data suggesting that WHtR exhibits a positive association with the CVD incidence in Asiatic adults from the hypertensive population without pre-existing CVD," wrote the authors.
This led to the conclusion that WHtR is a much better predictor of CVD risk versus other anthropometric indices of total and central obesity. There will be a requirement for further studies to evaluate the association between WHtR and CVD in different ethnic and patient populations.
Reference:
Zhang, S., Fu, X., Du, Z. et al. Is waist-to-height ratio the best predictive indicator of cardiovascular disease incidence in hypertensive adults? A cohort study. BMC Cardiovasc Disord 22, 214 (2022). https://doi.org/10.1186/s12872-022-02646-1
