The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.


PHILADELPHIA — Increased waist-to-hip ratio is associated with a higher risk for ischemic stroke and may predict stroke risk more accurately than measures of body mass index (BMI), according to study results presented at the American Academy of Neurology 2019 Annual Meeting, held May 4 to 10, 2019 in Philadelphia, Pennsylvania.

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Prior research has suggested that measurements of abdominal fat may predict risk for stroke more accurately than BMI. In this study, researchers pooled data from the Framingham Heart Study’s original and offspring cohorts to investigate whether the risk for incident ischemic stroke over 10 years was associated with measures of BMI, waist circumference, or waist-to-hip ratio using Cox proportional hazard models. Offspring participants were included if they did not have a stroke at the end of the first 10-year observation period, were age ≥45 years, and had recorded measures of BMI and waist and hip circumference.

The participants (mean age, 62±10 years; 54% women) were followed for a mean of 9.2±2.0 years. A total of 240 incident ischemic stroke events (3.7%) were recorded in 6533 observation periods.

All 3 measurements of body weight were associated with an increased risk for stroke in minimally adjusted models (BMI: hazard ratio [HR], 1.17; 95% CI, 1.04-1.32; waist circumference: HR, 1.24; 95% CI, 1.10-1.40; waist-to-hip ratio: HR, 1.30; 95% CI, 1.13-1.51). However, in models adjusted for obesity-related vascular risk factors, only waist-to-hip ratio remained significantly associated with ischemic stroke risk (HR per standard deviation increase in waist-to-hip ratio, 1.18; 95% CI, 1.02-1.37; P =.03).

Based on these results, the investigators suggest using waist-to-hip ratio as a simple measure of abdominal obesity in future studies examining weight loss interventions and stroke prevention.

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Reference

Aparicio HJ, Demissie S, Himali J, et al. Abdominal obesity predicts stroke risk in the Framingham Study. Presented at: American Academy of Neurology 2019 Annual Meeting; May 4-10, 2019; Philadelphia, Pennsylvania.