Waist-to-hip ratio (WHR) is a better predictor for sudden cardiac death than body mass index (BMI) or waist circumference (WC), suggests an analysis of the Atherosclerosis Risk in Communities (ARIC) cohort.

The study also showed that obese individuals with a larger WHR are at a greater risk for sudden cardiac death than those with a smaller WHR.

The findings were presented at the Heart Rhythm Society 2012 Scientific Sessions in Boston, Massachusetts, US.

The team, led by Selcuk Adabag from the University of Minnesota, US, used data from ARIC to examine the association between BMI, WHR, and WC with sudden cardiac death.

A total of 15,156 individuals were included in the study. The mean age of the participants was 54 years and 55% were female.

During 12.6 years of follow-up, 301 sudden cardiac deaths were reported.

BMI, WHR, and WC were all positively associated with sudden cardiac death after adjusting for age, gender, race, study center, education level, smoking status, and family history of coronary heart disease.

After further adjustment for diabetes, low-density lipoprotein cholesterol, hypertension, prevalent coronary heart disease, heart failure, and left ventricular hypertrophy, only WHR was significantly associated with sudden cardiac death.

Specifically, men and women in the highest WHR quintiles (≥1.01 and 0.97, respectively) were 40% more likely to experience sudden cardiac death than those in the lowest WHR quintiles (<0.92 and 0.82, respectively).

“The significance of this study is that it shows that abdominal obesity is an independent risk factor for sudden cardiac death even after accounting for factors such as diabetes, hypertension, and coronary heart disease,” remarked Adabag. “Physicians should make obesity prevention and treatment a priority to reduce the risk of coronary disease as well as sudden cardiac death.”

By Nikki Withers