Waist-lipid test spots CHD risk other checks miss

Even in the absence of traditional risk factors, people with large waistlines and high blood lipid levels may be at greater risk of heart disease, a study suggests.

Researchers say phenotype could be a useful addition to existing tools (Photograph: SPL)
Researchers say phenotype could be a useful addition to existing tools (Photograph: SPL)

Researchers suggest these characteristics, known as the hypertriglyceridaemic-waist phenotype, should be added to the Framingham risk score to improve accuracy.

The team, led by Dr Benoit Arsenault from the Quebec Heart and Lung Institute, Canada, found patients who had a combination of larger waistlines and high triglyceride levels were at an increased risk of developing CHD.

This raised risk was found even in those without any evidence of established risk factors for the disease.

Researchers examined whether the phenotype, which had previously been proposed as a marker of metabolic abnormalities, could help predict cardiovascular risk.

They screened 21,787 patients for waist size and triglyceride levels and followed them up for 10 years.

The phenotype was defined as a waistline of at least 90cm (35.4 inches), with a triglyceride level of 2mmol/L or more.

Researchers found that 2,109 patients developed CHD. Men with the phenotype were 2.4 times more likely to suffer CHD.

Women with the phenotype were 3.84 times more likely to have CHD after 10 years.

The authors concluded: 'Among individuals classified at low CHD risk based on the absence of traditional risk factors, the presence of the hypertriglyceridaemic waist is predictive of a substantially increased risk of CHD.'

Dr Arsenault and colleagues said that screening for the phenotype would be a low cost and effective way of identifying patients with excess intra-abdominal adiposity and associated metabolic abnormalities, who may be at increased risk of CHD.

They added that, although the hypertriglyceridaemic-waist phenotype could not be used on its own to assess patients' CHD risk, it could prove to be a useful addition to existing risk assessment tools such as the Framingham score.

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