A large waist circumference, which is known to raise the risk of cardiovascular disease, may also raise the risk of stroke or mini-stroke, researchers from Germany report.

A large waistline seems to be a better indicator of a person’s risk for suffering a stroke or mini-stroke, also known as “transient ischemic attack” or TIA, than a person’s overall body weight, they report.

Dr. Tobias Back at Saxon Hospital Arnsdorf in Arnsdorf/Dresden and colleagues investigated the extent to which various markers of obesity were associated with the risk of stroke or mini-stroke in 379 adults with a history of stroke or TIA and 758 stroke-free controls of similar age and gender.

While being overweight in general (that is, having a high body mass index or BMI) increased the risk of stroke, this association became nonsignificant after the investigators accounted for “confounding” factors, like being physical inactive, smoking, having high blood pressure or diabetes.

However, being fat around the middle remained strongly associated with an increased risk of stroke or TIA.

For example, individuals with the highest so-called “waist-to-hip ratio” had a greater than 7-fold increased risk of stroke or TIA compared with those with the lowest waist-to-hip ratio.

Waist-to-hip ratio is calculated by dividing the circumference of the waist by the circumference of the hips. More belly fat results in higher ratios.

“If the waist-to-hip ratio values were greater than 0.97 for men and 0.84 for women, then individuals faced almost 8 times increased risk for stroke compared to individuals with a waist-to-hip ratio less than 0.92 in men or less than 0.78 in women,” Back stated.

A large waistline also showed a strong association with stroke and TIA. If the waist circumference was greater than 40.2 inches for men or 34.6 inches for women, the risk of stroke increased more than 4-fold compared with individuals with a normal waist size, according to the researchers.

SOURCE: Stroke, December 2008.