Waist Circumference and Mortality or Cardiovascular Events in a General Korean Population

Obesity is associated with cardiovascular diseases (CVD). However, body mass index (BMI) has a limited ability to measure abdominal obesity. We aimed to evaluate the associations between waist circumference (WC) and mortality or CVD incidence in a general Korean population. We analyzed a total of 204,068 adults older than 40 years of age who had undergone a national health examination in the Korean National Health Insurance Service Cohort. Hazard ratios for death and CVD incidence were calculated using Cox proportional hazards models after adjustment for age, smoking, alcohol consumption status, levels of physical activity, total cholesterol, hypertension, and diabetes mellitus status. In men, WC and overall mortality showed a reverse J-shaped association. For both men and women, WC was not associated with risk of cardiovascular mortality. Contrary to mortality trend, CVD incidence was positively associated with WC in both men and women, and risk of the CVD incidence was the lowest in subjects with a WC < 80 cm. WC exhibited a significant J-shaped association with overall mortality in men. The risk of incident CVD showed a positive association with central obesity, where the lowest risk was observed for subjects in the lowest WC group in a general Korean population.