Rhéaume Caroline, Leblanc Marie-Ève, Poirier Paul
Institut Universitaire de Cardiologie et de pneumologie de Québec, 2725 ch Sainte-Foy, Québec, QC, G1V 4G5, Canada.
Expert Rev Cardiovasc Ther. 2011 Dec;9(12):1557-64. doi: 10.1586/erc.11.167.
Obesity is associated with a greater prevalence of cardiovascular risk factors and a higher risk of cardiovascular events, and contributes to the rise in cardiovascular morbidity and mortality worldwide. Increased BMI is established as an independent risk factor for cardiovascular disease (CVD). Attention has recently been drawn to alternate measures of adiposity/obesity, such as waist circumference, waist-to-hip ratio and waist-to-height ratio, that provide information regarding body fat distribution. Although BMI is the established clinical measurement to estimate CVD risk associated with excess bodyweight, there is evidence suggesting that abdominal obesity could represent a better marker of CVD risk than BMI. It is now recognized that abdominally obese individuals tend to have higher blood pressure. A major cardiovascular risk factor associated with stroke is systemic hypertension followed closely by obesity. Clinical adiposity indices used to describe obesity linked with systemic hypertension and stroke incidence are reviewed in this article. In summary, BMI, waist circumference, waist-to-hip ratio and waist-to-height ratio measurements are all useful tools for assessing adiposity/obesity in clinical practice, and should be evaluated with other cardiometabolic risk factors to refine cardiovascular risk stratification.
肥胖与心血管危险因素的更高患病率以及心血管事件的更高风险相关联,并导致全球心血管发病率和死亡率上升。体重指数(BMI)升高已被确认为心血管疾病(CVD)的独立危险因素。最近,人们的注意力已转向肥胖的替代测量指标,如腰围、腰臀比和腰高比,这些指标可提供有关体脂分布的信息。尽管BMI是用于估计与超重相关的CVD风险的既定临床测量指标,但有证据表明,腹部肥胖可能比BMI更能代表CVD风险。现在人们认识到,腹部肥胖的个体往往血压更高。与中风相关的一个主要心血管危险因素是系统性高血压,紧随其后的是肥胖。本文综述了用于描述与系统性高血压和中风发病率相关的肥胖的临床肥胖指数。总之,BMI、腰围、腰臀比和腰高比测量都是临床实践中评估肥胖的有用工具,并且应与其他心脏代谢危险因素一起评估,以完善心血管风险分层。