Overweight and obesity in the elderly are independently associated with an increased risk of cardiovascular mortality. However, beyond body mass index (BMI), other anthropometric measures such as waist-to-hip ratio (WHR) may provide a better indication of body fat distribution and may be especially useful in a geriatric population. This study explored the value of anthropometric indices in predicting major adverse cardiovascular events (MACE) among older adults.

3285 participants aged 65 years or older were included in this analysis. Eight anthropometric measures, including weight-related and weight-free measures, were measured and calculated. MACE included nonfatal myocardial infarction, nonfatal stroke or cardiovascular death. Median follow-up was 5.4 years with 218 events observed. Participants with obesity (BMI ≥ 28 kg/m ² ) were associated with a higher MACE risk compared with those with normal weight (adjusted Hazard Ratio (aHR) = 1.54, 95 % confidence interval (CI): 1.07–2.22, P = 0.020). Restricted cubic splines confirmed the robust correlation between high BMI and MACE risk. Similarly, the aHR for MACE in WHR quartile 4 versus quartile 1 was 1.96 (95 % CI: 1.26–3.05, P = 0.003). Results were unchanged when WHR was continuous. In adjusted models, all four weight-free measures were significantly associated with increased MACE risk (all P  <  0.05), while only two weight-related measures were significant.

In the elderly, weight-free measures may be more relevant to the risk of MACE.

NCT02368938