Levitan Emily B, Yang Amy Z, Wolk Alicja, Mittleman Murray A
Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Mass, USA.
Circ Heart Fail. 2009 May;2(3):202-8. doi: 10.1161/CIRCHEARTFAILURE.108.794099. Epub 2009 Apr 7.
Obesity is associated with heart failure (HF) incidence. We examined the strength of the association of body mass index (BMI) with HF by age and joint associations of BMI and waist circumference (WC).
Women aged 48 to 83 (n=36873) and men aged 45 to 79 (n=43487) self-reported height, weight, and WC. HF hospitalization or death (n=382 women, 718 men) between January 1, 1998, and December 31, 2004, was determined through administrative registers. Hazard ratios, from Cox proportional-hazards models, for an interquartile range higher BMI were 1.39 (95% CI, 1.15 to 1.68) at age 60 and 1.13 (95% CI, 1.02 to 1.27) at 75 in women. In men, hazard ratios were 1.54 (95% CI, 1.37 to 1.73) at 60 and 1.25 (95% CI, 1.16 to 1.35) at 75. A 10-cm higher WC was associated with 15% (95% CI, 2% to 31%) and 18% (95% CI, 4% to 33%) higher HF rates among women with BMI 25 and 30 kg/m(2), respectively; hazard ratios for 1 kg/m(2) higher BMI were 1.00 (95% CI, 0.96 to 1.04) and 1.01 (95% CI, 0.98 to 1.04) for WC 70 and 100 cm, respectively. In men, a 10-cm higher WC was associated with 16% and 18% higher rates for BMI 25 and 30 kg/m(2), respectively; a 1 kg/m(2) higher BMI was associated with 4% higher HF rates regardless of WC.
Strength of the association between BMI and HF events declined with age. In women, higher WC was associated with HF at all levels of BMI. Both BMI and WC were predictors among men.
肥胖与心力衰竭（HF）的发病率相关。我们通过年龄研究了体重指数（BMI）与HF之间关联的强度，以及BMI和腰围（WC）的联合关联。
48至83岁的女性（n = 36873）和45至79岁的男性（n = 43487）自行报告身高、体重和腰围。通过行政登记确定1998年1月1日至2004年12月31日期间的HF住院或死亡情况（女性382例，男性718例）。Cox比例风险模型得出的风险比显示，对于BMI四分位间距更高的情况，60岁女性的风险比为1.39（95%CI，1.15至1.68），75岁女性为1.13（95%CI，1.02至1.27）。在男性中，60岁时风险比为1.54（95%CI，1.37至1.73），75岁时为1.25（95%CI，1.16至1.35）。在BMI分别为25和30kg/m²的女性中，WC每增加10cm，HF发生率分别高出15%（95%CI，2%至31%）和18%（95%CI，4%至33%）；对于WC分别为70和100cm的情况，BMI每增加1kg/m²，风险比分别为1.00（95%CI，0.96至1.04）和1.01（95%CI，0.98至1.04）。在男性中，对于BMI为25和30kg/m²的情况，WC每增加10cm，发生率分别高出16%和18%；无论WC如何，BMI每增加1kg/m²，HF发生率高出4%。
BMI与HF事件之间关联的强度随年龄下降。在女性中，在所有BMI水平下，较高的WC均与HF相关。在男性中，BMI和WC都是预测因素。
