Abstract Details

Title Abdominal Obesity Predicts Stroke Risk in the Framingham Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S40 - Stroke Risk Factors and Epidemiology (3:41 PM-3:52 PM)

Poster/Presentation
Number 002

Background Previous studies have suggested that measurement of abdominal fat, such as waist circumference (WC) and waist-to-hip ratio (WHR), more accurately predict risk of stroke than body mass index (BMI).

Objective We assessed the risk of ischemic stroke associated with body mass index, waist circumference, and waist-to-hip ratio in a community sample.

Design/Methods We pooled Framingham Heart Study (FHS) participant data from FHS clinic examinations for the Original cohort (Exam 21, date range 1988-1992) and Offspring cohort (Exam 4, 1987-1991, and Exam 7, 1998-2001). Offspring participants who did not have stroke at the end of the first 10-year observation period could contribute data to the subsequent observation period. We included stroke-free participants 45 years of age or older who obtained measurements of BMI (kg/m²) and both waist and hip circumference (cm). Multivariable Cox proportional hazards regression models were used to separately relate BMI, WC, and WHR to risk of incident ischemic stroke over 10 years.

Results We analyzed data from 6,533 observation periods (mean age of participants 62±10 years, 54% female) with mean follow up time of 9.2 ±2 years. There were 240 (3.7%) incident ischemic stroke events. Each of the three body weight measurements was associated with increased stroke risk in models that adjusted for age and sex: BMI, HR 1.17 (95% CI 1.04-1.32); WC, HR 1.24 (95% CI 1.10-1.40); and WHR, HR 1.30 (95% CI 1.13-1.51). In full models, additionally adjusting for vascular risk factors that are more frequent in obese persons, only WHR predicted risk of ischemic stroke. The hazard ratio (HR) per standard deviation increase in waist-to-hip ratio was 1.18, 95% CI 1.02-1.37, p=0.030.

Conclusions Higher WHR predicted 10-year risk of ischemic stroke. WHR is a simple measure of abdominal obesity that should be used in future studies investigating weight loss interventions for stroke prevention.

Authors/Disclosures
Hugo Javier Aparicio, MD, MPH (Boston University) PRESENTER	Dr. Aparicio has received research support from ��ɫ��. Dr. Aparicio has received research support from Alzheimer's Association. Dr. Aparicio has received research support from National Institutes of Health. Dr. Aparicio has received personal compensation in the range of $10,000-$49,999 for serving as a expert panelist for the Memory & Healthy Aging Program with Cedars-Sinai.
	No disclosure on file
Jayandra Himali	Jayandra Himali has nothing to disclose.
Matthew Pase, PhD (Monash University)	Dr. Pase has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Alzheimer's Disease Drug Discovery Foundation.
Claudia L. Satizabal, PhD (UT Health San Antonio)	The institution of Dr. Satizabal has received research support from NIH and TARCC.
	No disclosure on file
Vasileios-Arsenios Lioutas, MD (Beth Israel Deaconess Medical Center, Department of Neurology)	Dr. Lioutas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Qmetis. Dr. Lioutas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mindray. The institution of Dr. Lioutas has received research support from NIH. The institution of Dr. Lioutas has received research support from Alzheimer's Association.
Jose R. Romero, MD (Boston University School of Medicine - Boston Medical Center)	The institution of Dr. Romero has received research support from NIH/NIA.
	No disclosure on file
Alexa Beiser	Alexa Beiser has nothing to disclose.
Sudha Seshadri, MD, FAAN (Glenn Biggs Institute for Alzheimer'S and Neurodegenerative Diseases)	Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Seshadri has received research support from NIH. The institution of Dr. Seshadri has received research support from Alzheimer Association.

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