Burden Of Cardiometabolic Risk Factors Research Articles

High burden of cardiometabolic risk factors in spouses of Indian women with hyperglycaemia in pregnancy.

To evaluate the burden and association of cardiometabolic risk factors in the spouses of women with and without hyperglycaemia in pregnancy. Women with (n=204) and without (n=197) hyperglycaemia in pregnancy, along with their spouses, participated in this cross-sectional study. The hyperglycaemia in pregnancy group included women with gestational diabetes and diabetes in pregnancy. A detailed questionnaire was completed for all participants (men and women), documenting relevant personal and medical history, along with biochemical investigations (men). A total of 401 couples were evaluated at the time point during the pregnancy of 24.7±5.2 gestational weeks (mean ± sd). Dysglycaemia (prediabetes or diabetes), overweight/obesity (BMI ≥25 kg/m2 ) and metabolic syndrome were detected in 120 (58.9%), 123 (60.3%) and 98 spouses (48.3%) of women with hyperglycaemia in pregnancy, respectively. In the fully adjusted model, an increased risk of dysglycaemia [odds ratio 1.43 (95% CI 0.95-2.17); P=0.088], overweight/obesity [odds ratio 1.49 (95% CI 0.98-2.27); P=0.064] and metabolic syndrome [odds ratio 2.00 (95% CI 1.30-3.07); P=0.001] was seen in the spouses of women with hyperglycaemia in pregnancy. The prevalence of these metabolic conditions was higher in spouses of women with diabetes in pregnancy compared to spouses of women with gestational diabetes mellitus. A high burden of cardiometabolic risk factors was observed in the spouses of women with hyperglycaemia in pregnancy. The opportunity provided by pregnancy could be used by the healthcare system not only to improve the health of the woman and her offspring, but also her spouse.

Clustering of Cardiometabolic Risk Factors among Children and Adolescents in a Rural Community in Ondo, Southwest Nigeria.

Clustering of cardiometabolic risk factors is rapidly becoming prevalent among children and adolescents with grave implications for their cardiovascular health. We set out to determine prevalence and pattern of clustering of risk factors and, identify factors (if any) that determine their clustering. A cross-sectional study of children (3-9 years) and adolescents (10-17 years) in a rural, agrarian community. Their blood pressure, body mass index and lipids were measured. Data was analyzed with SPSS 20. A total of 114 (M:F, 1:1.1) subjects were studied. The mean age of children and adolescents were 5.6 ± 2.1 and 12.9 ± 2.2 years respectively. The most prevalent cardiometabolic risk factors were elevated non-high density lipoprotein-cholesterol (HDL-c; 39.5%), low HDL-c (33.3%), prehypertension (12.3%) and overweight (9.6%). The prevalence of hypertension was higher among females (11.9% vs. 1.8%, p = 0.024) and adolescents (13.2% vs. 1.6%, p = 0.037). Serum levels of non-HDL-c was higher among adolescents than children (50.9% vs. 29.5%, p = 0.013). At least one risk factor was present in 68.4% of the subjects. Clustering of two and three risk factors were present in 18.4% and 6.1%. The presence of prehypertension (χ2 23.93, p < .001), hypertension (χ2 12.19, p = 0.002), high serum non-HDL-c (χ2 6.336, p = 0.011) and high serum total cholesterol (TC; χ2 8.810, p < 0.001) were associated with clustering of cardiometabolic risk factors. The burden of cardiometabolic risk factors among children and adolescents is high. Identified determinants of risk factor clustering were prehypertension, hypertension, non-HDL-c and TC.

Association between life-course socio-economic status and prevalence of cardio-metabolic risk ractors in five middle-income countries.

BackgroundThe burden of non-communicable diseases has increased rapidly in low- and middle-income countries. Past studies have reported an association between socioeconomic status (SES) and cardio-metabolic risk factors, but most have focused on upper income countries. The purpose of this study is to examine the association between SES over the life-course and the burden of cardio-metabolic risk factors in middle-income countries.MethodsA total of 38 297 adults from China, Mexico, India, South Africa and Russia were included in this cross-sectional study. Life-course SES was defined based on maternal and participant education, and data on blood pressure, body mass index (BMI), self-reported diabetes and hypertension were obtained by trained interviewers. Descriptive, age standardized and multivariable adjusted analyses were conducted using survey weighted statistical procedures in SAS 9.4 (SAS Institute, Cary, NC, USA).ResultsAlthough 14% of men and 12% of women had current hypertension based on blood pressure measurements, only 2% of men and 4% of women were aware of their hypertensive status. Men with stable high life-course SES had higher odds of being overweight/obese (odds ratio OR = 2.01, 95% confidence interval (CI) = 1.30-3.10), diabetic (OR = 4.82, 95% CI = 2.07-11.2) and hypertensive based on self-report (OR = 3.42, 95% CI = 1.85-6.32) compared to men of low life-course SES. Among women, the odds of being overweight/obese were significantly higher among women with high life-course SES (OR = 1.50, 95% CI = 1.08-2.08).ConclusionsHigher life-course SES for both men and women was associated with increased odds of overweight/ obesity, and additionally diabetes and hypertension for men in middle income countries.

