Technology The more fat in the waist, the greater the...

The more fat in the waist, the greater the risk of having a second heart attack

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Survivors of excess fat infarction around the waist have a higher risk of having another heart attack, according to research published in the “European Journal of Preventive Cardiology”
.

It was already known that abdominal obesity is an important risk factor for having a first heart attack. But until now the association between abdominal obesity and the risk of a heart attack or subsequent stroke was unknown.

“Patients generally receive a strict medical treatment regimen after their first attack to prevent second events (secondary prevention),” explains study author Hanieh Mohammadi of the Karolinska Institute (Sweden).

«Secondary prevention is based on the reduction of associated risk factors, such as blood sugar, cholesterol and blood pressure. Until now it was unknown if abdominal obesity is a risk factor for recurrent events among patients receiving secondary prevention treatments ».

The largest study on this topic controlled more than 22,000 patients after their first heart attack and investigated the relationship between abdominal obesity (measured by waist circumference) and the risk of recurrent cardiovascular disease events.

Waist circumference was a more important marker of recurring events than general obesity.

The researchers specifically looked at events caused by clogged arteries, such as a fatal and non-fatal heart attack and stroke. Patients were recruited from the national SWEDEHEART registry and followed for a median of 3.8 years.

The majority of patients, 78% of men and 90% of women, had abdominal obesity (waist circumference of 94 cm or more for men and 80 cm or more for women).

Increased abdominal obesity was independently associated with heart attacks and fatal and non-fatal strokes, regardless of other risk factors (such as smoking, diabetes, hypertension, blood pressure, blood lipids and body mass index). [IMC]) and secondary prevention treatments. Waist circumference was a more important marker of recurring events than general obesity.

Waist circumference was a more important marker of recurring events than general obesity.

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 Mohammadi explains that “the reason why the
 abdominal obesity
 It is very common in patients with a first heart attack is that it is closely related to

 conditions that accelerate the obstruction of the arteries through atherosclerosis. These include increased blood pressure, high blood sugar levels and diabetes, as well as elevated blood lipid levels.

“Our results, however, suggest that there may be other negative mechanisms associated with abdominal obesity that are independent of these risk factors and are not recognized,” he adds.

«In our study, patients with increasing levels of abdominal obesity still had a higher risk of recurrent events despite being on therapies that reduce traditional risk factors related to abdominal obesity, such as antihypertensives, diabetes medications and lipid-lowering medications ».

This was the first study of this kind to analyze men and women together and separately. The relationship between waist circumference and recurring events was stronger and more linear in men. In women, the U-shaped relationship, which means that the mid-range waist circumference (rather than the lower one) was the least risky. It should be noted that the mid-range waist circumference for women included in the study was higher than the limit traditionally recognized for abdominal obesity (80 cm).

Regarding the possible reasons for the different results between sexes, he clarifies that “some studies have suggested that abdominal obesity may be more directly associated with the evil visceral fat (fat that is around the organs) in men compared to women. In women it is believed that a larger portion of abdominal fat is constituted by subcutaneous fat that is relatively harmless.

Abdominal obesity can be addressed with a healthy and balanced diet and regular physical activity

And concludes; «Abdominal obesity not only increases the risk of a first heart attack or stroke, but also the risk of recurring events after the first event».

The authors recommend using waist circumference in clinical settings to identify patients with heart attack for the first time with a higher risk of recurrent events. .

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