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The INTERHEART Study was a case-control study involving 29,972 participants in 52 countries. The study examined the contribution of various cardiometabolic risk factors to the risk of a first acute myocardial infarction (AMI). The study quantified the relationships between risk factors and AMI through calculation of the population attributable risk (PAR), which measures the proportion of AMI among those who have the risk factor which would be eliminated if the risk factor was removed.
Dyslipidaemia (raised ApoB/ApoA1 ratio) and smoking were associated with the highest PAR. However, the PAR for abdominal obesity was greater than either diabetes or hypertension. BMI showed a modest correlation with the risk of AMI, but this was not significant when abdominal obesity was included in a multivariate analysis.
Abdominal obesity is therefore an important predictor of adverse cardiovascular outcomes in its own right.