• Cardiovascular Risk Markers: European Concerted Action Project

• The IDEA Survey

Two presentations in a series on risk assessment in diabetes and metabolic syndrome (MetS) focused on data that strengthened the case for CVD risk prediction. Both presenters acknowledged the foundation provided by the landmark INTERHEART study which established the importance of 9 key risk factors in >90% of acute myocardial infarction patients.

“INTERHEART clarified the role of obesity and other elements of the metabolic syndrome as critical to the development of CV disease,” said Tora Leong, MB, Adelaide and Meath Hospital, Dublin, Ireland. “In our studies, part of the European Concerted Action Project, we've found that MetS, homocysteine, and, to a lesser extent, the apo B/AI ratio are also independent predictors of CVD.

“Both individually and together, these factors improve risk prediction,” Dr. Leong said.

Complementing Dr. Leong's data was news from the IDEA (International Day for the Evaluation of Abdominal Obesity) Survey—the first international multi-center study to confirm that increased waist circumference is independently associated with an increased risk of CV disease. Presented by Steven M. Haffner, MD, University of Texas Health Science Center, IDEA data indicates that abdominal obesity is linked with CV risk independent of general obesity and age.

IDEA utilized a random sample culled from clinical measurements performed by more than 6,000 primary care clinicians in 63 countries. “Aside from establishing the link between abdominal obesity and CV disease,” said Dr. Haffner, “IDEA made it very clear that abdominal obesity is highly prevalent everywhere in the world.”

Haffner, a member of the IDEA study committee, noted that IDEA confirms the importance of measuring waist circumference along with other measures in identifying patients at increased risk.

IDEA also established that waist circumference and BMI are both independently associated with CVD in men and women.

Every increase in age by 16 years triples the likelihood of an adult having some form of CV disease, according to IDEA data. “And increases in waist circumference of 14 cm for men and 14.9 cm for women elevate the likelihood of that person having CVD from 21 percent to 40 percent,” according to Dr. Haffner.

“These data make it very clear that increased waist circumference is a very significant risk marker, and that we're facing nothing less than an international pandemic,” said Dr. Haffner.