Thank goodness, I'm a pear

Dr. Sharma and colleagues reported that of several measures of obesity, including BMI, the best predictor of heart attack risk is the waist-to-hip ratio.


"It just reinforces what we've known for a long time -- the whole apple-shaped, pear-shaped thing," he said. "What's new here is that BMI falls right out of the equation."


"If you just look at crude data, there is some association, but that's just because people with high BMI tend to have a high waist-to-hip ratio," he said. "If you correct for other risk factors, BMI essentially gives you no information."


On the other hand, he said, there's a smooth increase in risk with increasing waist-to-hip ratio, regardless of BMI.


The Interheart study -- a case-control analysis of acute myocardial infarction -- involved 27,098 participants in 52 countries, the investigators reported.

The study had three key findings, he said:

That BMI does not predict heart attack risk, while waist-to-hip ratio does.

That looking at obesity through this new measure triples the number of people who should be regarded as at risk.

And that the link between increased waist-to-hip ratio and increased heart attack risk is consistently found in all countries and cultures.

"The same rules apply to everybody," he said.