Abstract 15872: Abdominal Obesity is an Independent Risk Factor for Sudden Cardiac Death in Non-Smoking Individuals: The Atherosclerosis Risk in Communities Study
Background: Obesity has adverse hemodynamic and electrical consequences on the heart, including left ventricular hypertrophy (LVH), left ventricular dilatation and QT prolongation. We examined whether general obesity (measured using body mass index (BMI)), or abdominal obesity (measured using waist circumference (WC) and waist-to-hip ratio (WHR)), are associated with sudden cardiac death (SCD) in the general population.
Methods: We included 14,941 subjects enrolled in the Atherosclerosis Risk in Communities (ARIC) study, a US prospective biracial cohort study. Indices of obesity were measured at baseline (1987-1989). Participants were followed up through 2001. SCD, defined as a sudden pulseless condition from a cardiac origin in a previously stable individual, was adjudicated by an independent committee. Obesity measures were categorized according to the World Health Organization recommendations. We used Cox proportional-hazards models to assess the association between obesity and SCD.
Results: Mean age was 54±6 yrs, 55% were female and 26% were black. Over an average 12.6±2.5 yrs of follow-up, 253 SCD events were identified. There was a statistically significant interaction between obesity and current smoking at baseline (p=0.01). In models adjusting for age, sex, race, study center and education level, SCD risk increased with BMI (p for trend 0.0001), WC (p for trend 0.0002) and WHR (p for trend <0.0001) in non-smokers, but not in smokers. After further adjustment for potential mediators (hypertension, diabetes, lipid profile, prevalent coronary heart disease, heart failure and LVH), WHR was the only obesity variable associated with SCD in non-smokers (Table). Non-smokers in the highest WHR category (>0.95 in women; >1.01 in men) had a 2 times higher risk (HR 2.03, 95% CI 1.19-3.46) of SCD than those with normal WHR (<0.80 in women; <0.95 in men).
Conclusions: Abdominal obesity is an independent risk factor for SCD among non-smoking individuals.
- © 2013 by American Heart Association, Inc.