Cardiovascular disease is a major public health issue. Despite of recent advancement in cardiovascular care, cardiovascular diseases remain the leading cause of death in the world. It has more impact on mortality rates than cancer, respiratory diseases or accidents. One in eight men and one in seventeen women die from cardiovascular disease before the age of 65.Cadiovascular disease is responsible for 50 to 80 percent of deaths in the people with diabetes.

Abdominal obesity has reached epidemic proportions worldwide and the number of people affected is rising. Abdominal obesity alone or in combination with other risk factors predicts the development of type 2 diabetes and metabolic syndrome. A high waist circumference increases by 12-fold the risk of diabetes and double the risk of coronary artery disease.

Asian population have a relatively lower Body Mass Index (BMI) but high levels of abdominal fat. They are particularly prone to type 2 diabetes, hypertension and coronary artery disease. An Indian study recently revealed that almost 20 percent of adults who were not overweight or obese still have abdominal obesity, putting them at a greater risk of developing cardiovascular disease.

According to International Diabetic Federation, the cut off for at-risk waist circumference varies by ethnicity. For South Asians, waist circumference up to 90 cm (35.5 inches) for men and up to 80 cm ( 31.5 inches) for women is acceptable.

The health risk associated with abdominal obesity is thought to be due to an accumulation of fat around and inside the abdominal organs such as liver. It affects glucose metabolism and produces abnormal cholesterol and triglycerides.

A comprehensive approach is needed to combat this health problem which includes treatment of the sources of multiple risk factors. Treatment should be focused for cardiovascular prevention now and in the future. In this regard, behavioural modifications such as smoking cessation, correct diet, weight loss and exercise reduce of cardiovascular risks. Seek medical advice for therapies which can provide valuable assistance in future cardiovascular risk.

Dr Md Habibe Millat, MBBS, FRCS(Edin), is a Senior Specialist Registrar, Department of Cardiothoracic Surgery, Cork University Hospital, Republic of Ireland. [Email:mhmillat@hotmail.com]