Published Online
on October 18, 2004

A more recent version of this article appeared on November 2, 2004

This Article Full Text (PDF) All Versions of this Article: 110/18/2781    most recent 01.CIR.0000146395.64065.BAv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Empana, J. P. Articles by Jouven, X. Search for Related Content PubMed PubMed Citation Articles by Empana, J. P. Articles by Jouven, X. Related Collections Obesity Primary prevention Risk Factors Acute myocardial infarction Arrhythmias, clinical electrophysiology, drugs Epidemiology

Submitted on December 30, 2003
Revised on April 22, 2004
Accepted on June 30, 2004

Sagittal Abdominal Diameter and Risk of Sudden Death in Asymptomatic Middle-Aged Men. The Paris Prospective Study I

J. P. Empana MD, MPH^*, P. Ducimetiere PhD, M. A. Charles MD, MPH, and X. Jouven MD, PhD

From INSERM Avenir (J.P.E., X.J.), Epidemiology of Sudden Death in the Population, and INSERM U258 (J.P.E., P.D., M.A.C., X.J.), Cardiovascular and Metabolic Epidemiology Unit, Villejuif, France.

^* To whom correspondence should be addressed. E-mail: empana{at}vjf.inserm.fr.

Background--Abdominal (visceral) and overall obesity are both related to coronary heart disease mortality risk; however, the relative contribution of these 2 components of fat deposit in the etiology of sudden death is unknown.

Methods and Results--We used the data from 7079 asymptomatic men of the Paris Prospective Study I who were free of ischemic heart disease and who were 43 to 52 years of age at first clinical examination between 1967 and 1972. Body mass index (BMI) and sagittal abdominal diameter (SAD) were measured at baseline and used as markers of overall and abdominal obesity. During a follow-up of 23 years, there were 118 sudden deaths and 192 fatal myocardial infarctions. After adjustment for baseline level of cardiovascular risk factors, trunk subcutaneous fat, and thoracic diameter, the ratio of the fifth over the first quintile of SAD was 2.6 (95% CI 1.0 to 6.7) and 2. 6 (95% CI 1.3 to 5.1) for sudden death and fatal myocardial infarction, respectively, and the risk of sudden death increased proportionally with SAD level. The corresponding ratios for BMI were 2.0 (95% CI 1.1 to 3.8) and 1.0 (95% CI 0.6 to 1.7), respectively. Compared with men with low SAD (first tertile) and normal BMI (<25 kg/m²), men with elevated SAD (third tertile) were at increased risk of sudden death but not of fatal myocardial infarction, whether they were of normal weight (multivariate adjusted relative risk 3. 0 [95% CI 1.3 to 6. 9]) or overweight (BMI 25 kg/m²; 1.9 [95% CI 1.0 to 3.9]).

Conclusions--In asymptomatic French middle-aged men, larger SAD was associated with a particularly increased risk of sudden death, independent of BMI level and known cardiovascular risk factors.

Key words: epidemiology • risk factors • death, sudden • obesity

This article has been cited by other articles:

				S. Debette, N. Leone, D. Courbon, J. Gariepy, C. Tzourio, J.-F. Dartigues, K. Ritchie, A. Alperovitch, P. Ducimetiere, P. Amouyel, et al. Calf Circumference Is Inversely Associated With Carotid Plaques Stroke, November 1, 2008; 39(11): 2958 - 2965. [Abstract] [Full Text] [PDF]

				R. A. Whitmer, D. R. Gustafson, E. Barrett-Connor, M. N. Haan, E. P. Gunderson, and K. Yaffe Central obesity and increased risk of dementia more than three decades later Neurology, September 30, 2008; 71(14): 1057 - 1064. [Abstract] [Full Text] [PDF]

				R. Ceska Clinical implications of the metabolic syndrome Diabetes and Vascular Disease Research, September 1, 2007; 4(3_suppl): S2 - S4. [Abstract] [PDF]

				J.-P. Empana, P. Duciemetiere, B. Balkau, and X. Jouven Contribution of the metabolic syndrome to sudden death risk in asymptomatic men: the Paris Prospective Study I Eur. Heart J., May 1, 2007; 28(9): 1149 - 1154. [Abstract] [Full Text] [PDF]

				J.-P. Despres Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk Eur. Heart J. Suppl., May 1, 2006; 8(suppl_B): B4 - B12. [Abstract] [Full Text] [PDF]

				E. C. Stecker, C. Vickers, J. Waltz, C. Socoteanu, B. T. John, R. Mariani, J. H. McAnulty, K. Gunson, J. Jui, and S. S. Chugh Population-Based Analysis of Sudden Cardiac Death With and Without Left Ventricular Systolic Dysfunction: Two-Year Findings from the Oregon Sudden Unexpected Death Study J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1161 - 1166. [Abstract] [Full Text] [PDF]

				Other articles noted Evid. Based Med., August 1, 2005; 10(4): 127 - 128. [Full Text] [PDF]

				L. Esposito MEASURE FOR MEASURE DOC News, February 1, 2005; 2(2): 18 - 18. [Full Text]