Stroke is another cause of death wherein risk is significantly increased by obesity: "Analyzing the ARIC Study database in which subjects' BMI, waist circumference and waist-to-hip ratio were measured at the study's start, [researchers] followed 13,549 middle-aged black and white men and women in four U.S. communities from 1987 through 2005. Participants started the study free of cancer and cardiovascular disease. During the follow-up period of about 19 years, 598 ischemic strokes occurred. The researchers calculated incidence rate - the number of new cases per 1,000 people per year - according to groups representing different degrees of obesity, using each obesity measure ... the correlation between increasing stroke incidence and increasing degree of obesity was apparent in both races and genders ... Individuals in the highest BMI category had 1.43 to 2.12 times higher risk of stroke. When waist circumference was used as a measure of obesity instead of BMI, those risk ratios ranged from 1.65 to 3.19; and 1.69 to 2.55 when waist-to-hip ratio was used. Thus, for any obesity measure, individuals in the highest category had approximately two times higher risk of stroke compared to the lowest category in each race-sex group."