Waist circumference is a better predictor of hypertension than BMI



M

Matti Narkia

Guest
According to a recent study the risk for hypertension may be better identified by obesity defined by
higher waist circumference than higher BMI. The study is

Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association between
different measurements of obesity and the incidence of hypertension. Am J Hypertens. 2004 Jan;17(1):50-
3. PMID: 14700512 [PubMed - in process] <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retr-
ieve&db=PubMed&list_uids=14700512&dopt=Abstract>

Abstract:

"BACKGROUND: Obesity is a risk factor for the incidence of hypertension, but it is still unclear
whether this risk can be better estimated by body mass index (BMI) or waist circumference (WC).
METHODS: In the baseline evaluation of a population-based cohort, 1089 adults answered a
pretested questionnaire and had their baseline blood pressure (BP) and anthropometric
measurements assessed according to standardized recommendations. Excluding the individuals with
hypertension at baseline, and those deceased or lost during the follow-up, 592 individuals
(80.5% of those eligible) were visited again. Obesity was defined as BMI >/=30 kg/m(2) for both
genders, and WC >/=102 cm for men and WC >/=88 cm for women. Incident cases of hypertension were
characterized by BP >/=140/90 mm Hg or use of BP medication in the follow-up visit. RESULTS:
After a mean follow-up of 5.6 +/- 1.1 years, 127 incident cases of hypertension were identified.
The hazard ratios (Cox model), adjusted for age and baseline systolic BP (95% CI and P), for BMI
higher than 30 kg/m(2) were 1.08 (0.52-2.24, P =.82) in men and 1.74 (0.93-3.26, P =.08) in
women. The corresponding figures were 1.78 (0.76-4.09, P =.18) for men with WC >/=102, and 1.72
(1.09-2.73, P =.02) for women with WC >/=88 cm. CONCLUSIONS: We conclude that the risk for
hypertension may be better identified by obesity defined by higher WC than higher BMI."

--
Matti Narkia
 
Matti Narkia <[email protected]> wrote in
news:[email protected]:

> According to a recent study the risk for hypertension may be better identified by obesity defined
> by higher waist circumference than higher BMI. The study is
>
> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association between
> different measurements of obesity and the incidence of hypertension. Am J Hypertens. 2004 Jan;17(1):50-
> 3. PMID: 14700512 [PubMed - in process]
> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
> ed&list_uids=14700512&dopt=Abstract>
>
> Abstract:
>
> "BACKGROUND: Obesity is a risk factor for the incidence of hypertension, but it is still
> unclear whether this risk can be better estimated by body mass index (BMI) or waist
> circumference (WC). METHODS: In the baseline evaluation of a population-based cohort, 1089
> adults answered a pretested questionnaire and had their baseline blood pressure (BP) and
> anthropometric measurements assessed according to standardized recommendations. Excluding the
> individuals with hypertension at baseline, and those deceased or lost during the follow-up,
> 592 individuals (80.5% of those eligible) were visited again. Obesity was defined as BMI >/=30
> kg/m(2) for both genders, and WC >/=102 cm for men and WC >/=88 cm for women. Incident cases
> of hypertension were characterized by BP >/=140/90 mm Hg or use of BP medication in the follow-
> up visit. RESULTS: After a mean follow-up of 5.6 +/- 1.1 years, 127 incident cases of
> hypertension were identified. The hazard ratios (Cox model), adjusted for age and baseline
> systolic BP (95% CI and P), for BMI higher than 30 kg/m(2) were 1.08 (0.52-2.24, P =.82) in
> men and 1.74 (0.93-3.26, P =.08) in women. The corresponding figures were 1.78 (0.76-4.09, P
> =.18) for men with WC >/=102, and 1.72 (1.09-2.73, P =.02) for women with WC >/=88 cm.
> CONCLUSIONS: We conclude that the risk for hypertension may be better identified by obesity
> defined by higher WC than higher BMI."
>
> --
> Matti Narkia
>

But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
 
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Nigel wrote:

> Matti Narkia <[email protected]> wrote in news:[email protected]:
>
> > According to a recent study the risk for hypertension may be better identified by obesity
> > defined by higher waist circumference than higher BMI. The study is
> >
> > Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
> > between different measurements of obesity and the incidence of hypertension. Am J Hypertens.
> > 2004 Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
> > <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
> > ed&list_uids=14700512&dopt=Abstract>
> >
> > Abstract:
> >
> > "BACKGROUND: Obesity is a risk factor for the incidence of hypertension, but it is still
> > unclear whether this risk can be better estimated by body mass index (BMI) or waist
> > circumference (WC). METHODS: In the baseline evaluation of a population-based cohort, 1089
> > adults answered a pretested questionnaire and had their baseline blood pressure (BP) and
> > anthropometric measurements assessed according to standardized recommendations. Excluding
> > the individuals with hypertension at baseline, and those deceased or lost during the follow-
> > up, 592 individuals (80.5% of those eligible) were visited again. Obesity was defined as BMI
> > >/=30 kg/m(2) for both genders, and WC >/=102 cm for men and WC >/=88 cm for women. Incident
> > cases of hypertension were characterized by BP >/=140/90 mm Hg or use of BP medication in
> > the follow-up visit. RESULTS: After a mean follow-up of 5.6 +/- 1.1 years, 127 incident
> > cases of hypertension were identified. The hazard ratios (Cox model), adjusted for age and
> > baseline systolic BP (95% CI and P), for BMI higher than 30 kg/m(2) were 1.08 (0.52-2.24, P
> > =.82) in men and 1.74 (0.93-3.26, P =.08) in women. The corresponding figures were 1.78 (0.76-
> > 4.09, P =.18) for men with WC >/=102, and 1.72 (1.09-2.73, P =.02) for women with WC >/=88
> > cm. CONCLUSIONS: We conclude that the risk for hypertension may be better identified by
> > obesity defined by higher WC than higher BMI."
> >
> > --
> > Matti Narkia
> >
>
> But BMI is still a quick and easy risk assessment for _all_cause_ mortality.

