Abdominal Obesity Could Up Risk of Recurrent Heart Attacks

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Abdominal Obesity Could Up Risk of Recurrent Heart Attacks


This goes beyond
previous studies, which had shown that abdominal obesity increases the risk of
first-time heart attacks only.


The research
findings have been published in the European Journal of
Preventive Cardiology
which is the official journal of the European
Society of Cardiology.
 

“Patients are typically
put on a stringent medical treatment regimen after their first attack to
prevent second events (called secondary prevention),”
says lead author Dr.
Hanieh Mohammadi of the Karolinska Institute, Stockholm, Sweden. “Secondary prevention works through reducing
risk factors associated with a
heart attack and stroke such as high blood sugar,
lipids and blood
pressure
. It was previously unknown whether abdominal obesity is a
risk factor for recurrent events among patients on secondary prevention
treatments.”

Key Features of the Study

  • Largest study ever conducted on the relationship
    between abdominal obesity and the risk of
    recurrent heart attacks
  • 22,000 first-time heart attack patients
    were included in the study
  • Patients were recruited from the nationwide
    SWEDEHEART Registry – a representative cohort of the entire Swedish
    population
  • First study of its kind to analyze men and women
    together and separately
  • Abdominal obesity
    was measured by waist circumference (WC)
  • Cardiovascular events included fatal and non-fatal
    heart attacks and strokes
  • Median follow-up period was 3.8 years

Key Findings of the Study

  • 78 percent of men had abdominal obesity – WC ≥ 94
    cm
  • 90 percent of women had abdominal obesity – WC ≥ 80
    cm
  • Increasing abdominal obesity was independently
    associated with fatal and non-fatal heart attacks and strokes
  • The above association was independent of secondary
    preventive treatments, as well as the following risk factors:
  • WC was a better marker of recurrent cardiovascular
    events than overall obesity
  • Relationship between WC and recurrent
    cardiovascular events was stronger and more linear in the
    case of men
  • Relationship curve for WC and recurrent
    cardiovascular events was U-shaped in case of women,
    i.e. mid-range WC was less risky compared to the lowest WC
  • Mid-range WC for women was higher than the
    traditional cut-off for abdominal obesity (80 cm)

Mohammadi says: “The reason abdominal obesity is very common
in patients with a first heart attack is that it is closely linked with
conditions that accelerate the clogging of arteries through atherosclerosis. These conditions include
increased blood pressure high blood
sugar and insulin resistance (diabetes) as well as raised
blood lipid levels.”

“Our results, however, suggest that there may be other
negative mechanisms associated with abdominal obesity that are independent of
these risk factors and remain unrecognized,”
she adds. “In our study, patients with increasing
levels of abdominal obesity still had a raised risk for recurrent events
despite being on therapies that lower traditional risk factors connected with
abdominal obesity – such as anti-hypertensives, diabetes medication and lipid-lowering drugs.”

Reasons for Gender Differences in
Abdominal Obesity and Cardiovascular Events

The research team is of the opinion that gender differences in abdominal
obesity and propensity for cardiovascular events could arise from the fact that
fat distribution
in the body
varies between men and women. In men, abdominal
fat deposition
is higher around vital organs (visceral fat), which
can be harmful. However, in the case of women,
abdominal fat deposition is predominantly subcutaneous, which is relatively
harmless.

Limitations of the Study

The study included
3-times more men than women, which resulted in less statistical power in the
female group. Therefore, further studies are warranted in order to
unequivocally establish the accuracy of the data with reference to gender.

Concluding Remarks

Mohammadi
concludes: “Abdominal obesity not only
increases your risk for a first heart attack or stroke, but also the risk for
recurrent events after the first misfortune. Maintaining a healthy waist
circumference is important for preventing future heart attacks and strokes, regardless of how
many drugs you may be taking or how healthy your blood tests are. Abdominal
obesity can be tackled by eating a healthy and balanced diet and regular physical activity.

Recommendation

The research team
recommends that waist circumference should be used in clinical practice to
identify first-time heart attack patients who are likely to be at a higher risk
for further attacks.

Funding Source

The study was funded by the Janne Elgqvist Family
Foundation and the Serafimer
Laser Foundation, Sweden.

References :

  1. Abdominal Obesity and the Risk of Recurrent Atherosclerotic Cardiovascular Disease after Myocardial Infarction – (https://doi.org/10.1177/2047487319898019)
  2. Belly Fat Linked with Repeat Heart Attacks – (https://www.escardio.org/The-ESC/Press-Office/Press-releases/Belly-fat-linked-with-repeat-heart-attacks)

Source: Medindia

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