It’s been known for a while that having a pot belly, even if you are slim elsewhere, increases the odds of having a first heart attack, but the latest study, which published Monday in the European Journal of Preventative Cardiology, is the first time researchers have found a link between belly fat and the risk of a subsequent heart attack or stroke.
The link was particularly strong in men, researchers said.
“Abdominal obesity not only increases your risk for a first heart attack or stroke, but also the risk for recurrent events after the first misfortune,” said Dr. Hanieh Mohammadi of the Karolinska Institute in Stockholm, in a news release.
“Maintaining a healthy waist circumference is important for preventing future heart attacks and strokes regardless of how many drugs you may be taking or how healthy your blood tests are.”
The study tracked more than 22,000 Swedish patients after their first heart attack and looked at the link between their waist circumference and events caused by clogged arteries like fatal and non-fatal heart attacks and stroke. Patients were followed for nearly four years, with 1,232 men (7.3%) and 469 women (7.9%) experiencing a heart attack or stroke.
Most patients — 78% of men and 90% of women — had abdominal obesity, defined as a waist circumference of 94 cm (37.6 inches) or above for men, and 80 cm (32 inches) or above for women.
The study found that belly fat was associated with heart attacks and stroke independent of other risk factors like smoking, diabetes, hypertension, body mass index and prevention treatments. The researchers stressed that waist circumference was a more important marker than overall obesity and advised doctors to measure their patient’s waists to identify those at risk.
However, they said that the link was stronger and more linear in men, who made up nearly three-fourths of the patients included in the study, than women.
In women, Mohammadi said the relationship was “U-shaped” rather than linear, meaning that the mid-range waist measurement, rather than the narrowest, was least risky. What’s more, the mid-range waist measurement was in the range traditionally recognized as at risk for abdominal obesity: more than 80 cm wide.
This fat can be turned into cholesterol that can start collecting along and hardening your arteries, perhaps ultimately leading to a heart attack or stroke.
“In women it is thought that a greater portion of the abdominal fat is constituted by subcutaneous fat which is relatively harmless,” she said.
However, the lower numbers of women included in the study meant the findings had less “statistical power” and more research was needed to draw definite conclusions, Mohammadi said.