Correct.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147

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Nigel wrote:
<blockquote TYPE=CITE>Matti Narkia <[email protected]> wrote in
<br>news:[email protected]:
<p>> According to a recent study the risk for hypertension may be better
<br>> identified by obesity defined by higher waist circumference than
<br>> higher BMI. The study is
<br>>
<br>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers
F,
<br>> Fuchs FD.
<br>> Association between different measurements of obesity and the
<br>> incidence of hypertension.
<br>> Am J Hypertens. 2004 Jan;17(1):50-3.
<br>> PMID: 14700512 [PubMed - in process]
<br>> <URL:<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM</a>
<br>> ed&list_uids=14700512&dopt=Abstract>
<br>>
<br>> Abstract:
<br>>
<br>> "BACKGROUND: Obesity is a risk factor for
the
<br>> incidence of hypertension, but it is still
unclear
<br>> whether this risk can be better estimated
by body mass
<br>> index (BMI) or waist circumference (WC).
METHODS: In
<br>> the baseline evaluation of a population-based
cohort,
<br>> 1089 adults answered a pretested questionnaire
and had
<br>> their baseline blood pressure (BP) and anthropometric
<br>> measurements assessed according to standardized
<br>> recommendations. Excluding the individuals
with
<br>> hypertension at baseline, and those deceased
or lost
<br>> during the follow-up, 592 individuals (80.5%
of those
<br>> eligible) were visited again. Obesity was
defined as
<br>> BMI >/=30 kg/m(2) for both genders, and WC
>/=102 cm
<br>> for men and WC >/=88 cm for women. Incident
cases of
<br>> hypertension were characterized by BP >/=140/90
mm Hg
<br>> or use of BP medication in the follow-up
visit.
<br>> RESULTS: After a mean follow-up of 5.6 +/-
1.1 years,
<br>> 127 incident cases of hypertension were identified.
<br>> The hazard ratios (Cox model), adjusted for
age and
<br>> baseline systolic BP (95% CI and P), for
BMI higher
<br>> than 30 kg/m(2) were 1.08 (0.52-2.24, P =.82)
in men
<br>> and 1.74 (0.93-3.26, P =.08) in women. The
<br>> corresponding figures were 1.78 (0.76-4.09,
P =.18)
<br>> for men with WC >/=102, and 1.72 (1.09-2.73,
P =.02)
<br>> for women with WC >/=88 cm. CONCLUSIONS:
We conclude
<br>> that the risk for hypertension may be better
<br>> identified by obesity defined by higher WC
than higher
<br>> BMI."
<br>>
<br>> --
<br>> Matti Narkia
<br>>
<p>But BMI is still a quick and easy risk assessment for _all_cause_
<br>mortality.</blockquote>

<p><br>Correct.
<br>
<p>Servant to the humblest person in the universe,
<p>Andrew
<p>--
<br>Dr. Andrew B. Chung, MD/PhD
<br>Board-Certified Cardiologist
<br><A HREF="http://www.heartmdphd.com/">http://www.heartmdphd.com/</A>
<p>--
<br>Who is the humblest person in the universe?
<p><A HREF="http://makeashorterlink.com/?L21532147">http://makeashorterlink.com/?L21532147</A>
<br> </html>

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Thu, 05 Feb 2004 12:06:35 GMT in article <[email protected]> Nigel
<I.don'[email protected]> wrote:

>Matti Narkia <[email protected]> wrote in news:[email protected]:
>
>> According to a recent study the risk for hypertension may be better identified by obesity defined
>> by higher waist circumference than higher BMI. The study is
>>
>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
>> between different measurements of obesity and the incidence of hypertension. Am J Hypertens. 2004
>> Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
>> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
>> ed&list_uids=14700512&dopt=Abstract>
>>
[snip]
>
>But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
>
According to a recent Australian study waist-hip ratio is a better predictor of _CVD_ and _CHD_
mortality than waist circumference, which again is a better predictor than BMI:

Welborn TA, Dhaliwal SS, Bennett SA. Related Articles, Links Waist-hip ratio is the dominant risk
factor predicting cardiovascular death in Australia. Med J Aust. 2003 Dec 1-15;179(11-12):580-5.
PMID: 14636121 [PubMed - in process] <URL:http://www.mja.com.au/public/issues/179_11_011203/wel10182_fm-
1.html>

Abatract:

"OBJECTIVE: To evaluate clinical measures of obesity for their ability to predict death from
cardiovascular disease (CVD) and coronary heart disease (CHD), in parallel with conventional
cardiovascular risk factors. DESIGN, PARTICIPANTS AND SETTING: Cross-

sample of 9206 adults aged 20-69 years from Australian capital cities (1989 Australian Risk
Factor Prevalence Survey). Blood pressure, fasting serum lipid levels, smoking, history of
heart disease or diabetes, and obesity as measured by body mass index (BMI), waist
circumference and waist-hip ratio were recorded. These data were linked with the National Death
Index to determine causes of death of the 473 survey subjects who had died to 31 December 2000.
MAIN OUTCOME MEASURES: Hazard ratios for the risk factors predicting CVD mortality and CHD
mortality. RESULTS: Of the modifiable risk factors, obesity, as measured by waist-hip ratio, is
a dominant, independent, predictive variable for CVD and CHD deaths in Australian men and
women. Self-reported

cigarette smoking in women, are also independent risk factors. CONCLUSIONS: Obesity assessed by
waist-hip ratio is a better predictor of CVD and CHD mortality than waist circumference, which,
in turn, is a better predictor than BMI. The recognition of central obesity is clinically
important, as lifestyle intervention is likely to provide significant health benefits."

--
Matti Narkia
 
Thu, 05 Feb 2004 12:06:35 GMT in article <[email protected]> Nigel
<I.don'[email protected]> wrote:

>Matti Narkia <[email protected]> wrote in news:[email protected]:
>
>> According to a recent study the risk for hypertension may be better identified by obesity defined
>> by higher waist circumference than higher BMI. The study is
>>
>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
>> between different measurements of obesity and the incidence of hypertension. Am J Hypertens. 2004
>> Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
>> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
>> ed&list_uids=14700512&dopt=Abstract>
>
[snip]
>
>But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
>
According to Bigaard et al. below waist circumference for a given BMI is even better, and according
to Visscher et al. below waist circumference is better than BMI among never smoking elderly men:

Bigaard J, Tjonneland A, Thomsen BL, Overvad K, Heitmann BL, Sorensen TI. Waist circumference, BMI,
smoking, and mortality in middle-aged men and women. Obes Res. 2003 Jul;11(7):895-903. PMID:
12855760 [PubMed - indexed for MEDLINE
<URL:http://www.obesityresearch.org/cgi/content/abstract/11/7/895>

"OBJECTIVE: Measurement of waist circumference alone as a proxy of abdominal fat mass has been
suggested as a simple clinical alternative to BMI for detecting adults with possible health
risks due to obesity. RESEARCH METHODS AND PROCEDURES: From 1993 to 1997, 27,178 men and 29,875
women, born in Denmark, 50 to 64 years of age, were recruited in the Danish prospective study
Diet, Cancer and Health. By the end of the year 2000, 1465 deaths had occurred. We evaluated the
relationship between waist circumference and BMI (simultaneously included in the model) and all-
cause mortality. We used Cox regression models to estimate the mortality-rate ratios and to
consider possible confounding from smoking. RESULTS: Waist circumference among both men and
women showed a strong dose-response type of relationship with mortality when adjusted for BMI,
whereas the low range of BMI was inversely associated with mortality when adjusted for waist
circumference. A 10% larger waist circumference corresponded to a 1.48 (95% confidence interval:
1.36 to 1.61) times higher mortality over the whole range of waist circumference. The
associations were independent of age and time since baseline examination. Restriction to never
smokers showed a similar pattern, but a weakening of the associations. DISCUSSION: Despite the
high correlation between waist circumference and BMI, the combination may be very relevant in
clinical practice because waist circumference for given BMI was a strong predictor of all-cause
mortality. The inverse association between BMI and mortality for given waist circumference was
diminished in never smokers, particularly for high values of BMI."

Katzmarzyk PT, Craig CL, Bouchard C. Adiposity, adipose tissue distribution and mortality rates in
the Canada Fitness Survey follow-up study. Int J Obes Relat Metab Disord. 2002 Aug;26(8):1054-9.
PMID: 12119570 [PubMed - indexed for MEDLINE] <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cm-
d=Retrieve&db=PubMed&list_uids=11753597&dopt=Abstract>

"OBJECTIVE: To compare body mass index (BMI), waist- hip ratio (WHR) and waist circumference as
predictors of all-cause mortality among the elderly. DESIGN: Population-based cohort study; mean
follow-up was 5.4
J. SETTING: The Rotterdam Study. PARTICIPANTS: A total of 6296 men and women; baseline
age 55-102 y.

compared between quintiles of BMI, WHR and waist circumference and between predefined categories
of BMI and waist circumference, stratified for smoking category. RESULTS: High quintiles of
waist circumference, but not high quintiles of BMI and WHR were related to increased mortality
among never smoking men, without reaching statistical significance. Only the highest category of
BMI (BMI>30 kg/m2) among never smoking men was related to increased mortality, compared to
normal BMI (hazard ratio 2.6 (95% confidence interval: 1.3-5.3)). Waist circumference between 94
and 102 cm and waist circumference 102 cm and larger were related to increased mortality,
compared to normal waist circumference (hazard ratios 1.7 (95% confidence interval 1.1-2.8) and
1.6 (95% confidence interval
1.-2.8), respectively). The proportion of mortality attributable to large waist circumference
among never smoking men was three-fold the proportion attributable to high BMI. Among never
smoking women and ex- and current smokers, categories of large body fatness did not predict
increased mortality. CONCLUSION: Among never smoking elderly men waist circumference may have
more potential for detecting overweight than the BMI."

--
Matti Narkia
 
Thu, 05 Feb 2004 12:06:35 GMT in article <[email protected]> Nigel
<I.don'[email protected]> wrote:

>Matti Narkia <[email protected]> wrote in news:[email protected]:
>
>> According to a recent study the risk for hypertension may be better identified by obesity defined
>> by higher waist circumference than higher BMI. The study is
>>
>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
>> between different measurements of obesity and the incidence of hypertension. Am J Hypertens. 2004
>> Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
>> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
>> ed&list_uids=14700512&dopt=Abstract>
>
>
>But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
>
I the study by Kalmijn et al. below BMI was found to be a poor predictor of all-cause mortality
(inverse association) for elderly Japanese-American men whereas waist-hip-ratio (WHR) was a much
better predictor (positively related to mortality):

Kalmijn S, Curb JD, Rodriguez BL, Yano K, Abbott RD. The association of body weight and
anthropometry with mortality in elderly men: the Honolulu Heart Program. Int J Obes Relat Metab
Disord. 1999 Apr;23(4):395-402. PMID: 10340818 [PubMed - indexed for MEDLINE] <URL:http://www.ncbi.-
nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10340818&dopt=Abstract>

"... CONCLUSIONS: In older men, BMI and skinfold thickness showed a consistent inverse
association with mortality, even after accounting for early mortality. The WHR, on the other
hand, was positively related to mortality, especially when BMI was high. Thus, excess abdominal
fat mass (FM) warrants closer concern than being overweight, in terms of affecting mortality in
the elderly."

--
Matti Narkia
 
On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote
(in message <[email protected]>):

> Nigel wrote:
>
>> Matti Narkia <[email protected]> wrote in news:[email protected]:
>>
<snip>

>
> Correct.
>
>
> Servant to the humblest person in the universe,
>
> Andrew

Thanks for quoting all of this, Mr. Humble, just so that you could add "Correct". After all, it's
sooooo important for everyone to have your IMAX certified approval. What a puffed-up, pompous, self-
important jerk.

I'll be turning in several other "papers" for you to grade... be sure not to miss them :)

--
Steve

Who is the humblest person in the universe? According to Chung, God :) ROTFL! "I'm Humble!
Worship Me!"

Weeding the Lord's Vineyards Since 2003
 
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Matti Narkia wrote:

> Thu, 05 Feb 2004 12:06:35 GMT in article <[email protected]> Nigel
> <I.don'[email protected]> wrote:
>
> >Matti Narkia <[email protected]> wrote in news:[email protected]:
> >
> >> According to a recent study the risk for hypertension may be better identified by obesity
> >> defined by higher waist circumference than higher BMI. The study is
> >>
> >> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
> >> between different measurements of obesity and the incidence of hypertension. Am J Hypertens.
> >> 2004 Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
> >> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
> >> ed&list_uids=14700512&dopt=Abstract>
> >
> >
> >But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
> >
> I the study by Kalmijn et al. below BMI was found to be a poor predictor of all-cause mortality
> (inverse association) for elderly Japanese-American men whereas waist-hip-ratio (WHR) was a much
> better predictor (positively related to mortality):
>
> Kalmijn S, Curb JD, Rodriguez BL, Yano K, Abbott RD. The association of body weight and
> anthropometry with mortality in elderly men: the Honolulu Heart Program. Int J Obes Relat Metab
> Disord. 1999 Apr;23(4):395-402. PMID: 10340818 [PubMed - indexed for MEDLINE] <URL:http://www.ncb-
> i.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10340818&dopt=Abstract>
>
> "... CONCLUSIONS: In older men, BMI and skinfold thickness showed a consistent inverse
> association with mortality, even after accounting for early mortality. The WHR, on the other
> hand, was positively related to mortality, especially when BMI was high. Thus, excess
> abdominal fat mass (FM) warrants closer concern than being overweight, in terms of affecting
> mortality in the elderly."
>
> --
> Matti Narkia

Why are you interested in only elderly japanese men, Matti?

Here are some better studies, including one looking at women.

