Magazine article Clinical Psychiatry News

Waist Size Is a Vital Sign of Hypertension Risk

Magazine article Clinical Psychiatry News

Waist Size Is a Vital Sign of Hypertension Risk

Article excerpt

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. Debo- rah 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 NIH guidelines include a lessthan-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 risk in patients who have 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.

"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," Dr. Levine said.

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

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