Abstract 8419: Impact of Abdominal Obesity and Physical Inactivity on the Relationship Between Systemic Hypertension and Risk of Coronary Heart Disease in Apparently Healthy Men and Women
Background Individuals with systemic hypertension (HT) are at increased of future coronary heart disease (CHD). Physical inactivity and abdominal obesity may increase the risk of HT and impact on the relationship of HT and CHD risk. Therefore, the objective of the present study was to test the hypothesis that active individuals with smaller waist circumference (WC) will have lower blood pressure (BP) than inactive individuals with higher WC in a large population-based sample of individuals representative of a contemporary European population. Our second objective was to determine the respective contributions of WC and HT to CHD risk.
Methods and Results A total of 9580 men and 12250 women aged 45 to 79 years residing in Norfolk, United Kingdom participated in a prospective, population-based study with a 11.4-year follow-up. During follow-up, 2191 CHD events were recorded. Physical activity was evaluated using a validated lifestyle questionnaire that takes into account both leisure-time and work-related physical activity. WC was measured at the smallest circumference between the ribs and iliac crest with a D-loop non-stretch fibreglass tape. BP was measured by using a non-invasive oscillometric device in sitting position. Within each physical activity category, a consistent relationship was observed between increasing WC tertiles and increasing systolic (SBP) and diastolic BP. Within each WC tertile, inactive individuals had higher SBP than active individuals (P for trend <0.001). After adjusting for traditional CHD risk factors, compared to individuals with both low WC and BP, those with high BP and high WC were at increased CHD risk (Hazard ratio (HR) =3.32 [95% CI, 2.25-4.89] and 3.11 [1.98-4.87] respectively in men and women). In individuals with normal BP, those in the top WC tertile were at increased CHD risk compared to those in the bottom WC tertile (HR=2.78 [1.66-4.66] and 2.23 [1.18-4.20] respectively in men and women).
Conclusion In this population-based study, elevated WC and HT have an independent and additive impact on CHD risk. Targeting elevated abdominal obesity by increasing physical activity levels may reduce the increased CHD risk associated with elevated BP in primary prevention.
- © 2011 by American Heart Association, Inc.