Central Obesity and Visceral Adipose Tissue Are Not Associated With Incident Atherosclerotic Cardiovascular Disease Events in Older Men

BACKGROUND: Visceral adipose tissue (VAT) and other measures of central obesity predict incident atherosclerotic cardiovascular disease (ASCVD) events in middle‐aged individuals, but these associations are less certain in older individuals age 70 years and older. Our objective was to estimate the associations of VAT and the android–gynoid fat mass ratio, another measure of central obesity, with incident ASCVD events among a large cohort of older men. METHODS AND RESULTS: Two thousand eight hundred ninety‐nine men (mean [SD] age 76.3 [5.5] years) enrolled in the Outcomes of Sleep Disorders in Older Men study had rigorous adjudication of incident ASCVD events (myocardial infarction, coronary heart disease death, or fatal or nonfatal stroke). We used proportional hazards models to estimate the hazard ratios for incident ASCVD per SD increase of VAT or android–gynoid fat mass ratio (measured at baseline with dual‐energy absorptiometry), adjusted for age, race, education, systolic blood pressure, smoking status, oxidized low‐density lipoprotein level, treatment for hypertension, statin use, aspirin use, presence of diabetes mellitus, and study enrollment site. Over a mean (SD) follow‐up period of 7.9 (3.4) years, 424 men (14.6%) had an incident ASCVD event. Neither VAT nor android–gynoid fat mass ratio were associated with incident ASCVD events, either unadjusted or after multivariable‐adjustment (hazard ratios [95% confidence interval ] per SD increase 1.02 [0.92–1.13] and 1.05 [0.95–1.17], respectively). CONCLUSIONS: Central adipose tissue, as measured by VAT or android–gynoid fat mass ratio, was not associated with incident ASCVD events in this study of older men.