Cited by 264Diabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Risk FactorsObesity, Physical Activity, Diet

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Waist-hip ratio is the dominant risk factor predicting cardiovascular death in Australia

Welborn, Timothy A, Dhaliwal, Satvinder S, Bennett, Stanley A·2003·Medical Journal of Australia

DOI 10.5694/j.1326-5377.2003.tb05704.x

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Abstract

OBJECTIVE: To evaluate clinical measures of obesity for their ability to predict death from cardiovascular disease (CVD) and coronary heart disease (CHD), in parallel with conventional cardiovascular risk factors. DESIGN, PARTICIPANTS AND SETTING: Cross-sectional analysis of an age- and sex-stratified sample of 9206 adults aged 20-69 years from Australian capital cities (1989 Australian Risk Factor Prevalence Survey). Blood pressure, fasting serum lipid levels, smoking, history of heart disease or diabetes, and obesity as measured by body mass index (BMI), waist circumference and waist-hip ratio were recorded. These data were linked with the National Death Index to determine causes of death of the 473 survey subjects who had died to 31 December 2000. MAIN OUTCOME MEASURES: Hazard ratios for the risk factors predicting CVD mortality and CHD mortality. RESULTS: Of the modifiable risk factors, obesity, as measured by waist-hip ratio, is a dominant, independent, predictive variable for CVD and CHD deaths in Australian men and women. Self-reported angina/myocardial infarction in both sexes, and cigarette smoking in women, are also independent risk factors. CONCLUSIONS: Obesity assessed by waist-hip ratio is a better predictor of CVD and CHD mortality than waist circumference, which, in turn, is a better predictor than BMI. The recognition of central obesity is clinically important, as lifestyle intervention is likely to provide significant health benefits.

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Authors: Welborn, T. A., Dhaliwal, S. S., & Bennett, S. A.
Affiliations: Sir Charles Gairdner Hospital (AU)
Curtin University (AU)
Australian Institute of Health and Welfare (AU)
ORCID: Welborn, Timothy A
Dhaliwal, Satvinder S
Venue: Medical Journal of Australia
Publisher: AMPCo
Published: 2003-12
Volume: 179
Issue: 11
Pages: 580-585
ISSN: 0025-729X (ISSN-L)
1326-5377
DOI: 10.5694/j.1326-5377.2003.tb05704.x
OpenAlex: W67916611
Cited by: 264
References: 28
Citations by year: 2026: 3 · 2025: 6 · 2024: 1 · 2023: 9 · 2022: 8 · 2021: 4 · 2020: 12 · 2019: 7 · 2018: 9 · 2017: 10 · 2016: 12 · 2015: 19 · 2014: 14 · 2013: 24 · 2012: 21
FWCI: 6.28
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
doi.wiley.com/10.1002/tdm_license_1.1 (tdm)
Locations: The Medical Journal of Australia (publishedVersion)
PubMed (publishedVersion)
Funders: Healthway
National Heart Foundation of Australia
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: waist-to-hip ratio, cardiovascular mortality, coronary heart disease mortality, obesity, abdominal obesity, waist circumference, body mass index, cardiovascular risk factors, cigarette smoking, angina pectoris, myocardial infarction, Australian adults
MeSH terms: Adult, Aged, Analysis of Variance, Australia, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Body Mass Index, Waist-Hip Ratio

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Waist-hip ratio is the dominant risk factor predicting cardiovascular death in Australia

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