The journal of nutrition, health & aging

, Volume 15, Issue 5, pp 393–397 | Cite as

Measures of body composition and risk of heart failure in the elderly: The Rotterdam study

  • M. A. W. Van Lieshout
  • G. C. Verwoert
  • F. U. S. Mattace-Raso
  • M. C. Zillikens
  • E. J. Sijbrands
  • J. W. Deckers
  • A. Hofman
  • J. C. M. Witteman
JNHA: Geriatric Science
First Online:
Received:
Accepted:

Abstract

Objectives

The incidence of heart failure increases with aging. Aim of the present, study was to determine whether measures body composition predict incident heart failure in older adults.

Selling

Prospective community-based cohort study. 5, 868 men and women aged 55 years and older participating the Rotterdam study. Measures of body mass index and waist circumference were obtained at baseline. Information on incident heart failure was obtained during follow-up. Cox regression analyses were performed to investigate the possible association between measure of body composition and incident heart failure.

Results

During a mean follow up of 10.9 (SD ±4.4) years, 765 participants had heart failure. After adjustment for age and gender, 1-standard deviation of body mass index, waist circumference and the waist-hip ratio predicted heart failure (HR 1.25; 95% CI 1.17–1.34; HR 1.26; 95% CI 1.18–1.36; and HR 1.17; 95% CI 1.08–1.27), respectively. In age-stratified analyses, 1-standard deviation of body mass index (1.17; 95% CI 1.06–1.29) and waist circumference (1.16; 95% CI 1.05–1.29) were still associated with the risk of heart failure in the oldest participants, whereas the waist-hip ratio was not (1.06; 95% CI 0.945–1.18).

Conclusion

Although estimates decrease with age, measures of overall and central adiposity predict incident heart failure among community dwelling older adults.

