Hypertriglyceridemic waist: the point of divergence for prediction of CVD vs. mortality: Tehran Lipid and Glucose Study

Aims We examined hypertriglyceridemic waist (HTGW) predictability for CVD and mortality. Methods Among Tehran Lipid and Glucose Study's participants aged ≥30 (n=8071), we selected those who participated in the follow-up study until 20-March-2009 (n=7154). After exclusions (320 missing data on waist circumference or triglycerides), 6834 (3830 women) participants remained eligible with a total of 59,873 person-year follow-up. When CVD was outcome, we further excluded 426 participants with history of previous CVD. Results All-cause mortality, CVD mortality, and incident CVD rate among men (per 1000-person-year) were 7.9 (95% CIs: 6.9–9.1), 4.1 (95% CIs: 3.4–5.0), and 13.0 (95% CIs: 11.7–14.6), respectively. Among women, corresponding figures were 3.7 (95% CIs: 3.1–4.4), 1.7 (95% CIs: 1.3–2.1), and 7.3 (95% CIs: 6.4–8.3), respectively. After adjustment for potential confounders, HTGW came to be inversely associated with all-cause mortality among both men (HR 0.384, 95% CIs 0.281–0.526) and women (HR 0.642, 95% CIs 0.430–0.958). Multivariate adjusted HR (95% CIs) of HTGW for CVD mortality was 0.453 (95% CIs 0.298–0.688) among men and 0.760 (95% CIs 0.431–1.338) among women. HTGW increased the age-adjusted risk of incident CVD, among both men (40%) and women (97%). The multivariate hazard ratio of HTGW for incident CVD was 0.945 (95% CIs 0.746–0.1.198, P value=0.640) among men and 1.470 among women (HR 95% CIs 1.111–1.944, P value=0.007). Conclusion HTGW was the point of divergence for prediction of CVD vs. mortality. HTGW, despite its predictive value for CVD, might not help in capturing risk of all-cause or CVD mortality. Individuals without HTGW constitute a heterogeneous subgroup with a jumble of risk factors that put them at risk for all-cause or CVD mortality.