Abdominal obesity may boost heart failure risk
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Older adults who carry their fat around the middle may be at risk of chronic heart failure, even in the absence of other serious health conditions, research suggests.
In a study of more than 2,400 older men and women, researchers found that those with large waistlines were at increased risk of chronic heart failure - regardless of whether they had major risk factors like high blood pressure, diabetes or a history of heart attack.
The findings suggest that excessive abdominal fat, in and of itself, can contribute to heart failure, according to the investigators, led by Dr. Barbara J. Nicklas of Wake Forest University School of Medicine in Winston-Salem, North Carolina.
The study also adds to evidence that, when it comes to the health consequences of excess pounds, the location of a person’s body fat matters more than overall weight.
Past studies have found that “apple-shaped” people appear to be at particular risk of clogged arteries, high blood pressure and diabetes.
In turn, all of those diseases can lead to heart failure, a chronic condition in which the heart can’t pump blood efficiently enough to meet the body’s needs, resulting in symptoms like fatigue, breathlessness and fluid build-up.
The current study appears to be the first to find that otherwise healthy, heart-disease-free adults may be at risk of heart failure due to abdominal obesity alone.
For their study, published in the Journal of the American Geriatrics Society, Nicklas and colleagues followed 2,435 men and women in their 70s for about 6 years. All were free of heart disease at the outset.
By the end of the study, 166 participants had developed heart failure, and the risk of the disease climbed in tandem with waistline measurements.
Men and women with “high-risk” waistlines - 35 inches or more for women, and at least 40 inches for men - were nearly twice as likely to develop heart failure as those who were trimmer around the middle.
In contrast, the researchers found, body mass index (BMI), a measure of weight in relation to height, was not a good predictor of heart failure once waist circumference was taken into account.
Abdominal fat, according to Nicklas and her colleagues, may contribute to heart failure in several ways, including through increased pressure within the abdominal cavity. Abdominal obesity may also lead to an enlargement of the heart’s main pumping chamber, or to stiffness in the aorta, the major artery supplying blood to the rest of the body, they note.
Coupled with past studies, the researchers conclude, the findings suggest that excess fat - particularly in the abdomen - should be added to the list of risk factors for heart failure.
SOURCE: Journal of the American Geriatrics Society, March 2006.
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