Research Article

Abdominal obesity in predicting myocardial infarction risk. Waist-to-Hip Ratio: The metric that confused cardiology worldwide for a long time

Angel Martin Castellanos*

Published: 03/24/2021 | Volume 6 - Issue 1 | Pages: 026-028

Important differences has been found in assessing the effects of obesity on cardiovascular disease (CVD) risk [1]. Interestingly, accurate estimation of the body composition (BC) is highly relevant from a public health perspective [2], and it has the importance of being essential in establishing the impact of adiposity on increased myocardial infarction (MI) risk. However, in non-randomized studies, baseline differences of BC between groups to be compared may introduce bias in results.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001113 Cite this Article


  1. Lassale C, Tzoulaki I, Moons KGM, Sweeting M, Boer J, et al. Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis. Eur Heart J. 2018; 39: 397-406. PubMed:
  2. Cornier MA, Després JP, Davis N, Grossniklaus DA, Klein S, et al. Assessing adiposity: a scientific statement from the American Heart Association. Circulation. 2011; 124: 1996–2019. PubMed:
  3. Yusuf S, Hawken S, Ounpuu S. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004; 364: 937-952. PubMed:
  4. Egeland GM, Igland J, Vollset SE, Sulo G, Eide GE, et al. High population attributable fractions of myocardial infarction associated with waist-hip ratio. Obesity. 2016; 24:1162-1169. PubMed:
  5. Cao Q, Yu S, Xiong W, Li Y, Li H, et al. Waist-hip ratio as a predictor of myocardial infarction risk. A systematic review and meta-analysis. Medicine (Baltimore). 2018; 97: e11639. PubMed:
  6. Peters SAE, Bots SH, Woodward M. Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results From the UK Biobank. J Am Heart Assoc. 2018; 7. pii: e008507. PubMed:
  7. Choi D, Choi S, Son JS, Oh SW, Park SM, et al. Impact of Discrepancies in General and Abdominal Obesity on Major Adverse Cardiac Events. J Am Heart Assoc. 2019; 8: e013471. PubMed:
  8. Martin-Castellanos A, Cabañas-Armesilla MD, Barca-Durán FJ, Castellanos PM, Barrado JJG, et al. Obesity and risk of Myocardial Infarction in a Sample of European Males. Waist To-Hip-Ratio Presents Information Bias of the Real Risk of Abdominal Obesity. Nutr Hosp. 2017; 34: 88-95. PubMed:
  9. Martin-Castellanos A, Cabañas MD, Martín-Castellanos P, et al. The body composition and risk prediction in myocardial infarction men. Revealing biological and statistical error bias for both general obesity and waist-to-hip ratio. Card Res Med. 2018; 2: 13-20.
  10. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. World Health Organization 2011.  
  11. Rost S, Freuer D, Peters A, Thorand B, Holle R, et al. New indexes of body fat distribution and sex-specific risk of total and cause-specific mortality: a prospective cohort study. BMC Public Health. 2018; 18: 427. PubMed:
  12. Medina-Inojosa JR, Batsis JA, Supervia M, Somers VK, Thomas RJ, et al. Relation of Waist-Hip Ratio to Long-Term Cardiovascular Events in Patients With Coronary Artery Disease. Am J Cardiol. 2018; 121: 903-909. PubMed: