Predicting Cardiovasular Disease with a Measuring Tape

Waist to Hip Ratio
Dr. Geoffrey Harris, MD

Don’t be surprised at your next doctor’s visit if someone pulls out the measuring tape. In addition to the typical weight, height, pulse and blood pressure assessments at the beginning of your typical doctor’s visit, your physician may want the circumference of your waist and hips.

The ratio of your waist to your hips, or Waist to Hip Ratio (WHR), has been shown to give a better correlation to dangerous atherosclerosis than weight, waist circumference or even BMI (Body Mass Index).

Typically, when we think about atherosclerosis, or hardening of the arteries, we think of the plaques and cholesterol that become deposited on the walls of our arteries. Atherosclerosis leads to heart disease, stroke, and peripheral vascular disease. It can also worsen high blood pressure and damage the kidneys.

A recent study published in the Journal of the American College of Cardiology explored WHR and its relationship to health. The study sought to correlate various body measurements with degrees of hardening of the arteries. We know that obesity is a risk for developing heart disease, but the difficulty is in trying to identify people who are at high risk.

Previous measurements of obesity like weight and BMI were not always accurate predictors of risk. Since muscle is denser than fat, muscle weighs more than an equivalent volume of fat. Consequently, weight charts and BMI measurements may categorize athletic and muscular individuals as obese, putting them in a higher risk category.

The study looked at WHR, obesity and atherosclerosis in a group of over 3,000 individuals. The researchers from the Division of Cardiology at the University of Texas Southwestern Medical Center in Dallas found an association between higher WHR’s and elevated degrees of hardening of the arteries. These results were the same for men and women. Basically, individuals who have more fat on their abdomen have more hardening of the arteries. This information serves to strengthen recent evidence that fat deposited on the abdomen tends to be unhealthy fat that increases the risk of developing high blood pressure, heart disease, and diabetes. People with an “apple” shape and high WHR’s are at a higher risk for cardiovascular disease than people with a “pear” shape and lower WHR’s.

As the number of obese people increases in this country, understanding how obesity leads to heart disease, high blood pressure and diabetes becomes increasingly important. Monitoring and tracking WHR’s in patients gives doctors better information. The good news is that the WHR is easy to calculate yourself. Here is how to do it:

  1. While standing, use a tape measure to measure (in inches) your waist at its smallest point. Don’t suck in your stomach or hold your breath. Write down this measurement as your “waist.”
  2. While still standing, measure your hips (also in inches) at the widest point. Write down this measurement as your “hip.”
  3. Divide your waist measurement by your hip measurement. This number is your waist-to-hip ratio (WHR).

Now, what does this number mean? The WHR recommendations are different for men and women.

Low Cardiovascular Risk = 0.8 or below
Moderate Cardiovascular Risk = 0.81 to 0.85
High Cardiovascular Risk = Greater than 0.85

Low Cardiovascular Risk = 0.95 or below
Moderate Cardiovascular Risk = 0.96 to 1.0
High Cardiovascular Risk = Greater than 1.0

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