A recent study confirms previous research that extra inches around the waist can mean higher risk for heart disease in women, but some local doctors and patients are hesitant to pull out the tape measure.
Women with waistlines measuring more than 35 inches should get an annual check-up and risk assessment for heart problems, said the study’s author, Dr. Erin Michos, professor at Johns Hopkins University’s Heart and Vascular Institute.
“If they have more fat in the abdomen, they have more problems with diabetes, insulin secretion and lower levels of good cholesterol…” Michos said. “We know that fat pattern is associated with women with increased risks.”
Excess fat in the midsection increases these risks more than extra inches on the thighs, buttocks or other areas, she explained. While researchers are unsure why fat in that area is related to heart disease, Michos said the excess fat likely upsets the body’s hormone balance.
The study evaluated nearly 9,000 women participating in health screenings in 14 major U.S. cities, including Chicago, in 2006.
The screenings, which were conducted by a women’s heart disease prevention group, Sister to Sister: Everyone Has a Heart Foundation, checked women for traditional risk factors of heart disease including cholesterol levels and blood pressure, as well as waist circumference.
However, one in 10 women opted not to have their waists measured during the screenings, according to the study. This can be common, said Dr. Matthew Sorrentino, professor at the University of Chicago’s Pritzker School of Medicine.
“I’ve had a number of patients refuse it,” he said. “They don’t want us to know, or they don’t want to know, what their waist circumference is. [And] many patients who are very overweight or obese are well aware that they are and are well aware that it’s a risk factor. They don’t understand how measuring their waist size has much to do with it.”
Even though being measured can be uncomfortable for some, women with “apple-shaped” bodies are often aware they are genetically predisposed to having heart problems, said Dr. Alan Brown, medical director of the Midwest Heart Disease Prevention Center in Naperville.
“It helps when we make it more of discussion about health, not appearance,” he said.
While patients can be hesitant, most doctors also bypass regularly measuring patient’s waists during office visits, although extra inches around the middle have been considered a risk factor for cardiovascular disease for years.
“It hasn’t become so pervasive that people are measuring in their offices regularly,” Brown said. “But [measuring] makes an important point to patients.”
Sorrentino agreed that most doctors don’t measure.
“I think they find it is extra work that doesn’t really add all that much because many times it’s pretty obvious when people walk in the door that they have central obesity,” he said.
For those who have waist sizes over the recommended 35 inches for women and 40 inches for men, the answer to reducing risks is simple, explained Brown.
“[A large waist circumference] is associated with insulin resistance, abnormal cholesterol, diabetes, and a two-fold increased risk of cardiac disease," he said. "The good news is all of those different maladies respond remarkably to weight loss.”
And while waist circumference is a valuable consideration for determining heart disease risk in some men and women, it isn’t an infallible test, Sorrentino said.
“Not everybody who is overweight or who is obese has these clustering of risk factors,” he said. “A number of studies have shown that some people who are obese are quite healthy… whereas some people who are below the waist circumference criteria have lots of risk factors. It’s not an absolute.”