Results from a 27 country survey reveal that six out of ten physicians recognise abdominal fat as a significant risk factor for heart disease. However, only a minority of the public are aware of the waist size that puts them at risk for heart disease and less than one in five people can expect to have their waist circumference measured by their doctor.

The survey, called Shape of the Nations, was conducted in 27 countries during July 2005 amongst the general public, people identified as at risk for heart disease, as well as primary care physicians, to assess knowledge and understanding of the increased risk of heart disease posed by excess abdominal fat. It was conducted to coincide with World Heart Day on 25th September 2005. Under this year’s theme, ‘Healthy Weight, Healthy Shape’, World Heart Day activities will be run by the World Heart Federation’s members in 100 countries to encourage the world's population to lead a healthier lifestyle by increasing physical activity and further reducing the risk of heart disease through healthy nutrition, weight control and smoke-free living.

“The Shape of the Nations survey findings point to the need for more education and stronger action to safeguard people from the risk of heart disease, which is the leading single greatest cause of death worldwide,” said Professor Sidney Smith, Chairman of the Scientific Advisory Board for the World Heart Federation.

“Waist circumference is a very important measure of cardiovascular risk, for example we know that patients with increasing abdominal obesity, when occurring with other cardiovascular risk factors including dyslipidaemia, hypertension and raised glucose levels, are at risk of heart disease. Therefore, measuring waist circumference is an easy, low cost indicator that should be added to measurements of other cardiovascular risk factors, such as blood pressure, lipid levels and blood glucose. Unfortunately, the results show that the public does not know about this indicator, or that waist circumference is a cardiovascular risk measure,” added Professor Sidney Smith.

Measuring waist circumference, which is thought to be a better indicator of risk than Body Mass Index (BMI), is a simple and practical way to identify people who may be at high risk of developing disorders such as heart disease, other vascular disease and diabetes. A high-risk waistline is more than 88 cm for women and 102 cm for men from North America; 80 cm for women and 94 cm for men from Europe, 80 cm for women and 90 cm for men from Central and Latin America; the Middle East, India and Asia, 90 cm for women and 85 cm for men from Japan; and 80 cm for women and 94 cm for men from the rest of the world.(1)


Measure Your Waist, Measure Your Risk
Maintaining a healthy weight and body shape is essential as waist circumference has been shown to be linked with increased risk of coronary heart disease (CHD).(2) However, the results of the Shape of the Nations survey highlight that the general population are still focused on absolute weight: 52 per cent of the population currently weigh themselves rather than focusing on where they carry their weight. “It is crucial to increase knowledge about waist measurement as a simple, immediate, reliable indicator of obesity and risk for cardiovascular disease. World Heart Day will help to focus the attention of the general public on waist circumference as well as stimulate medical practitioners to integrate waist measurement within their practices and include it as part of the assessment of cardiovascular risk,” said Professor Smith.

Despite therapeutic advances, cardiovascular disease remains the leading cause of death worldwide. Seventeen million or one in three global deaths each year are the result of heart disease and stroke. It has been predicted that by 2010, heart disease will be the leading cause of death in countries with developing economies.(3) Another factor contributing to the expanding epidemic of cardiovascular disease is the prevalence of diabetes which is set to increase by 72 per cent by the year 2025.(4)

Abdominal obesity (measured by high waist circumference) is linked to the development of several risk factors such as abnormal cholesterol levels, insulin resistance, type 2 diabetes, metabolic syndrome, hypertension inflammation and thrombosis, which may lead to heart disease (myocardial infarction, stroke). (5 ,6) People with abdominal obesity often present to their general practitioner with one or more these additional risk factors.(7) A high waist circumference is also independently associated with an increased risk of cardiovascular disease.(2, 7) The measurement of waist circumference provides physicians with important information on health risk in the evaluation of overweight and obese people(8).


Excess Fat Stored in the Abdomen is Damaging to Health
Not all fat is the same. Subcutaneous fat is stored directly under the skin. The health threat posed by abdominal obesity is largely due to intra-abdominal fat (adipose tissue) located inside the abdominal region and wrapped around the major organs of the body.(5) This intra-abdominal adipose tissue is acknowledged to impact glucose metabolism and cause abnormal levels of HDL cholesterol and triglycerides.(9)

Sanofi-aventis is delighted to partner with the World Heart Federation, a powerful voice in cardiovascular health, to highlight the need for greater preventive measures to help combat this global threat.


Notes to Editors

Shape of the Nations Survey
The survey was conducted by IFOP, a global market research company and
commissioned by sanofi-aventis. Interviews took place via phone during July 2005
among three audiences:
• General population (approximately 400 participants per country); total 11,077 interviews
• At risk patients (approximately 100 participants per country); total of 2,727 interviews
• Primary care physicians (approximately 100 participants per country); total of 2,672 interviews

The countries surveyed were Australia, Austria, Belgium, Brazil, Canada, China, Denmark, Finland, France, Germany, Greece, India, Italy, Japan, Mexico, Netherlands, Poland, Portugal, Russia, South Africa, South Korea, Spain, Sweden, Switzerland, Turkey, United Kingdom and the United States.


About sanofi-aventis
sanofi-aventis is the world’s third largest pharmaceutical company, ranking number one in Europe. Backed by a world-class R&D organization, sanofi-aventis is developing leading positions in seven major therapeutic areas: cardiovascular disease, thrombosis, oncology, diabetes, central nervous system, internal medicine and vaccines. Sanofi-aventis is listed in Paris (EURONEXT:SAN) and in New York (NYSE:SNY). For further information visit: www.sanofi-aventis.com.


About the World Heart Federation
The World Heart Federation, a non-governmental organization based in Geneva, Switzerland, is committed to helping the global population achieve a longer and better life through prevention and control of heart disease and stroke, with a particular focus on low and middle-income countries. It is comprised of 186 member societies of cardiology and heart foundations from 100 countries covering the regions of Asia-Pacific, Europe, the Americas and Africa. For further information visit: www.worldheart.org.

World Heart Federation Media Contact: Lauren O'Brien, Cohn & Wolfe PR Tel: +41 22 908 4074, E-mail: lauren_o'brien@ch.cohnwolfe.com Or visit: http://www.cwnewsroom.ch

Sanofi-aventis Media Contact: Nazira Amra Tel: +33 1 53 77 47 88, Email:nazira.amra@sanofi-aventis.com

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(1) International Diabetes Federation ethnic specific values for waist circumference, the ATP III values for North America only and the ASSO values.

(2) Rexrode KM et al. Abdominal Adiposity and Coronary Heart Disease in women. JAMA 1998;280:1843-8

(3) World Health Organization

(WHO) http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/. Last accessed 25th August 2005

(4) International Diabetes Federation website. Facts and figures. http://www.idf.org/home/index.cfm?node=6. Last accessed 25th August 2005

(5) Després J et al. Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ 2001; 322: 716-720

(6) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Executive Summary of Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001 – 285, 2486-2497

(7) US National Health And Nutrition Examination Survey (NHANES) 1999-2000.

(8) Zhu et al. Waist Circumference and obesity-associated risk factors among whites in the third National health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr 2002; 76: 743-9

(9) Pouliot MC, Despres JP, Nadeau A, et al. Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels. Diabetes 1992; 41:826-34.