Key words

Body mass index waist circumference waist-hip ratio heart failure older adults 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    McTigue K, Larson JC, Valoski A, Burke G, Kotchen J, Lewis CE, Stefanick ML, Van Horn L, Kuller L. Mortality and cardiac and vascular outcomes in extremely obese women. Jama 2006 Jul 5;296:79–86.PubMedCrossRefGoogle Scholar
  2. 2.
    Bogers RP, Bemelmans WJ, Hoogenveen RT, Boshuizen HC, Woodward M, Knekt P, van Dam RM, Hu FB, Visseher TL, et al. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med. 2007 Sep 10; 167:1720–1728.PubMedCrossRefGoogle Scholar
  3. 3.
    Flegal KM, Graubard BI, Williamson DF, Gail MH Cause-specific excess deaths associated with underweight, overweight, and obesity. Jama 2007 Nov 7:298:2028–2037.PubMedCrossRefGoogle Scholar
  4. 4.
    Dagenais GR, Yi Q, Mann JF, Bosch J, Pogue J, Yusuf S, Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J. 2005 Jan; 149:54–60.PubMedCrossRefGoogle Scholar
  5. 5.
    Rosamond W, Flegal K, Furie K, Go A, Greenland K, Haase N, Hailpern SM, Ho M, Howard V, et al. Heart disease and stroke statistics—2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008 Jan 29:117;e25–e146.PubMedCrossRefGoogle Scholar
  6. 6.
    Visseher IL, Seidell JC, Molarius A, van der Kuip D, Hofman A, Witteman JC. A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study. Int J Obes Relat Metab Disord. 2001 Nov;25:1730–1735.CrossRefGoogle Scholar
  7. 7.
    Loebr LR, Rosamond WD, Poole C, McNeill AM, Chang PP, Folsorn AR, Chambless LE, Heiss G. Association of multiple anthropometrics of overweight and obesity with incident heart failure: the Atherosclerosis Risk in Communities study. Circ Heart Fail. 2009 Jan;2:18–24.CrossRefGoogle Scholar
  8. 8.
    Kenchaiah S, Evans JC, Levy D, Wilson PW, Benjamin FJ, Larson MG, Kannel WB, Vasan RS. Obesity and the risk of heart failure. N Engl J Med. 2002 Aug 1;347:305–313.PubMedCrossRefGoogle Scholar
  9. 9.
    Nicklas BJ, Cesari M, Penninx BW, Kritchevsky SB, Ding J, Newman A, Kitzman DW, Kanaya AM, Pahor M, Harris TB. Abdominal obesity is an independent risk factor for chronic heart failure in older people. J Am Geriatr Soc. 2006 Mar;54:413–420.PubMedCrossRefGoogle Scholar
  10. 10.
    Levitan EB, Yang AZ, Wolk A, Mittleman MA. Adiposity and incidence of heart failure hospitalization and mortality: a population-based prospective study. Circ Heart Fail. 2009 May:2:202–208.PubMedCrossRefGoogle Scholar
  11. 11.
    Hofman A, Grobbee DE, de Jong PT, van den Ouweland FA. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol. 1991 Jul;7:403–422.PubMedCrossRefGoogle Scholar
  12. 12.
    Hofman A, Breteler MM, van Duijn CM, Krestin GP, Pols HA, Strieker BH, Tiemeier H, Uitterlinden AG, Vingerling JR, Witteman JC. The Rotterdam Study: objectives and design update. Eur J Epidemiol. 2007:22:819–829.PubMedCrossRefGoogle Scholar
  13. 13.
    Hofman A, Breteler MM, van Duijn CM, Janssen HL, Krestin GP, Kuipeis EJ, Strieker BH, Tiemeier H, Uitterlinden AG, et al. The Rotterdam Study: 2010 objectives and design update. Eur J Epidemiol. 2009;24:553–572.PubMedCrossRefGoogle Scholar
  14. 14.
    Mosterd A, Hoes AW, de Bruyne MC, Deckers JW, Linker DT, Hofman A, Grobbee DF. Prevalence of heart failure and left ventricular dysfunction in the general population: The Rotterdam Study. Eur Heart J. 1999 Mar:20:447–455.PubMedCrossRefGoogle Scholar
  15. 15.
    Remme WJ, Swedberg K, Task Force for the Diagnosis and Treatment of Chronic Heart Failure ESoC. Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J. 2001 Sep:22:1527–1560.PubMedCrossRefGoogle Scholar
  16. 16.
    Chen YT, Vaccarino V, Williams CS, Butler J, Berkman LF, Krumholz HM. Risk factors for heart failure in the elderly: a prospective community-based study. Am J Med 1999 Jun; 106:605–612.PubMedCrossRefGoogle Scholar
  17. 17.
    He J, Ogdeo LG, Bazzano LA, Vupputuri S, Loria C, Whelton PK. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med. 2001 Apr 9:161:996–1002.PubMedCrossRefGoogle Scholar
  18. 18.
    Wilhelrnsen L, Rosengren A, Eriksson H, Lappas G. Heart failure in the general population of men—morbidity, risk factors and prognosis. J Intern Med. 2001 Mar;249:253–261.CrossRefGoogle Scholar
  19. 19.
    Stamler J. Epidemiologic findings on body mass and blood pressure in adults. Ann Epidemiol. 1991 May;1:347–362.PubMedCrossRefGoogle Scholar
