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The risk of general and abdominal adiposity in the occurrence of new vascular events and mortality in patients with various manifestations of vascular disease

International Journal of Obesity volume 36, pages 695–702 (2012)Cite this article

Abstract

Aims:

Adiposity is associated with an increased but also with a decreased risk for successive vascular events or mortality in patients with different manifestations of vascular disease. In this study we directly compare the risk of general adiposity or abdominal obesity on the occurrence of new vascular events or mortality in these patients.

Methods:

Patients with cerebrovascular disease (CVD; n=973), coronary artery disease (CAD; n=2339) or peripheral arterial disease (PAD; n=894) were prospectively followed for the occurrence of a vascular event or death. The median follow-up was 4.5 years. Adiposity was assessed with body mass index (BMI), waist circumference (WC) and determination of intra-abdominal fat through ultrasound. Cox proportional hazards models were used to evaluate the risk for new vascular events, vascular mortality and all-cause mortality.

Results:

CAD patients had a 12% increased risk for vascular mortality with 1 BMI unit increase (hazard ratio (HR) 1.12; 95% confidence interval (CI) 1.05–1.20) and a 25% increased risk with 1cm increase in intra-abdominal adipose tissue (HR 1.25; 95% CI 1.12–1.39). The risk for all-cause mortality was increased by 3% (HR 1.03; 95% CI 1.01–1.05) with 1 cm increase in WC and was increased by 15% (HR 1.15; 95% CI 1.06–1.25) with 1 cm increase in intra-abdominal adipose tissue. In PAD patients there was an inverse relationship between BMI and vascular mortality (HR 0.93; 95% CI 0.87–0.98) and all-cause mortality (HR 0.90; 95% CI 0.86–0.94). In CVD patients there was no relation between obesity and vascular events or mortality.

Conclusion:

General adiposity is associated with an increased risk for vascular mortality in CAD patients and a decreased risk for (vascular) mortality in PAD patients.

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Acknowledgements

This work was financially supported by the UMC Utrecht Vascular Prevention Project. We gratefully acknowledge the members of the SMART Study Group of UMC Utrecht: PA Doevendans, MD, PhD, Department of Cardiology; A Algra, MD, PhD; Y van der Graaf, MD, PhD; DE Grobbee, MD, PhD; GEHM Rutten, MD, PhD, Julius Center for Health Sciences and Primary Care; LJ Kappelle, MD, PhD, Department of Neurology; WPTM Mali, MD, PhD, Department of Radiology; FL Moll, MD, PhD, Department of Vascular Surgery; FLJ Visseren, MD, PhD, Department of Vascular Medicine.

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Authors and Affiliations

  1. Department of Vascular Medicine, University Medical Center Utrecht (UMC Utrecht), Utrecht, The Netherlands

    D A Kanhai & F L J Visseren

  2. Department of Neurology, UMC Utrecht, Utrecht, The Netherlands

    L J Kappelle

  3. Rudolf Magnus Institute of Neuroscience, UMC Utrecht, Utrecht, The Netherlands

    L J Kappelle

  4. Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands

    Y van der Graaf & C S P M Uiterwaal

Authors
  1. D A Kanhai
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  2. L J Kappelle
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  3. Y van der Graaf
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  4. C S P M Uiterwaal
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  5. F L J Visseren
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for the SMART Study Group

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Correspondence to F L J Visseren.

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The authors declare no conflict of interest.

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Kanhai, D., Kappelle, L., van der Graaf, Y. et al. The risk of general and abdominal adiposity in the occurrence of new vascular events and mortality in patients with various manifestations of vascular disease. Int J Obes 36, 695–702 (2012). https://doi.org/10.1038/ijo.2011.115

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