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Stroke, Vol 21, 701-706, Copyright © 1990 by American Heart Association
AR Folsom, RJ Prineas, SA Kaye and RG Munger
The relation between body fat distribution, as measured by the waist-to-
hip circumference ratio, and the 2-year incidences of hypertension and
stroke were examined in a cohort of 41,837 women aged 55-69 years. Women
who developed hypertension were 2.1 (95% confidence interval 1.7- 2.6)
times more likely to be in the upper tertile of waist-to-hip ratio than
those who did not. Adjustment for age, body mass index (kilograms per meter
squared), cigarette smoking, physical activity, alcohol intake, and
education level reduced this odds ratio to 1.6 (95% confidence interval
1.3-2.1). Women who developed a stroke were also 2.1 (95% confidence
interval 1.5-2.9) times more likely to be in the upper tertile of
waist-to-hip ratio than those who did not. Adjustment for the same
covariates also lowered this odds ratio to 1.6 (95% confidence interval
1.1-2.4). Further adjustment for hypertension and diabetes mellitus reduced
the estimated risk of stroke due to elevated waist-to-hip ratio to 1.3 (95%
confidence interval 0.8-2.1). Hypertension, diabetes mellitus, and
cigarette smoking remained significantly associated with stroke incidence
in the multivariate model. These results indicate that abdominal adiposity,
as measured by an increased waist-to-hip ratio, increases the risks of
hypertension and stroke, even after accounting for overall body mass. The
association of abdominal adiposity with risk of stroke is related, in part,
to the association of abdominal adiposity with hypertension and diabetes.
ARTICLES
Incidence of hypertension and stroke in relation to body fat distribution and other risk factors in older women
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455.
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|
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|
|
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|
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|
|
|
|
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|
|
|
|
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|
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|
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|
|
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|
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