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Dual measurement of waist circumference and triglyceride level can be used by GPs as a quick and accurate predictor of heart disease risk in apparently healthy individuals, new research shows. Only 1 in 4 patients get their waist measured by their physicians.
Experts said ‘hypertriglyceridaemic waist’ was an effective screening tool and could easily be used in primary care to identify those who would benefit from preventive treatment.
Data from the Department of Health-funded EPIC-Norfolk study found that men with fat waists and high triglyceride levels (see box) had a 66% increased risk of future CHD compared with the general population.
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In women with a large waist and high triglycerides, the risk of developing CHD is more than two-fold, the European Association for the Study of Diabetes meeting was told.
Adjustment of the data – from 900 45- to 79-year-olds with CHD and 1,600 controls – showed high waist girth and high triglycerides predicted risk even after traditional risk factors had been taken into account.
Study author Professor Jean-Pierre Despres, director of cardiology research at the Hôpital Laval Research Centre in Quebec, Canada, said the work built on previous studies on the importance of abdominal fat in cardiovascular risk.
The analysis provided further evidence that GPs should measure waist and pay attention to it, especially when abdominal obesity accompanied hypertriglyceridaemia, he added.
‘It is simple and I often say waist circumference is a vital sign and that it should be in the medical chart of every patient,’said Professor Despres.
Dr Colin Waine, chair of the National Obesity Forum, said the data supported what he had been advocating for some time and would be included in its upcoming guidance. ‘It’s a good way for primary care to pick out very high-risk patients – it’s quick and easy.’
•A survey of 102 GPs, commissioned by Sanofi Aventis, has found that only 40% of GPs who responded routinely measure patients’ waists. An accompanying survey of overweight and obese patients found only one in four had had abdominal obesity measured.
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