Waist to hip ratio predicts heart attack risks among women

By Dr. Ananya Mandal, MDMar 1 2018

According to a new study from the George Institute for Global Health, women who have larger waists compared to their hips are at a greater risk of heart attacks than men who have a similar shape. A larger waist compared to hips is typically called the “apple shape”. The study appeared in the latest issue of the Journal of the American Heart Association and was sourced by data and other aids by UK Biobank.

Image Credit: Kotin / Shutterstock

An ideal waist-to-hip ratio is a predictor for health similar to body mass index. According to this new study, the waist-to-hip ratio or WHR is a better predictor for risk of heart attacks than BMI or other obesity parameters. Among women it is an 18 percent stronger predictor and among men it is a 6 percent stronger predictor of heart attacks. BMI is linked to heart disease as has been seen in previous studies as well. For this study the team of researchers interviewed around 500,000 UK adults aged between 40 and 69 years.

According to the World Health Organization a WHR of over 0.85 in women and 0.9 in men indicates abdominal obesity. The study showed that a WHR rise of 0.09 (for example from 0.82 to 0.91) could raise the risk of heart attacks by 50 percent among women. Similar change among men showed a rise of 36 percent in heart attack risk. Among women having a higher WHR meant a 10 to 20 percent greater risk of heart disease than having a higher BMI, the study authors noted. According to the National Health and Nutrition Examination Survey though, the actual risk of heart attacks among women aged 40 to 69 is 1.8 to 4.2 percent compared to 3.3 to 11.3 percent among men of the same age group.

Lead author, Dr Sanne Peters at the University of Oxford said that this study adds to the scientific evidence that being fatter around the middle is more dangerous than being fat around the hips. The apple shape she added is more risky than the pear shape. She explained that among women the fat distribution rather than the general obesity is a better predictor of heart attacks. She said that this “sex-specific” difference in predictions of heart attack also means than gender specific public health campaigns are warranted. In that way, the global obesity epidemic may be better addressed she hoped. She explained that males and females tended to have different body fat distribution and body composition. While women tend to gave more fat mass and greater subcutaneous fat, men have more lean mass and visceral fat.

Abdominal fat, explain the researchers, is one that is called visceral fat and is accumulated inside the abdominal cavity around organs such as liver, pancreas etc. This raises the risk of insulin resistance and diabetes as well as raised triglyceride levels and bad cholesterol levels. Fat around the hips is mostly subcutaneous which means, it lies underneath the skin and has a lesser chance to cause the metabolic changes than visceral fat. Women store more fat around their abdomen than men due to their hormonal make up.

Peters added that this study is a robust one because it included a large population of individuals whose BMI as well as WHR was directly measured and analyzed. Only caveat she added, was that the UK Biobank primarily includes a white population and larger studies with adequate population representation from all racial, ethnic and genetic individuals would be necessary to come to a generalized conclusion.