American Heart Association Comment: Abdominal Adiposity And Coronary Heart Disease In Women

December 01, 1998

A paper published in the December 2nd issue of the Journal of the American Medical Association reports that women with a waist-to-hip ratio of 0.88 were 3.25 times more likely to have coronary heart disease, the cause of heart attacks, than women with a waist-to-hip ratio of 0.72.

To calculate a person's waist-to-hip ratio, the waist measure (at its narrowest) is divided by the hip measurement (at its widest). According to the American Heart Association, a man's risk of developing obesity-related complications is lower if the number is less than 0.95 for men and 0.8 for women. People who have a tendency to accumulate weight around their waistline are sometimes referred to as "apples," compared to people who accumulate fat around their buttocks and thighs, who are called "pears."

"This study confirms the American Heart Association's viewpoint that obesity is a serious risk factor for coronary heart disease," says Robert H. Eckel, M.D., chairman of the American Heart Association's Nutrition Committee and professor of medicine and physiology at the University of Colorado Health Sciences Center.

"However, in this study it should be noted that thinner people -- with a body mass index (BMI) less than 25 -- were also at increased relative risk for coronary heart disease when their waist circumference was greater than 30 inches," says Eckel. "It is still too soon to be absolutely certain that body fat distribution is a risk factor for coronary heart disease in patients who are not heavy."

BMI is a measure of excess body weight. BMI is defined as weight in kilograms divided by height in meters squared. A BMI between 25 and 30 is considered overweight. For a 5'5" woman, a BMI of 25 is equal to 150 pounds.

"In some individuals, increasing weight can be associated with an increased waist circumference. People with that shape of body fat distribution appear to be at an enhanced risk for coronary heart disease. In addition, when other risk factors for coronary heart disease are present, such as high blood pressure or high blood cholesterol, more aggressive treatment should be considered," says Eckel.

In 1997, the American Heart Association issued a scientific position paper titled, "Obesity and Heart Disease," (Circulation, November 4, 1997). Last June, the American Heart Association issued a "Call to Action on Obesity" and elevated obesity to major risk factor status. Both documents are available on the organization's website at

For additional information please contact Darcy Spitz of the AHA's News Media Relations department at 212-878-5940.

American Heart Association

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