Coronary heart disease and cardiac arrests are more common among obese patients than among those of normal weight. The risk due to obesity can be explained not only by associated cardiovascular risk factors, but also by body fat mass and the amount of intra-abdominal fat.
Obese people are at particular risk of developing coronary heart disease (CHD). This has been explained by the frequent occurrence of cardiovascular risk factors. Since it has been shown on many occasions that an increase in body fat alone, assessed according to BMI, increases the risk of CHD, this begs this question whether intra-abdominal (visceral fat) also leads to CHD and heart attacks.
The Physicians´ Health Study reported [Hennekens et al. 1996] on a group of 16,164 doctors between the age of 40 and 84. When they entered the study there was no known incidence of CHD, stroke or neoplasia. Height and weight were measured together with waist and hip circumferences.
Over an observation period of 3.9 years, 552 doctors developed CHD. The following results were obtained after adjustments had been made for age, smoking, alcohol consumption and family history of CHD:
This large, and in terms of data collection, reliable group of doctors shows again that obesity – even without other metabolic diseases - is a cardiovascular risk factor that needs to be taken seriously. If these results are compared with those of studies involving women there are interesting differences:
Among women, and in particular younger women, visceral fat mass represents a greater and more independent risk factor than among men. Depending on the respective study, they are between 2.6 and 8.2 times more likely to develop CHD if their waist circumference increases.