Am J Cardiovasc Dis 2012;2(4):323-330

Original Article
Neck circumference and central obesity are independent predictors of
coronary artery disease in patients undergoing coronary angiography

Vanessa Zen, Flávio D Fuchs, Marco V Wainstein, Sandro C Gonçalves, Karina Biavatti, Charles E Riedner, Felipe C
Fuchs, Rodrigo V Wainstein, Ernani L Rhoden, Jorge P Ribeiro, Sandra C Fuchs

Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul. R.
Ramiro Barcelos 2600, CEP 90035-003, Porto Alegre, RS, Brazil; Division of Cardiology, Hospital de Clinicas de Porto
Alegre, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2350, Centro de Pesquisa Clínica. CEP
90035-003, Porto Alegre, RS, Brazil; Postgraduate Studies Program in Cardiology, School of Medicine, Universidade
Federal do Rio Grande do Sul. R. Ramiro Barcelos 2600, CEP 90035-003, Porto Alegre, RS, Brazil; Department of Surgery,
Division of Urology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil

Received September 23, 2012; accepted October 20, 2012; Epub October 25, 2012; Published November 31, 2012

Abstract: Excess of adiposity is a risk factor for coronary artery disease, but it remains unclear if the distribution of fat is an
effect modifier or if the risk is mediate by hypertension, diabetes and dyslipidemia. We investigated the association of
central in addition to general obesity with coronary artery disease (CAD). A case-control study was conducted in 376
patients, aged 40 years or more, with chronic coronary disease, undergoing elective coronary angiography. Excess of
adiposity was evaluated by the Body Mass Index (BMI), waist circumference, waist-hip ratio, and neck circumference.
Cases (n=155) were patients referred for coronary angiography with at least 50% of coronary stenosis in at least one
epicardial vessels or their branches, with diameter greater than 2.5 mm. Controls (n=221) were patients referred for
coronary angiography without significant coronary disease. Odds ratios and 95%CI for significant coronary stenosis were
calculated using multiple logistic regression, controlling for age, sex, years at school, smoking, hypertension,
HDL-cholesterol, diabetes mellitus, and an adiposity index. There was a predominance of men and individuals older than
50 years among cases. The waist-hip ratio increased four times the chance of CAD, even after the control for confounding
factors, including BMI. Neck circumference above the 90th Percentile doubled the chance of CAD, after adjustment for
traditional risk factors. Neck circumference and waist-hip ratio are independent predictors of CAD, even taking into account
traditional risk factors for CAD. These findings highlight the need of anthropometric assessment among patients with
suspected coronary artery disease. (AJCD1209002).

Keywords: Obesity, central obesity, abdominal obesity, coronary artery disease, coronary angiography


Address all correspondence to:
Dr. Sandra C Fuchs
Centro de Pesquisa Clínica
2º andar, CARDIOLAB-Hipertensão
Hospital de Clínicas de Porto Alegre
Universidade Federal do Rio Grande do Sul
Ramiro Barcellos, 2350, 2º andar
90.035-003, Porto Alegre, RS, Brasil.
Tel: + 5551-33597621/3359-7695; Fax: + 5551-33597621/3359-7695;
E-mail: scfuchs@terra.com.br
AJCD Copyright © 2011-present, All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711, USA