Researchers at the Karolinska Institute in Sweden found that survivors of a heart attack have an increased risk of another heart attack if they have excess fat around their waists.
The findings, published in the European Journal of Preventive Cardiology, suggest that abdominal obesity not only increases the risk of a first heart attack or stroke, but also increases the risk of repeated attacks.
Keeping a healthy waistline therefore plays an important role in preventing future heart attacks and strokes.
Previous studies have shown that abdominal obesity is an important risk factor for a first heart attack.
So far, however, the association between abdominal obesity and the risk of subsequent heart attack or stroke is unclear.
The study is the largest and most definitive on the subject to date.
The researchers examined the relationship between abdominal obesity, as measured by waist circumference, and the risk of repeated cardiovascular events in 22,882 patients after their first heart attack.
The researchers looked specifically at events caused by clogged arteries, such as fatal and non-fatal heart attacks and strokes.
The majority of patients (78 percent of men and 90 percent of women) have abdominal obesity (94 centimeters or more for men and 80 centimeters or more for women).
At a median follow-up of 3.8 years, 1232 men (7.3%) and 469 women (7.9%) experienced recurrent atherosclerotic cardiovascular events.
The analysis showed that increased abdominal obesity was independently associated with fatal and non-fatal heart attacks and strokes, and not with other risk factors (such as smoking, diabetes, high blood pressure, blood lipids and body mass index) and secondary prevention treatment.
Waist circumference was a more important indicator of relapsed events than overall obesity.
The relationship between waist circumference and recurrent events was stronger and more linear in men.
Among women, the relationship was U-shaped, meaning that women with moderate waistlines, not the smallest, had the lowest risk of recurrence.
It’s important to note that the median waist circumference for women in the study was higher than the traditionally accepted threshold for abdominal obesity (80 cm).