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J Am Geriatr Soc. 2010 Aug;58(8):1433-40. doi: 10.1111/j.1532-5415.2010.02979.x. Epub 2010 Jul 28.

Waist circumference but not body mass index predicts long-term mortality in elderly subjects with chronic heart failure.

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  • 1Department of Clinical Medicine, Cardiovascular Science and Immunology, Cattedra di Geriatria, Universit√† degli Studi di Napoli Federico II, Naples, Italy.



To examine whether waist circumference (WC) and body-mass index (BMI) can predict long-term mortality in elderly subjects with and without chronic heart failure (CHF).


Longitudinal evaluation with a 12-year follow-up.


Campania, a region of southern Italy.


One thousand three hundred thirty-two subjects aged 65 and older selected from the electoral rolls of Campania.


The relationship between WC or BMI and mortality during a 12-year follow-up in 125 subjects with and 1,143 subjects without CHF.


Mortality increased as WC increased in elderly subjects without CHF (from 47.8% to 56.7%, P=.01), and the increase was even greater in patients with CHF (from 58.1% to 82.0%, P=.01). In contrast, mortality decreased as BMI increased in elderly subjects without CHF (from 53.8% to 46.1%, P0=.046) but not in those with CHF. According to Cox regression analysis, BMI protected against long-term mortality in the absence but not in the presence of CHF. In the absence of CHF, WC was associated with a 2% increased risk of long-term mortality for each 1-cm greater WC (Hazard Ratio (HR)=1.02, 95% confidence interval (CI)=1.01-1.03; P<.001), versus 5% increased in the presence of CHF (HR=1.06, 95% CI=1.02-1.10; P<.001).


WC, but not BMI, is predictive of long-term mortality in elderly individuals with CHF and to a lesser extent in those without CHF.

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