http://makeashorterlink.com/?X54D23F47

http://makeashorterlink.com/?I27D12F47

http://makeashorterlink.com/?U2AD42F47

Truth is simple.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147

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Matti Narkia wrote:
<blockquote TYPE=CITE>Thu, 05 Feb 2004 12:06:35 GMT in article
<br><[email protected]> Nigel
<br><I.don'[email protected]> wrote:
<p>>Matti Narkia <[email protected]> wrote in
<br>>news:[email protected]:
<br>>
<br>>> According to a recent study the risk for hypertension may be better
<br>>> identified by obesity defined by higher waist circumference than
<br>>> higher BMI. The study is
<br>>>
<br>>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers
F,
<br>>> Fuchs FD.
<br>>> Association between different measurements of obesity and the
<br>>> incidence of hypertension.
<br>>> Am J Hypertens. 2004 Jan;17(1):50-3.
<br>>> PMID: 14700512 [PubMed - in process]
<br>>> <URL:<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM</a>
<br>>> ed&list_uids=14700512&dopt=Abstract>
<br>>
<br>>
<br>>But BMI is still a quick and easy risk assessment for _all_cause_
<br>>mortality.
<br>>
<br>I the study by Kalmijn et al. below BMI was found to be a poor
predictor of
<br>all-cause mortality (inverse association) for elderly Japanese-American
men
<br>whereas waist-hip-ratio (WHR) was a much better predictor (positively
<br>related to mortality):
<p>Kalmijn S, Curb JD, Rodriguez BL, Yano K, Abbott RD.
<br>The association of body weight and anthropometry with mortality in
elderly
<br>men: the Honolulu Heart Program.
<br>Int J Obes Relat Metab Disord. 1999 Apr;23(4):395-402.
<br>PMID: 10340818 [PubMed - indexed for MEDLINE]
<br><URL:<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10340818&dopt=Abstract">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10340818&dopt=Abstract</a>>
<p> "... CONCLUSIONS: In older men, BMI and skinfold
<br> thickness showed a consistent inverse association
with
<br> mortality, even after accounting for early mortality.
<br> The WHR, on the other hand, was positively related
to
<br> mortality, especially when BMI was high. Thus, excess
<br> abdominal fat mass (FM) warrants closer concern
than
<br> being overweight, in terms of affecting mortality
in
<br> the elderly."
<p>--
<br>Matti Narkia</blockquote>

<p><br>Why are you interested in only elderly japanese men, Matti?
<p>Here are some better studies, including one looking at women.
<p><A HREF="http://makeashorterlink.com/?X54D23F47">http://makeashorterlink.com/?X54D23F47</A>
<p><A HREF="http://makeashorterlink.com/?I27D12F47">http://makeashorterlink.com/?I27D12F47</A>
<p><A HREF="http://makeashorterlink.com/?U2AD42F47">http://makeashorterlink.com/?U2AD42F47</A>
<br>
<p>Truth is simple.
<br>
<p>Servant to the humblest person in the universe,
<p>Andrew
<p>--
<br>Dr. Andrew B. Chung, MD/PhD
<br>Board-Certified Cardiologist
<br><A HREF="http://www.heartmdphd.com/">http://www.heartmdphd.com/</A>
<p>--
<br>Who is the humblest person in the universe?
<p><A HREF="http://makeashorterlink.com/?L21532147">http://makeashorterlink.com/?L21532147</A>
<br> </html>

--------------DCE3D3A24540F4E8705287F6--
 
On Thu, 5 Feb 2004 12:22:23 -0500, Matti Narkia wrote
(in message <[email protected]>):

> Thu, 05 Feb 2004 12:06:35 GMT in article <[email protected]> Nigel
> <I.don'[email protected]> wrote:
>
>> Matti Narkia <[email protected]> wrote in news:[email protected]:
>>
>>> According to a recent study the risk for hypertension may be better identified by obesity
>>> defined by higher waist circumference than higher BMI. The study is
>>>
>>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
>>> between different measurements of obesity and the incidence of hypertension. Am J Hypertens.
>>> 2004 Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
>>> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
>>> ed&list_uids=14700512&dopt=Abstract>
>>
> [snip]
>>
>> But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
>>
> According to Bigaard et al. below waist circumference for a given BMI is even better, and
> according to Visscher et al. below waist circumference is better than BMI among never smoking
> elderly men:
>
> Bigaard J, Tjonneland A, Thomsen BL, Overvad K, Heitmann BL, Sorensen TI. Waist circumference,
> BMI, smoking, and mortality in middle-aged men and women. Obes Res. 2003 Jul;11(7):895-903. PMID:
> 12855760 [PubMed - indexed for MEDLINE
> <URL:http://www.obesityresearch.org/cgi/content/abstract/11/7/895>
>
> "OBJECTIVE: Measurement of waist circumference alone as a proxy of abdominal fat mass has been
> suggested as a simple clinical alternative to BMI for detecting adults with possible health
> risks due to obesity. RESEARCH METHODS AND PROCEDURES: From 1993 to 1997, 27,178 men and
> 29,875 women, born in Denmark, 50 to 64 years of age, were recruited in the Danish prospective
> study Diet, Cancer and Health. By the end of the year 2000, 1465 deaths had occurred. We
> evaluated the relationship between waist circumference and BMI (simultaneously included in the
> model) and all-cause mortality. We used Cox regression models to estimate the mortality-rate
> ratios and to consider possible confounding from smoking. RESULTS: Waist circumference among
> both men and women showed a strong dose-response type of relationship with mortality when
> adjusted for BMI, whereas the low range of BMI was inversely associated with mortality when
> adjusted for waist circumference. A 10% larger waist circumference corresponded to a 1.48 (95%
> confidence interval: 1.36 to 1.61) times higher mortality over the whole range of waist
> circumference. The associations were independent of age and time since baseline examination.
> Restriction to never smokers showed a similar pattern, but a weakening of the associations.
> DISCUSSION: Despite the high correlation between waist circumference and BMI, the combination
> may be very relevant in clinical practice because waist circumference for given BMI was a
> strong predictor of all-cause mortality. The inverse association between BMI and mortality for
> given waist circumference was diminished in never smokers, particularly for high values of
> BMI."
>
>
> Katzmarzyk PT, Craig CL, Bouchard C. Adiposity, adipose tissue distribution and mortality rates in
> the Canada Fitness Survey follow-up study. Int J Obes Relat Metab Disord. 2002 Aug;26(8):1054-9.
> PMID: 12119570 [PubMed - indexed for MEDLINE]
>
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMe d&lis
> t_uids=11753597&dopt=Abstract>
>
> "OBJECTIVE: To compare body mass index (BMI), waist- hip ratio (WHR) and waist circumference
> as predictors of all-cause mortality among the elderly. DESIGN: Population-based cohort study;
> mean follow-up was 5.4
> y. SETTING: The Rotterdam Study. PARTICIPANTS: A total of 6296 men and women; baseline age 55-
> 102 y.

