Abstract 16078: Abdominal and Total Adiposity and Sudden Cardiac Death Risk in Men
BACKGROUND: Adiposity is a prevalent, modifiable risk factor for sudden cardiac death (SCD). Abdominal adiposity, defined by anteroposterior diameter measured at the xiphoid, was associated with SCD in a prospective study of French individuals, but data on more commonly obtained measures are sparse in men.
METHODS: We assessed the association between several measures of abdominal adiposity, including waist circumference, waist hip ratio, and waist height ratio, and SCD among 16,327 men in the Physicians’ Health Study initially free of cardiovascular disease. At year 9 of follow-up, participants were asked to record waist and hip circumference using a tape measure provided by the study. Participants were instructed to measure waist circumference at the level of the navel and hip circumference at the largest point between waist and thighs while standing. Total adiposity, as measured by body mass index (BMI), was also calculated and examined. SCD was defined as death within one hour of the onset of symptoms. Cox proportional hazards models were used to determine the relative risk of SCD controlling for age and multiple confounders.
RESULTS: Over a mean follow-up of 14.4 years, 145 SCDs were confirmed. In age- and multivariable-adjusted models (Table), there was no association between any measure of abdominal adiposity and SCD, even after adjusting for BMI. In contrast, obesity (BMI ≥ 30 kg/m2) conferred nearly double the risk of SCD (RR 1.87, 95% CI 1.03-3.42, p=0.04) compared to those with a BMI of 22.5-<25, where the risk was lowest. This was not altered after further adjustment for abdominal adiposity in the same model. Consistent with prior studies, abdominal adiposity was associated with non-fatal MI (data not shown).
CONCLUSIONS: In this cohort of apparently healthy men without known cardiovascular disease, prospectively obtained measures of abdominal adiposity were not associated with increased risk of SCD. However, obesity was associated with increased SCD risk.
- © 2013 by American Heart Association, Inc.