Glossary Of Terms - WXYZ

Waist-to-hip ratio Walking Warfarin Weight Weil's disease

Waist-to-hip ratio, WHR, has been found to be a better guide to risk of atherosclerosis and/or other heart disease than Body Mass Index BMI, or waist or hip measurements. Atherosclerosis here means the fatty deposits on artery walls, with related thickening, so the narrowing reduces the blood flow.

Some doctors currently (2011) recommend that men should try to keep their waist not greater than 37 inches; and women should try to keep theirs below 35 - to minimise the risk of type 2 diabetes, cancers, and heart disease.

To get your WHR

● While standing and breathing normally, measure around your waist – about level with or just above your belly button, half way between the bottom of your rib cage and the top of your hips; without pulling the tape measure tight.

● Measure around the widest part of your hips, over your buttocks, similarly.

● Divide the waist measurement by the hip measurement to get the WHR.

Women with a ratio of 0.85 or over, and men with 0.95 or over are said to have raised WHR. This is found to be a predictor of atherosclerosis and/or other heart disease – a much better predictor of heart disease than BMI.

To get your BMI, divide your weight in kilograms by the square of your height in metres. BMI under 18.5 is underweight, 18.5 to 25 healthy, 25 to 30 overweight, and over 30 obese.

Obesity increases the risks of: high blood pressure, diabetes, high cholesterol, heart attack, stroke, gallbladder disease, osteoarthritis, endometrial cancer, depression, and fertility problems; and shortens life expectancy.

Research at the University of Texas had found that men over 37 inches (94cm) waist, and women over 32 inches (81.3cm) had an increased heart disease risk. The sample was 2744 people.

Walking can help one to:

● feel good, sleep better, reduce stress, keep heart healthy, reduce blood pressure; and lose weight;

● reduce risks of CHD, strokes, diabetes, and bowel cancer;

● maintain independence longer when older; and

● live longer and in better health.

See also Exercise.

Warfarin. Warfarin is named after Wisconsin Alumni Research Foundation and Coumarin. Coumarin is an anticoagulant. See under Anticoagulant, under ablation for AF, and under Valve surgery.

See Glucosamine as that and some other drugs that may interact with warfarin are: aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs); diuretics; chemotherapy; oral contraceptives; lipid-lowering drugs (statins, drugs that bind to bile salts, and drugs that act on the liver); amiodarone (for some abnormal heart rhythms); barbiturates; cimetidine (anti-ulcer); steroids; some laxatives; some antidepressants; some antibiotics; and some herbal medicines.

The main treatment used to be warfarin, which required frequent monitoring of the INR. Newer types of anticoagulants are also available and are becoming increasingly common. These include:
● rivaroxaban (Xarelto)
● dabigatran (Pradaxa)
● apixaban (Eliquis)
● edoxaban (Lixiana)

Weight. See Body mass index, waist to hip ratio.

Weil's disease is typically caused by the water of a lake or river entering the body eg through a wound not covered by a waterproof dressing, or by swallowing. It is carried by water rats. It can come on in 0 to 19 days. The symptoms, with mnemonic THE FARM VioLiNs, are:

● Temperature
● Headache
● Eyes sore
● Fever
● Appetite loss
● Rash or red spots that may or may not disappear when pressure is applied, eg by a glass tumbler. In meningitis the spots disappear when pressure applied.
● Muscular pain
● Violent vomiting
● Light aversion, wanting to be in the dark
● Neck stiff.
These THE FARM VioLiNs are similar to meningitis.

Take the patient to A&E without delay. Tell the doctor / nurse that he or she has been in a lake or whatever, as Weil's disease is rare and a medic might not think of this or meningitis. Delay could be fatal.

In the UK there are less than or up to about 100 cases per year, mostly sewage workers. But occasionally a canoeist, dinghy sailor, or swimmer who was in contact with a lake, river water, or seaside gets it.

Prevention is by covering any skin injury with a waterproof dressing, and not allowing any such water to enter the body – eg by mouth or nose. Then have a bath or shower before bedtime that day.


This information was created and edited by Richard Maddison for the BCPA.
Copyright © 1997-2019 The British Cardiac Patients Association, and/or Richard Maddison.
BCPA Head Office: 15 Abbey Road, Bingham, Nottingham NG13 8EE
Reg Charity 289190. Email:

First published in this form 2002, and updated 2005, 2007, 2008, 2011, 2012, 2013, 2017.
All rights reserved. No part of this work may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without written permission from the BCPA Head Office.

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Authors, sources and acknowledgements

The main sources are BCPA Journal published articles, other information from authors, and publicly available documents and websites. In many cases the journal articles give sources and further information than the Glossary entries.

Parts of the wordings under ECG and Echocardiogram are adapted with permission from BUPA's health information resources, available at

We hope we have thanked everyone.

Richard Maddison

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