Prospective study of body size and risk for stroke amongst women below age 60

Abstract

The relation between obesity, particularly abdominal obesity, and risk of stroke amongst women remains unclear. In 1991-1992, a prospective study was initiated in Sweden amongst women who returned a self-administered questionnaire. Through linkage with nation-wide registries, 45 449 women, free of stroke at entry, were followed up until diagnosis of first incident stroke, death, or the end of follow-up in 2002. We estimated multivariate relative risks (RRs) with 95% confidence intervals (CIs) from Cox proportional hazards regression models. A total of 170 incident stroke cases occurred during an average of 11 years of follow-up. The RR of stroke amongst women in the highest compared with the lowest quintile was 2.4 (95% CI 1.3-4.2; P for trend 0.04) for waist-to-hip ratio, 2.5 (95% CI 1.5-4.3; P for trend 0.01) for waist-to-height ratio and 2.3 (95% CI 1.2-4.3; P for trend 0.02) for waist circumference. Adjustment for hypertension and diabetes attenuated these risk estimates. In contrast, birth weight, body mass index (BMI) at age 18, BMI at entry, weight change in adulthood and adult height were not significantly associated with risk of stroke. This study provides evidence that, in contrast to BMI, several different measures of abdominal obesity are strong predictors of stroke in women.

A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value

“…In women (30) Before, but not after adjustment for history of hypertension and diabetes (38) Hypertension, SBP and DBP…”

“…In men (29,32,36) and women (29,31,34,36) Not in whole population or non-hypertensive men and women (33) , for obstructive CAD, all adverse events, major adverse events or all-cause mortality (37) All stroke 2/2 In women (38) and in women before and after adjustment for BMI (30) 2/2…”

Contribution of Obesity and Abdominal Fat Mass to Risk of Stroke and Transient Ischemic Attacks

“…Case-control studies-like the present one-in which obesity markers are measured closely to the time point of the vascular event 4,11 frequently show a stronger association between (abdominal) obesity and risk for stroke/TIA compared to longitudinal studies. 10,12,14,25 Based on the study design, the predictive value of case-control studies may focus on a short-term perspective, the one of longitudinal studies more on a long-term prediction.…”

Diabetes, the Metabolic Syndrome, and Ischemic Stroke

“…Taken together, these studies suggest that obesity-in particular, abdominal obesity-is a significant risk factor for ischemic stroke (81). Regardless, the impact that obesity has on the risk of diabetes, CAD, hypertension, and hyperlipidemia will confound studies that address the risk of stroke (71).…”