Neck Circumference as a Novel Predictor of Cardiovascular Risk Assessed Using Framingham and PREVENT Equations

Purpose: While body mass index (BMI) and waist circumference (WC) are standard clinical tools for anthropometric cardiovascular risk assessment, they are limited by measurement variability and patient discomfort. Neck circumference (NC) may offer a novel, convenient, and accurate alternative anthropometric measure for assessment of cardiovascular risk. Methods: Standardized anthropometric measurements (NC, WC, BMI) were obtained by trained medical students from eligible patients (n = 110, 68% female, 75% African American) from primary care and cardiology offices in an IRB-approved cohort study with retrospective chart review. Electronic medical record data extraction via double data entry was used to calculate cardiovascular risk scores: Framingham, PREVENT CVD, PREVENT ASCVD, and PREVENT HF. Pearson correlation assessed unadjusted associations between NC and cardiovascular risk scores. Separate multivariate linear regression models were constructed for each score, adjusting for age, sex, race, and ethnicity. Results: The African American patient subgroup (n = 82) displayed a positive association of NC with PREVENT Heart Failure Risk (r = 0.22, p = 0.048). Multivariate regression adjusted for age, sex, race, and ethnicity further demonstrated NC as a positive predictor of PREVENT Heart Failure Risk across the entire cohort (β = 0.60, p < 0.01). NC was not predictive of Framingham, PREVENT CVD, or PREVENT ASCVD risk scores, possibly due to sample size limitations. Subject accrual to increase sample size is ongoing. Conclusion: Preliminary data suggest that NC shows potential as a practical tool for clinical prediction of heart failure and cardiovascular risk, particularly in at-risk African Americans.