> compared between quintiles of BMI, WHR and waist circumference and between predefined
> categories of BMI and waist circumference, stratified for smoking category. RESULTS: High
> quintiles of waist circumference, but not high quintiles of BMI and WHR were related to
> increased mortality among never smoking men, without reaching statistical significance. Only
> the highest category of BMI (BMI>30 kg/m2) among never smoking men was related to increased
> mortality, compared to normal BMI (hazard ratio 2.6 (95% confidence interval: 1.3-5.3)). Waist
> circumference between 94 and 102 cm and waist circumference 102 cm and larger were related to
> increased mortality, compared to normal waist circumference (hazard ratios 1.7 (95% confidence
> interval 1.1-2.8) and 1.6 (95% confidence interval
> 1.-2.8), respectively). The proportion of mortality attributable to large waist circumference
> among never smoking men was three-fold the proportion attributable to high BMI. Among never
> smoking women and ex- and current smokers, categories of large body fatness did not predict
> increased mortality. CONCLUSION: Among never smoking elderly men waist circumference may
> have more potential for detecting overweight than the BMI."
>
>
> --
> Matti Narkia

Correct ;-)

--
Steve

Who is the humblest person in the universe? According to Chung, God :) ROTFL! "I'm Humble!
Worship Me!"

Weeding the Lord's Vineyards Since 2003
 
On Thu, 5 Feb 2004 13:11:25 -0500, Matti Narkia wrote
(in message <[email protected]>):

> Thu, 05 Feb 2004 12:06:35 GMT in article <[email protected]> Nigel
> <I.don'[email protected]> wrote:
>
>> Matti Narkia <[email protected]> wrote in news:[email protected]:
>>
>>> According to a recent study the risk for hypertension may be better identified by obesity
>>> defined by higher waist circumference than higher BMI. The study is
>>>
>>> Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, Albers F, Fuchs FD. Association
>>> between different measurements of obesity and the incidence of hypertension. Am J Hypertens.
>>> 2004 Jan;17(1):50-3. PMID: 14700512 [PubMed - in process]
>>> <URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubM
>>> ed&list_uids=14700512&dopt=Abstract>
>>
>>
>> But BMI is still a quick and easy risk assessment for _all_cause_ mortality.
>>
> I the study by Kalmijn et al. below BMI was found to be a poor predictor of all-cause mortality
> (inverse association) for elderly Japanese-American men whereas waist-hip-ratio (WHR) was a much
> better predictor (positively related to mortality):
>
> Kalmijn S, Curb JD, Rodriguez BL, Yano K, Abbott RD. The association of body weight and
> anthropometry with mortality in elderly men: the Honolulu Heart Program. Int J Obes Relat Metab
> Disord. 1999 Apr;23(4):395-402. PMID: 10340818 [PubMed - indexed for MEDLINE]
>
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMe d&lis
> t_uids=10340818&dopt=Abstract>
>
> "... CONCLUSIONS: In older men, BMI and skinfold thickness showed a consistent inverse
> association with mortality, even after accounting for early mortality. The WHR, on the other
> hand, was positively related to mortality, especially when BMI was high. Thus, excess
> abdominal fat mass (FM) warrants closer concern than being overweight, in terms of affecting
> mortality in the elderly."
>
>
> --
> Matti Narkia

Correct.

--
Steve

Who is the humblest person in the universe? According to Chung, God :) ROTFL! "I'm Humble!
Worship Me!"

Weeding the Lord's Vineyards Since 2003
 
Thu, 5 Feb 2004 13:34:39 -0500 in article
<[email protected]> Steve
<[email protected]> wrote:

>On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
><[email protected]>):
>
>> Nigel wrote:
>>
>>> Matti Narkia <[email protected]> wrote in news:[email protected]:
>>>
><snip>
>
>>
>> Correct.
>>
>>
>> Servant to the humblest person in the universe,
>>
>> Andrew
>
>Thanks for quoting all of this, Mr. Humble, just so that you could add "Correct". After all, it's
>sooooo important for everyone to have your IMAX certified approval. What a puffed-up, pompous, self-
>important jerk.
>
Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity as an
assesment of all-cause mortality is questionable at least for some fairly large subpopulations.

--
Matti Narkia
 
Steve wrote:

> On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
> <[email protected]>):
>
> > Nigel wrote:
> >
> >> Matti Narkia <[email protected]> wrote in news:[email protected]:
> >>
> <snip>
>
> >
> > Correct.
> >
> >
> > Servant to the humblest person in the universe,
> >
> > Andrew
>
> <hiss>

You poor guy.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147
 
Matti Narkia wrote:

> Thu, 5 Feb 2004 13:34:39 -0500 in article <[email protected]>
> Steve <[email protected]> wrote:
>
> >On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
> ><[email protected]>):
> >
> >> Nigel wrote:
> >>
> >>> Matti Narkia <[email protected]> wrote in news:[email protected]:
> >>>
> ><snip>
> >
> >>
> >> Correct.
> >>
> >>
> >> Servant to the humblest person in the universe,
> >>
> >> Andrew
> >
> ><hiss>
> >
> Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity as an
> assesment of all-cause mortality is questionable at least for some fairly large subpopulations.
>
> --
> Matti Narkia

I sense that Matti's BMI is 55.

