We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Waist to Hip Ratio as a Supplement to Body Mass Index—Reply

Gang Hu, MD, PhD; Jaakko Tuomilehto, MD, PhD; Karri Silventoinen, PhD; Pekka Jousilahti, MD, PhD
Arch Intern Med. 2008;168(2):238. doi:10.1001/archinternmed.2007.62.
Text Size: A A A
Published online


In reply

We appreciate Hartz and Rimm for their comments on our results regarding BMI, waist circumference, and WHR and the risk of total and type-specific stroke.1 We agree with their first comment that the article would be valuable if more than 1 obesity indicator were included in the same regression equation. We have reanalyzed our data and included both BMI and WHR in the multivariate model. After adjustment for age, study year, smoking, and WHR, hazard ratios of ischemic stroke among subjects who were underweight (BMI [calculated as weight in kilograms divided by height in meters squared] <18.5), overweight (BMI, 25.0-29.9), and obese (BMI ≥30.0) were 0 (no ischemic cases), 1.41 (95% confidence interval [CI], 0.96-2.07), and 1.75 (95% CI, 1.12-2.76), respectively, among men, and 5.94 (95% CI, 2.11-16.7), 1.26 (95% CI, 0.84-1.90), and 1.75 (95% CI, 1.11-2.74), respectively, among women, compared with men and women with normal weight (BMI, 18.5-24.9). The joint association of BMI and WHR with the risk of ischemic stroke is also shown in the Figure. After adjustment for age, study year, and smoking, the positive trend of WHR on the risk of ischemic stroke was found at different levels of BMI only among men.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Adjusted data for ischemic stroke according to joint effects of body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and waist to hip ratio among men (A) and women (B). Data are given as relative risk; adjusted for age, study year, and smoking.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Quick Reference