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European Heart Journal Advance Access published online on September 23, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp371
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Does abdominal obesity have a similar impact on cardiovascular disease and diabetes? A study of 91 246 ambulant patients in 27 European Countries

Keith A.A. Fox1,*, Jean-Pierre Després2, Alain-Jean Richard3, Sandrine Brette4, John E. Deanfield5 on behalf of the IDEA Steering Committee and National Co-ordinators

1 Department of Cardiovascular Research, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK
2 Quebec Heart and Lung Institute, Université Laval, Québec, Canada
3 Sanofi-Aventis, Paris, France
4 Statistician, Lincoln, France
5 Vascular Physiology Unit, University College, London, UK

Received 21 October 2008; revised 29 May 2009; accepted 17 August 2009 * Corresponding author. Tel: +44 131 242 6378, Fax: +44 131 242 6379, Email: k.a.a.fox{at}ed.ac.uk

Aims: Differences in cardiovascular risk factors across Europe provide an opportunity to examine the impact of adiposity on the frequency of diabetes and cardiovascular disease (CVD).

Methods and results: The International Day for Evaluation of Abdominal obesity (IDEA) study evaluated the prevalence of abdominal obesity, elevated body mass index (BMI), and other cardiometabolic risk factors among primary care patients. Abdominal obesity predicted increased diabetes risk, despite socio-economic, demographic, and risk factor differences. Cardiovascular disease was at least two-fold more frequent in Eastern Europe vs. Northwest Europe (P < 0.0001) and 2.5-fold more vs. Southern Europe (P < 0.0001). Waist circumference (WC) predicted increased (P < 0.0001) age- and BMI-adjusted risks of CVD and diabetes. In women, odds ratios (95% confidence intervals) for CVD per 1 SD increase in WC were: Northwest Europe 1.28 (1.18–1.40); Southern Europe 1.26 (1.16–1.37); and Eastern Europe 1.10 (1.03–1.18). Values for diabetes were 1.72 (1.58–1.88), 1.45 (1.35–1.56), and 1.59 (1.46–1.73), with similar findings in men.

Conclusion: Abdominal obesity impacted similarly on the frequency of diabetes across Europe, despite regional differences in cardiovascular risk factors and CVD rates. Increasing abdominal obesity may offset future declines in CVD, even where CVD rates are lower.

Key Words: Cardiovascular disease • Diabetes • Risk factors • Abdominal obesity


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