Neck circumference for predicting the occurrence of future cardiovascular events: A 7.6-year longitudinal study

Background & aims: This study aimed to investigate whether neck circumference (NC) could be used to predict future cardiovascular (CV) events in a community-based Chinese cohort.Methods and results: We enrolled 1435 participants aged 50-80 years (men, 43.62%) from com-munities in Shanghai. High NC was defined as NC >= 38.5 cm in men and NC >= 34.5 cm in women. Kaplan-Meier analysis and Cox proportional hazards regression were performed to explore the association between NC and CV events. During a mean follow-up period of 7.6 years, 148 CV events (10.31%) occurred. The incidence of CV events was higher in men than in women (83 (13.26%) vs. 65 (8.03%), P Z 0.002). Multivariable-adjusted Cox regression analysis showed that for every 1-SD increase in NC in the whole population, the hazard ratio (HR) of CV events was 1.45 (95% confidence interval [CI], 1.15-1.83). The dose-response association between NC and CV events was significant in men (HR, 1.37, 95% CI, 1.10-1.71) but not in women (HR, 1.19, 95% CI, 0.94-1.52). In comparison with participants showing low baseline NC, those with high base-line NC showed a significantly higher risk of CV events (HR, 1.59, 95% CI, 1.14-2.22). Further strat-ified by sex, the positive association remained significant in men (HR, 1.90, 95% CI, 1.21-2.98) but not in women (HR, 1.25, 95% CI, 0.75-2.07).Conclusion: NC was significantly associated with the risk of future CV events in middle-aged and elderly populations in the community and was a better predictor in men.(c) 2022 The Author(s). Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).