Current guidelines show that people with three of these five factors -- big waist, high levels of blood fats called triglycerides, high blood pressure, low levels of "good" HDL cholesterol, and high blood sugar levels -- have "metabolic syndrome." People with metabolic syndrome are at high risk of diabetes as well as heart disease and stroke.
Now -- for women -- there may be a simpler way to tell who's at high risk of death. Lázló B. Tankó, MD, PhD, and colleagues at the Center for Clinical and Basic Research in Ballerup, Denmark, suggest that heart deaths concentrate in women with just two factors -- high levels of triglycerides and a 34 2/3-inch waist or larger.
"A high triglyceride level plus waist size was sufficient to predict death from heart disease. Other measures add little to this," Tankó said during an American Heart Association news conference.
Two out of three women who die suddenly from heart disease have no obvious symptoms. Doctors badly need better ways to detect women at high risk. The new findings may help, Tankó says.
Tankó and colleagues report their findings in the April 19 issue of Circulation.
Tankó's team followed 557 48- to 76-year-old women for 8.5 years. At the start of the study, nearly 16% of the women had both a big waist and high triglycerides. These women died of heart disease nearly five times as often as women who did not have both risk factors.
Fifty percent of the heart disease deaths were explained by the combination of these two risks; 45% of the deaths could be explained by the combined risk factors known as metabolic syndrome. The researchers say that of the 16 deaths explained by the metabolic syndrome, 88% could have been predicted by the enlarged waist and elevated triglyceride level.
Interestingly, the women at highest risk of death had a lot of abdominal fat but had relatively little fat on their buttocks.
The finding adds to a growing body of research showing that for women, abdominal fat is much more dangerous than buttocks fat. Tankó says that lower-body fat may actually be protective. That's because below-the-waist fat cells may make a hormone that fights some of the heart-damaging effects of upper-body fat.
"In our general understanding, a pear-shaped body is not a danger for women," Tankó says. "Obesity is not harmless, but when you don't have peripheral fat to balance abdominal fat, you lose an important defense system."
SOURCES: Tankó, L.B. Circulation, April 19, 2005; vol 111: pp 1883-1890. News conference with Lázló B. Tankó, MD, PhD, Center for Clinical and Basic Research, Ballerup, Denmark; and Robert H. Eckel, MD, president-elect, American Heart Association; and director, general clinical research center, University of Colorado Health Sciences Center.