Abstract

Purpose : To determine if waist circumference (WC) or body mass index (BMI) is more strongly associated with cardiometabolic risk factors among family members of patients hospitalized for cardiac disease, overall and by race/ethnicity. Methods : Participants in the NHLBI F amily I ntervention T rial for Heart Health ( F.I.T. Heart ) were included in this analysis (n=472; mean age 48±14 years, 67% female, 36% non-white). Height, weight, WC, BMI, blood pressure, high density lipoprotein (HDL)-cholesterol, triglycerides, fasting glucose, and c-reactive protein (hs-CRP) were systematically measured in all participants. Global risk was calculated using the Framingham function. Results : The prevalence of cardiometabolic risk factors and their association with WC and BMI is shown in Table 1 . The most common correlate of increased WC and BMI was elevated hs-CRP. Overall, increased WC was the strongest correlate of glucose≥100 and hs-CRP≥3.0. BMI≥25 was the strongest predictor of blood pressure≥140/90, low HDL, triglycerides≥150, and global risk≥10%. Among non-whites, increased WC did not identify those with blood pressure≥140/90, glucose≥100 or global risk≥10% and BMI≥25 did not identify those with low HDL or glucose≥100. There was a significant interaction between race/ethnicity and increased BMI in predicting low HDL (p<0.01), with a stronger correlation in whites than non-whites. Conclusions : The prevalence of cardiometabolic risk factors and their correlation with WC and BMI varies by race/ethnicity. Our data support inclusion of both WC and BMI in screening guidelines for diverse populations to identify individuals at increased cardiometabolic and global risk. Table 1. Prevalence of and Association between Indices of Obesity and Cardiometabolic Risk

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