n Cardiovascular Journal of Africa - Is the relationship of body mass index to severity of coronary artery disease different from that of waist-to-hip ratio and severity of coronary artery disease? Paradoxical findings : cardiovascular topic




Although for decades there has been controversy regarding the relationship between obesity and coronary artery disease (CAD), it has been assumed that high body mass index (BMI) is a risk factor for CAD. However, the findings of some recent studies were paradoxical.

The aim of this study was to find a relationship between high BMI and waist-to-hip ratio (WHR) with severity of CAD.
This study was a cross-sectional, prospective study where 414 patients with suspected coronary artery disease, in whom coronary angiography was performed, were enrolled. The mean ± SD of their ages was 61.2 ± 27.4 years (range 25-84), and 250 (60.4%) were male. Regarding cardiovascular risk factors, 113 (27.3%) patients had a history of diabetes mellitus (DM), 162 (39.1%) had hypercholesterolaemia, 238 (57.4%) had hypertension, 109 (26.3%) were current smokers and 24 (5.8%) had a family history of CAD. The mean ± SD of the patients' BMI was 26.04 ± 4.08 kg/m2 (range 16-39) and means ± SD of their WHR ranged from 0.951 ± 0.07 to 0.987 ± 0.05. The mean ± SD of the severity of CAD according to the SYNTAX and Duke scores were 17.7 ± 9.6 (range 0-64) and 3.2 ± 1.7 (range 0-12), respectively.
In this study, findings showed a negative correlation between the severity of CAD and BMI, according to both SYNTAX and Duke scores ( ≤ 0.001 and = 0.001, respectively). However, there was a positive correlation between WHR and severity of CAD, according to the Duke score ( = 0.03).
BMI had a negative correlation with the severity of CAD, but waist-to-hip ratio had a positive correlation with severity of CAD.


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