Body mass index and waist circumference as predictors of recurrent vascular events after a recent ischemic stroke

• Published in: Journal of stroke and cerebrovascular diseases 2023-09, Vol.32 (9), p.107221-107221, Article 107221
• Main Authors: Kang, Kyusik, Park, Jong-Moo, Ryu, Wi-Sun, Jeong, Sang-Wuk, Kim, Dong-Eog, Park, Hong-Kyun, Cho, Yong-Jin, Hong, Keun-Sik, Lee, Kyung Bok, Park, Tai Hwan, Park, Sang-Soon, Lee, Juneyoung, Kim, Beom Joon, Han, Moon-Ku, Bae, Hee-Joon
• Format: Article
• Language: English
• Subjects: Abdominal obesity; Body mass index; Cardiovascular diseases; Ischemic stroke; Obesity paradox; Waist circumference
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2023.107221

•Data on the relationship between larger WC and recurrent vascular risk are scarce.•This study included data on patients with a first-ever stroke who had their WC measured on admission.•Patients in the fourth quintile of WC had the lowest risk of recurrent stroke and major vascular events.•Our results show favorable effects of abdominal obesity on the avoidance of recurrent stroke and major vascular events after ischemic stroke. Although elevated body mass index (BMI) is a risk factor for stroke, it appears to protect against recurrent vascular events. We tried to evaluate BMI and waist circumference (WC) as predictors of recurrent stroke and vascular events in a cohort of stroke survivors who were followed for 12 months. We analyzed the stroke registry database of 6 hospitals and recruited patients with a first-ever stroke who were admitted from January 2011 to November 2019 and had their BMI and WC measured. Cox proportional hazards models were used to compare risks of recurrent stroke and major vascular events (a composite of stroke, myocardial infarction, or vascular death) between different BMI and WC quintiles. Reference categories were patients in the lowest quintiles. A total of 14 781 patients were analyzed. Patients in the second quintile of BMI had the lowest risk of recurrent stroke (adjusted hazard ratio (HR) 0.72; 95% confidence interval (CI) 0.58–0.91); patients in the highest quintile had the lowest risk or a major vascular event (adjusted HR 0.71; 95% CI 0.58–0.86). Patients in the fourth quintile of WC had the lowest risk of recurrent stroke (adjusted HR 0.73; 95% CI 0.59–0.91) and a major vascular event (adjusted HR 0.72; 95 % CI 0.60–0.86). Our results show favorable effects of excess body weight and intra-abdominal fat on avoidance of vascular events after stroke and a favorable effect of intra-abdominal fat on avoidance of recurrent stroke.