  20. 20.
    Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes;, arid obesity related health risk factors, 2001. Jama. 2003 Jan 1;289:76–79.PubMedCrossRefGoogle Scholar
  21. 21.
    Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994 Sep;17:961–969.PubMedCrossRefGoogle Scholar
  22. 22.
    Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995 Apr 1;122:481–486.PubMedGoogle Scholar
  23. 23.
    Yisuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11–17:364:937–952.CrossRefGoogle Scholar
  24. 24.
    Garni AS, Witt BJ, Howard DE, Erwin PJ, Garni LA, Somers VK, Montori VM. Melabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007 Jan 30; 49:403–414.CrossRefGoogle Scholar
  25. 25.
    Conrady AO, Rudomanov OG, Zaharov DV, Krutikov AN, Vahrameeva NV, Yakovleva OI, Alexeeva NP, Shlyakhto EV. Prevalence and determinants of left ventricular hypertrophy and remodelling patterns in hypertensive patients: the St. Petersburg study. Blood Press. 2004; 13:101–109.PubMedCrossRefGoogle Scholar
  26. 26.
    Houterman S, Verschuren WM, Hofman A, Witteman JC. Serum cholesterol is a risk factor for myocardial infarction in elderly men and women: the Rotterdam Study. J Intern Med. 1999 Jul;246:25–33.PubMedCrossRefGoogle Scholar
  27. 27.
    Sutton GC. Epidemiologic aspeds of heart failure. Am Heat J. 1990 Dec;120:1538–1540.CrossRefGoogle Scholar
  28. 28.
    Yudkin JS. Adipose tissue, insulin action and vascular disease: inflammatory signals. Int J Obes Relat Metab Disord. 2003 Dec;27Suppl 3:S25–S28.PubMedCrossRefGoogle Scholar
  29. 29.
    Diamant M, Lamb HJ, van de Ree MA, Endert EL, Groeneveld Y, Bots ML, Kostense PJ, Radder JK. The association between abdominal visceral fat and carotid stiffness is mediated by circulating inflammatory markers in uncomplicated type 2 diabetes. J Clin Endocrinol Metab. 2005 Mar:90:1495–1501.PubMedCrossRefGoogle Scholar
  30. 30.
    Vasan RS, Sullivan LM, Roubenoff R, Dinarello CA, Harris T, Benjamin EJ, Sawyer DB, Levy D, Wilson PW, et al. Inflammatory markers and risk of heat! failure in elderly subjects without prior myocardial infarction the Framing ham Heart Study. Circulation. 2003 Mar 25:107:1486–1491.PubMedCrossRefGoogle Scholar
  31. 31.
    Kardys T, Knetseh AM, Bleumink GS, Deckers JW, Hofman A, Stricker BH, Witteman JC. C-reactive protein and risk of heart failure. The Rotterdam Study. Am Heart J. 2006 Sep;152:514–520.PubMedCrossRefGoogle Scholar
  32. 32.
    Bastard JP, Maachi M, Van Nhieu JT, Jardel C, Bruckert E, Grimaldi A, Robert JJ, Capeau J, Hainque B. Adipose tissue IL-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. J Clin Endocrinol Metab, 2002 May;87:2084–2089.PubMedCrossRefGoogle Scholar
  33. 33.
    Pantanetti P, Garrapa GG, Mantero F, Boscaro M, Faloia E, Venarucci D. Adipose tissue as an endocrine organ? A review of recent data related to cardiovascular complications of endocrine dysfunctions. Clin Exp Hypertens. 2004 May;26:387–398.PubMedCrossRefGoogle Scholar
  34. 34.
    Adams KF, Jr. Pathophysiologic role of the renin-angiotensin-aldosterone and sympathetic nervous systems in heart failure. Am J Health Syst Pharm. 2004 May 1;61Suppl 2:S4–S13.PubMedGoogle Scholar
  35. 35.
    Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T. et al. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun. 1999 Apr 2;257:79–83.PubMedCrossRefGoogle Scholar
  36. 36.
    Lu JY, Huang KC, Chang LC, Huang YS, Chi YC, Su TC, Chen CL, Yang WS. Adiponectin: a biomarker of obesity-induced insulin resistance in adipose tissue and beyond. J Biomed Sci. 2008 Sep; 15:565–576.PubMedCrossRefGoogle Scholar

Copyright information

© Serdi and Springer Verlag France 2011

Authors and Affiliations

  • M. A. W. Van Lieshout
    • 1
  • G. C. Verwoert
    • 1
    • 3
  • F. U. S. Mattace-Raso
    • 1
    • 2
  • M. C. Zillikens
    • 3
  • E. J. Sijbrands
    • 3
  • J. W. Deckers
    • 4
  • A. Hofman
    • 1
  • J. C. M. Witteman
    • 1
  1. 1.Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
  2. 2.Section of Geriatric Medicine, Department of Internal MedicineErasmus University Medical CenterRotterdamThe Netherlands
  3. 3.Department of Internal MedicineErasmus University Medical CenterRotterdamThe Netherlands
  4. 4.Department of CardiologyErasmus University Medical CenterRotterdamThe Netherlands

Personalised recommendations