Bad news for you Matti:

http://makeashorterlink.com/?X54D23F47

http://makeashorterlink.com/?I27D12F47

http://makeashorterlink.com/?U2AD42F47

Sorry :-(

Truth is simple.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147
 
Thu, 05 Feb 2004 13:59:10 -0500 in article
<[email protected]> "Dr. Andrew B. Chung, MD/PhD"
<[email protected]> wrote:

>Matti Narkia wrote:
>
>> Thu, 5 Feb 2004 13:34:39 -0500 in article <[email protected]>
>> Steve <[email protected]> wrote:
>>
>> >On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
>> ><[email protected]>):
>> >
>> >> Nigel wrote:
>> >>
>> >>> Matti Narkia <[email protected]> wrote in news:[email protected]:
>> >>>
>> ><snip>
>> >
>> >>
>> >> Correct.
>> >>
>> >>
>> >> Servant to the humblest person in the universe,
>> >>
>> >> Andrew
>> >
>> ><hiss>
>> >
>> Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity as
>> an assesment of all-cause mortality is questionable at least for some fairly large
>> subpopulations.
>>
>> --
>> Matti Narkia
>
>I sense that Matti's BMI is 55.
>
In that case you are totally senseless and perhaps also have memory impairment, because you can't
remember that I've repeatedly mentioned that unfortunately my BMI is only 20.2. I'd like to raise it
a bit, so I guess I have to start eating more and lifting some weights ;-).

--
Matti Narkia
 
Matti Narkia wrote:

> Thu, 05 Feb 2004 13:59:10 -0500 in article <[email protected]> "Dr. Andrew B.
> Chung, MD/PhD" <[email protected]> wrote:
>
> >Matti Narkia wrote:
> >
> >> Thu, 5 Feb 2004 13:34:39 -0500 in article <[email protected]>
> >> Steve <[email protected]> wrote:
> >>
> >> >On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
> >> ><[email protected]>):
> >> >
> >> >> Nigel wrote:
> >> >>
> >> >>> Matti Narkia <[email protected]> wrote in news:[email protected]:
> >> >>>
> >> ><snip>
> >> >
> >> >>
> >> >> Correct.
> >> >>
> >> >>
> >> >> Servant to the humblest person in the universe,
> >> >>
> >> >> Andrew
> >> >
> >> ><hiss>
> >> >
> >> Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity as
> >> an assesment of all-cause mortality is questionable at least for some fairly large
> >> subpopulations.
> >>
> >> --
> >> Matti Narkia
> >
> >I sense that Matti's BMI is 55.
> >
> In that case you are totally senseless and perhaps also have memory impairment, because you can't
> remember that I've repeatedly mentioned that unfortunately my BMI is only 20.2. I'd like to raise
> it a bit, so I guess I have to start eating more and lifting some weights ;-).
>
> --
> Matti Narkia

Should we really take you at your word for your BMI?

I have to wonder.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147
 
Matti Narkia wrote:
>

> >> >
> >> Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity as
> >> an assesment of all-cause mortality is questionable at least for some fairly large
> >> subpopulations.
> >>
> >> --
> >> Matti Narkia
> >
> >I sense that Matti's BMI is 55.
> >
> In that case you are totally senseless and perhaps also have memory impairment, because you can't
> remember that I've repeatedly mentioned that unfortunately my BMI is only 20.2. I'd like to raise
> it a bit, so I guess I have to start eating more and lifting some weights ;-).
>

Getting married could raise it to a cool 27 or more ;-) .

If you are already married, deal with the tape worm or quit smoking.

Amongst the humblest,
A.L.
 
Thu, 05 Feb 2004 14:28:53 -0500 in article
<[email protected]> "Dr. Andrew B. Chung, MD/PhD"
<[email protected]> wrote:

>Matti Narkia wrote:
>
>> Thu, 05 Feb 2004 13:59:10 -0500 in article <[email protected]> "Dr. Andrew B.
>> Chung, MD/PhD" <[email protected]> wrote:
>>
>> >Matti Narkia wrote:
>> >
>> >> Thu, 5 Feb 2004 13:34:39 -0500 in article
>> >> <[email protected]> Steve <[email protected]> wrote:
>> >>
>> >> >On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
>> >> ><[email protected]>):
>> >> >
>> >> >> Nigel wrote:
>> >> >>
>> >> >>> Matti Narkia <[email protected]> wrote in
>> >> >>> news:[email protected]:
>> >> >>>
>> >> ><snip>
>> >> >
>> >> >>
>> >> >> Correct.
>> >> >>
>> >> >>
>> >> >> Servant to the humblest person in the universe,
>> >> >>
>> >> >> Andrew
>> >> >
>> >> ><hiss>
>> >> >
>> >> Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity
>> >> as an assesment of all-cause mortality is questionable at least for some fairly large
>> >> subpopulations.
>> >>
>> >> --
>> >> Matti Narkia
>> >
>> >I sense that Matti's BMI is 55.
>> >
>> In that case you are totally senseless and perhaps also have memory impairment, because you can't
>> remember that I've repeatedly mentioned that unfortunately my BMI is only 20.2. I'd like to raise
>> it a bit, so I guess I have to start eating more and lifting some weights ;-).
>>
>> --
>> Matti Narkia
>
>Should we really take you at your word for your BMI?
>
Should we really take you at your word that you are a certain cardiologist in Atlanta?

--
Matti Narkia
 
Matti Narkia wrote:

> Thu, 05 Feb 2004 14:28:53 -0500 in article <[email protected]> "Dr. Andrew B.
> Chung, MD/PhD" <[email protected]> wrote:
>
> >Matti Narkia wrote:
> >
> >> Thu, 05 Feb 2004 13:59:10 -0500 in article <[email protected]> "Dr. Andrew B.
> >> Chung, MD/PhD" <[email protected]> wrote:
> >>
> >> >Matti Narkia wrote:
> >> >
> >> >> Thu, 5 Feb 2004 13:34:39 -0500 in article
> >> >> <[email protected]> Steve <[email protected]> wrote:
> >> >>
> >> >> >On Thu, 5 Feb 2004 10:00:02 -0500, Dr. Andrew B. Chung, MD/PhD wrote (in message
> >> >> ><[email protected]>):
> >> >> >
> >> >> >> Nigel wrote:
> >> >> >>
> >> >> >>> Matti Narkia <[email protected]> wrote in
> >> >> >>> news:[email protected]:
> >> >> >>>
> >> >> ><snip>
> >> >> >
> >> >> >>
> >> >> >> Correct.
> >> >> >>
> >> >> >>
> >> >> >> Servant to the humblest person in the universe,
> >> >> >>
> >> >> >> Andrew
> >> >> >
> >> >> ><hiss>
> >> >> >
> >> >> Funny thing is that Chung's comment "correct" was probably incorrect, because BMI's validity
> >> >> as an assesment of all-cause mortality is questionable at least for some fairly large
> >> >> subpopulations.
> >> >>
> >> >> --
> >> >> Matti Narkia
> >> >
> >> >I sense that Matti's BMI is 55.
> >> >
> >> In that case you are totally senseless and perhaps also have memory impairment, because you
> >> can't remember that I've repeatedly mentioned that unfortunately my BMI is only 20.2. I'd like
> >> to raise it a bit, so I guess I have to start eating more and lifting some weights ;-).
> >>
> >> --
> >> Matti Narkia
> >
> >Should we really take you at your word for your BMI?
> >

No?

>
> Should we really take you at your word that you are a certain cardiologist in Atlanta?
>

Yes.

Truth is simple.

Now, should we really believe you when you say that you don't work in a vitamin store?

Try to be truthful, Matti. You might like it :)

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147
 
Thu, 05 Feb 2004 14:39:10 -0500 in article
<[email protected]> "Dr. Andrew B. Chung, MD/PhD"
<[email protected]> wrote:

>Matti Narkia wrote:
>
>> Thu, 05 Feb 2004 14:28:53 -0500 in article <[email protected]> "Dr. Andrew B.
>> Chung, MD/PhD" <[email protected]> wrote:
>>
>> >Should we really take you at your word for your BMI?
>
>No?
>
Unlike you, I don't lie in the newsgroups. Partly, because it serves no useful purpose, IMHO, but
mostly, because I don't feel good about it.
>>
>> Should we really take you at your word that you are a certain cardiologist in Atlanta?
>
>Yes.
>
Prove it.
>
>Now, should we really believe you when you say that you don't work in a vitamin store?
>
See my first comment in this message.

Now, should we really believe you, when you say that you have hospital privileges? Try to be
truthful this time. In the long run it pays off.

--
Matti Narkia
 
Matti Narkia wrote:

> Thu, 05 Feb 2004 14:39:10 -0500 in article <[email protected]> "Dr. Andrew B.
> Chung, MD/PhD" <[email protected]> wrote:
>
> >Matti Narkia wrote:
> >
> >> Thu, 05 Feb 2004 14:28:53 -0500 in article <[email protected]> "Dr. Andrew B.
> >> Chung, MD/PhD" <[email protected]> wrote:
> >>
> >> >Should we really take you at your word for your BMI?
> >
> >No?
> >
> Unlike you, I don't lie in the newsgroups.

Prove that you don't lie by answering the question truthfully.

> Partly, because it serves no useful purpose, IMHO, but mostly, because I don't feel good about it.

Sounds like you haven't felt good in a while ;-)

>
> >>
> >> Should we really take you at your word that you are a certain cardiologist in Atlanta?
> >
> >Yes.
> >
> Prove it.
>

If I did, then you wouldn't need to take my word for it now would you?

Remember trying to be truthful?

Try it some time and maybe you will feel better ;-)

> >
> >Now, should we really believe you when you say that you don't work in a vitamin store?
> >
> See my first comment in this message.
>
> Now, should we really believe you, when you say that you have hospital privileges?

In truth, I haven't said one way or another here on Usenet :)

> Try to be truthful this time.

Always.

> In the long run it pays off.
>

It certainly does :)

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

--
Who is the humblest person in the universe?

http://makeashorterlink.com/?L21532147