Waist Size Tied to Hypertension Risk.

http://internalmedicinenews.com/arti...04797/fulltext

COLORADO SPRINGS — Marginally increased waist circumference is
strongly associated with prevalent hypertension in normal-weight and
overweight adults, according to data from a large National Institute
of Neurological Disorders and Stroke-sponsored study.

The finding is likely to change both clinical practice and guidelines,
Dr. Deborah A. Levine predicted in reporting the results at a
conference of the American Heart Association.

“As a practicing general internist, I do not routinely measure waist
circumference as well as I should,” conceded Dr. Levine of Ohio State
University, Columbus. “And I certainly don't do it in persons with
normal [body mass index] at this time. But these data have prompted me
to reconsider that practice.”

Moreover, the new data indicate a need to revise current U.S.
guidelines regarding how waist circumference measurement is used as a
cardiovascular risk assessment tool.

Current National Institutes of Health guidelines include a less-than-
forceful recommendation to consider measuring waist circumference—a
guide to central adiposity—in individuals with normal BMIs. But the
new data presented by Dr. Levine indicate that waist circumference
measurement is a valuable indicator of cardiovascular risk in patients
with normal BMIs.

The U.S. guidelines define normal waist circumference as less than 80
cm in women and 94 cm in men, and elevated waist circumference as more
than 88 and 102 cm, respectively. The middle zone of marginally
elevated values—80–88 cm in women and 94–102 cm in men—is a gray area
that's largely disregarded by physicians and researchers alike. But
this needs to change, Dr. Levine said.

“Our data suggest that we should be treating waist circumference as a
continuous risk factor and not a categorical variable where the middle
category is actually ignored in practice and in studies,” she said.

In light of the new findings, she said, the current International
Diabetes Federation guidelines make far more sense.

In the IDF guidelines on metabolic syndrome, the group defines any
waist circumference that's above normal as elevated, period.

Dr. Levine presented an analysis of waist circumference and prevalent
hypertension in 21,351 black and white adult community-dwelling
participants in the Reasons for Geographic and Racial Differences in
Stroke (REGARDS) study, a population-based study whose primary goal is
to identify explanations for the excess stroke mortality in the so-
called “stroke belt” in the southeastern United States. The prevalence
of baseline hypertension was found to be 45% among the participants
with a normal body mass index, 56% in those who were overweight, and
66% in the subjects with class I obesity.

After adjustment for numerous demographic factors as well as for
alcohol and tobacco use, physical activity, and glomerular filtration
rate, a marginally increased waist circumference—that is, 80–88 cm in
women and 94–102 cm in men—was independently associated with a 58%
higher hypertension prevalence in normal-weight individuals and a 31%
higher hypertension prevalence in those who were overweight, compared
with the participants who had comparable BMI values but normal waist
circumference. An elevated waist circumference was associated with a
2.1-fold increased hypertension prevalence in normal-weight subjects,
a 1.6-fold increase in those who were overweight, and a 48% increase
in the REGARDS participants who were obese class I.

As the researchers expected, a marginally increased waist
circumference did not confer a significantly increased risk of
hypertension in obese subjects. It has been previously shown that
waist circumference has a diminished ability to independently predict
cardiovascular risk factors and morbidity in obese individuals.

*** end article excerpt ***

It remains much smarter to eat less, down to the right amount, to lose
the VAT (black fat), which increases waist size:

http://HeartMDPhD.com/BeSmart

Here again is a simple parable given in hopes of promoting much
greater understanding:

http://HeartMDPhD.com/Parable

Life in industrialized countries is essentially life in blessed feed
lots.

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http://HeartMDPhD.com/HolySpirit/Counsels