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Clinical Summary

Increasing BMI, waist-to-hip ratio may up cardiac death risk

Takeaway

  • This meta-analysis suggests that the risk for sudden cardiac arrest may increase with increasing BMI and waist-to-hip ratio.

Why this matters

  • The finding has clinical and public health implications because of increasing prevalence of overweight and obesity worldwide.

Key results

  • A total of 3376 cases were included among 406,079 participants.
  • The relative risk (RR) for cardiac arrest increased by 16% per 5 units increase in BMI (RR, 1.16; Pheterogeniety<.0001), whereas it was 82% increase per 0.1 unit increase in waist-to-hip ratio (RR, 1.82; Pheterogeniety= .77).
  • The summary RR was 1.03 per 10 cm increase in waist circumference (2 studies; Pheterogeniety=.54).
  • A non-linear J-shaped association was seen between BMI and sudden cardiac death (Pnon-linearity<.0001), with a slight increase in risk in the underweight categories.
  • The risk increased by 14%, 60% and 2-3 fold in the overweight, obese and severely obese categories, respectively.
  • The association was stronger among studies with <10 years follow-up vs ≥10 years follow-up.

Study design

  • Systematic review and meta-analysis of 14 prospective studies evaluating the association between adiposity and risk for sudden cardiac death.
  • Funding: Imperial College National Institute of Health Research.

Limitations

  • Confounding by other risk factors may have influenced the results.
  • Heterogeneity among included studies.

References


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