It is well known that obesity is a risk factor for coronary heart disease CHD) and mortality. Measured by waist-to-hip ratio (WHR), it is also related to increased risk of coronary artery disease. However, the relationship between obesity and ischaemic stroke has previously been unclear.

Dr Seung-Han Suk, from the Columbia University College of Physicians and Surgeons in New York, evaluated whether abdominal obesity was an independent risk factor for ischaemic stroke in a multi-ethnic community.

The researchers undertook a case-control study of 576 first ischaemic stroke patients who were matched by age, sex and race-ethnicity to 1,142 stroke-free control subjects in their community.

All subjects were interviewed and had WHR measurements taken. Using simple and conditional logistic regression models for matched and case-control data, the researchers calculated the odds ratio (OR) and confidence intervals for gender-specific quartiles and gender-specific medians of WHR and ischaemic stroke. Odds ratios were adjusted for confounding factors.

The results clearly revealed a significant and independent association between ischaemic stroke and elevated WHR. Those with WHR equal to or greater than the median had an overall OR of 3.0 for ischaemic stroke, even after adjustment for other risk factors and BMI.

The association between WHR and ischaemic stroke was true for men, women, all race-ethnic groups and those with and without large artery atherosclerotic stroke.

Dr Suk, the principal investigator, says, “[Abdominal obesity] is a stronger risk factor than BMI and has a greater effect among younger people.” And he adds, “Prevention of obesity and weight reduction need greater emphasis in stroke prevention programs.”

Reference: Suk et al, Stroke 2003; 34:1586-1592

© HMG Worldwide 2003
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