RELATION OF BODY-FAT DISTRIBUTION TO ISCHEMIC-HEART-DISEASE - THE NATIONAL-HEALTH AND NUTRITION EXAMINATION SURVEY-I (NHANES-I) EPIDEMIOLOGIC FOLLOW-UP-STUDY

Although an excess of adipose tissue in the abdominal and truncal regi ons is associated with various metabolic alterations, relatively few c ohort studies have examined its importance in the development of ische mic heart disease, and little information is available from black popu lations. The authors examined the relation of central obesity, as char acterized by a thick subscapular skinfold relative to the triceps skin fold, to the incidence of ischemic heart disease among 9,822 persons i n the Epidemiologic Follow-up Study of the National Health and Nutriti on Examination Survey 1; baseline data were collected in 1971-1975 and follow-up was through 1987. We found that, independently of relative weight, cigarette smoking, and other covariates, the hazard rate ratio s for ischemic heart disease incidence contrasting the upper and lower quintiles of central obesity were 1.75 (95% confidence interval 1.3-2 .3) among women and 1.85 (95% confidence interval 1.3-2.2) among men. Although central obesity was related similarly to disease among white and black men, the association among women differed between whites (ra te ratio = 1.94) and blacks (rate ratio = 0.73); p = 0.002 for race x the central obesity product term. Additional research is needed to cla rify the relation of various anthropometric measurements to ischemic h eart disease, particularly among blacks, but the assessment of fat dis tribution may help identify high-risk persons for whom weight loss mig ht be most beneficial.