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Risk Assessment: Metabolic Syndrome and Diabetes

Waist Circumference and BMI Are Both Independently Associated with CVD: The International Day for the Evaluation of Abdominal Obesity (IDEA) Survey

Steven M. Haffner, MD, Professor of Medicine, University of Texas Health Science Center, Member, IDEA Study Executive Committee

The IDEA study confirms the importance of waist-circumference measures (in addition to body mass index (BMI), blood pressure, blood glucose, and lipid levels) in identifying patients in a primary-care setting who are at increased cardiometabolic risk.

The IDEA study involved more than 6,000 primary-care physicians in 63 countries worldwide (the United States declined to participate). An unselected population made up of 177,345 patients aged 18 to 80 years who consulted their primary-care physicians for any reason on 2 prespecified days were enrolled in the study. In addition to waist circumference, height, and body weight, data were collected on presence or absence of classic cardiovascular disease (CVD) risk factors (eg, hypertension, diabetes, dyslipidemia, and smoking status) and existing CVD (coronary heart disease, stroke, or prior revascularization).

The prevalence of overweight (BMI = 25-30 kg/m2) did not differ regionally, but was consistently higher in men than in women. In contrast, there were large differences in the prevalence of obesity (BMI ≥30 kg/m2) among countries. The prevalence of obesity was highest in Canadian and Middle Eastern countries, and lowest in Asia. Waist circumference in both men and women was lowest in East Asia and highest in South Africa, the Middle East, and Eastern Europe.

Both waist circumference and BMI were independently associated with the presence of CVD. Each increase in waist circumference of 14 cm for men and 14.9 cm for women increased the likelihood of CVD between 21% and 40%. When adjusted for BMI, waist circumference was an even stronger predictor of CVD, particularly in men. Across all regions, in both women and men, both waist circumference and BMI were significant predictors of CVD. This was true in countries in East Asia—China, Hong Kong, Taiwan—where the population is relatively lean.

The International Study of Prediction of Intra-Abdominal Adiposity and its Relationship with Cardiometabolic Risk/Intra Abdominal Adiposity will examine the relationship between cardiometabolic risk markers and intra-abdominal adiposity (as measured by computed tomography).

This website is sponsored by The University of Kansas School of Medicine-Wichita. The University of Kansas School of Medicine-Wichita is accredited by the ACCME to provide continuing medical education for physicians.


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		ACC Symposium: Risk Assessment:

Overview Risk Assessment: Metabolic Syndrome and Diabetes	Metabolic Syndrome and Diabetes Print Version March 14, 2006 *Atlanta, GA* Risk Assessment: Metabolic Syndrome and Diabetes *Waist Circumference and BMI Are Both Independently Associated with CVD: The International Day for the Evaluation of Abdominal Obesity (IDEA) Survey* Steven M. Haffner, MD, Professor of Medicine, University of Texas Health Science Center, Member, IDEA Study Executive Committee The IDEA study confirms the importance of waist-circumference measures (in addition to body mass index (BMI), blood pressure, blood glucose, and lipid levels) in identifying patients in a primary-care setting who are at increased cardiometabolic risk. The IDEA study involved more than 6,000 primary-care physicians in 63 countries worldwide (the United States declined to participate). An unselected population made up of 177,345 patients aged 18 to 80 years who consulted their primary-care physicians for any reason on 2 prespecified days were enrolled in the study. In addition to waist circumference, height, and body weight, data were collected on presence or absence of classic cardiovascular disease (CVD) risk factors (eg, hypertension, diabetes, dyslipidemia, and smoking status) and existing CVD (coronary heart disease, stroke, or prior revascularization). The prevalence of overweight (BMI = 25-30 kg/m2) did not differ regionally, but was consistently higher in men than in women. In contrast, there were large differences in the prevalence of obesity (BMI ≥30 kg/m2) among countries. The prevalence of obesity was highest in Canadian and Middle Eastern countries, and lowest in Asia. Waist circumference in both men and women was lowest in East Asia and highest in South Africa, the Middle East, and Eastern Europe. Both waist circumference and BMI were independently associated with the presence of CVD. Each increase in waist circumference of 14 cm for men and 14.9 cm for women increased the likelihood of CVD between 21% and 40%. When adjusted for BMI, waist circumference was an even stronger predictor of CVD, particularly in men. Across all regions, in both women and men, both waist circumference and BMI were significant predictors of CVD. This was true in countries in East Asia—China, Hong Kong, Taiwan—where the population is relatively lean. The International Study of Prediction of Intra-Abdominal Adiposity and its Relationship with Cardiometabolic Risk/Intra Abdominal Adiposity will examine the relationship between cardiometabolic risk markers and intra-abdominal adiposity (as measured by computed tomography).

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