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Bad breadth.


If what studies from Boston University (BU) are saying is true, a little vanity can be a good thing. BU researchers say that abdominal obesity can lead to an increased risk of stroke in men and heart failure in both sexes. When blood flow is cut off from certain parts of the brain, stroke and other neurological problems result.

Congestive heart failure occurs when a weakened cardiac muscle somehow doesn't deliver enough oxygen to the body. Bu researchers have studied a group of 4500 adults from the Framingham Heart Study for two decades. The study has investigated the developments of heart and blood vessel disease in residents of Framingham, Mass., a town of over 64,000, since the 1940s.

Dr. Joseph Stokes III, professor of medicine at BU, says that certain obesity patterns in individuals may increase their odds of developing future cardiovascular complications. Interviewed last spring at the 28th annual conference of the American Heart Association's council on epidemiology in Santa fe, N.M., Stokes said that heart failure was the complication most strongly associated with abdominal obesity, and that for each 2.5 inches of portliness, 10-12 people per 1000 developed heart failure. Researchers have theorized that this may be due to the fact that the blood that flows through this fatty tissue has more direct access to the liver, the organ that secretes and removes cholesterol from the blood. Some researchers also believe that abdominal fat cells may be regulated in a different way than those in the buttocks and thighs.

"Just looking at overall weight won't predict which people will develop cardiovascular disease or die," Stokes said. However, he adds, "as the ratio of abdominal growth increases, so does the risk of developing cardiovascular disease."

Dr. Aaron Folsom of the University of Minnesota, Minneapolis, agrees. Folsom, who presented his study's findings on fat distribution in young adults at the Santa Fe conference, said that young adults with abdominal obesity have worse risk factors for heart disease than those who are merely fat in the hips. This is true, he added, even among those not considered obese. He and his colleagues analyzed data accumulated during physical examinations of 5000 blacks and whites 18-30 years of age.

"Regardless of how much fat you have, the greater the proportion of fat in the abdomen, the greater is your risk," he said. Folsom said his analysis also supports previous research in other populations that suggests "people who are fatter have higher insulin levels, which seem to have a detrimental effect on blood fats and the risk of heart disease." (Cardiovascular Research Report, Winter 1988-89, pages 6,8.)
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Title Annotation:abdominal obesity and risk of stroke and heart failure
Publication:Medical Update
Date:Mar 1, 1989
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