PO509 High Burden of Cardio-Metabolic Risk Factors Among People With Diabetes In India: Results From a Large Community Based Study UDAY

PO509 High Burden of Cardio-Metabolic Risk Factors Among People With Diabetes In India: Results From a Large Community Based Study UDAY

Cardiometabolic Risk Factors among Healthcare Workers: A Cross-Sectional Study at the Sefwi-Wiawso Municipal Hospital, Ghana.

Background There is a dearth of information about the burden of cardiometabolic risk factors among the Ghanaian health workforce in the Western Region. This study sought to determine the prevalence of cardiometabolic risk factors among healthcare workers at the Sefwi-Wiawso Municipal Hospital in the Western Region of Ghana. Materials and Methods A hospital-based cross-sectional study involving 112 employees of the Sefwi-Wiawso Municipal Hospital was conducted. The cardiometabolic risk variables assessed were obesity, hypertension, dyslipidaemia, and diabetes. Sociodemographic parameters were also captured. The prevalence of hypertension and obesity was determined using the JNC VII panel and WHO BMI criteria for obesity classifications. Blood lipids and glucose concentrations were evaluated using standard methods. Results The prevalence of hypertension and prehypertension was 16.07% and 52.68%, respectively. About 38.39% of participants were overweight, and 12.50% were obese. Atherogenic dyslipidaemia was 26.79%, whereas prediabetes glycaemic levels and diabetes incidence were 5.41% and 4.50%, respectively. Fifty percent (50.00%) of participants presented at least one cardiometabolic risk factor. Aging and adiposity were associated with increasing cardiometabolic risk. Conclusion Cardiometabolic risk factors are prevalent among healthcare providers in Sefwi-Wiawso. The cardiometabolic dysregulation observed among this cohort of healthcare professionals may be modulated by age and adiposity.

A biomarker feasibility study in the South East Asia Community Observatory health and demographic surveillance system.

Integration of biomarker data with information on health and lifestyle provides a powerful tool to enhance the scientific value of health research. Existing health and demographic surveillance systems (HDSSs) present an opportunity to create novel biodata resources for this purpose, but data and biological sample collection often presents challenges. We outline some of the challenges in developing these resources and present the outcomes of a biomarker feasibility study embedded within the South East Asia Community Observatory (SEACO) HDSS. We assessed study-related records to determine the pace of data collection, response from potential participants, and feedback following data and sample collection. Overall and stratified measures of data and sample availability were summarised. Crude prevalence of key risk factors was examined. Approximately half (49.5%) of invited individuals consented to participate in this study, for a final sample size of 203 (161 adults and 42 children). Women were more likely to consent to participate compared with men, whereas children, young adults and individuals of Malay ethnicity were less likely to consent compared with older individuals or those of any other ethnicity. At least one biological sample (blood from all participants - finger-prick and venous [for serum, plasma and whole blood samples], hair or urine for adults only) was successfully collected from all participants, with blood test data available from over 90% of individuals. Among adults, urine samples were most commonly collected (97.5%), followed by any blood samples (91.9%) and hair samples (83.2%). Cardiometabolic risk factor burden was high (prevalence of elevated HbA1c among adults: 23.8%; of elevated triglycerides among adults: 38.1%; of elevated total cholesterol among children: 19.5%). In this study, we show that it is feasible to create biodata resources using existing HDSS frameworks, and identify a potentially high burden of cardiometabolic risk factors that requires further evaluation in this population.

Apolipoprotein L1 Genetic Variants Are Associated with Chronic Kidney Disease but Not with Cardiovascular Disease in a Population Referred for Cardiac Catheterization

Background: While the association between APOL1 genetic variants and chronic kidney disease (CKD) has been established, their association with cardiovascular disease (CVD) is unclear. This study sought to understand CKD and cardiovascular risk conferred by APOL1 variants in a secondary cardiovascular prevention population. Methods: Two risk variants in APOL1 were genotyped in African-Americans (n = 1,641) enrolled in the CATHGEN biorepository, comprised of patients referred for cardiac catheterization at Duke University Hospital, Durham, NC, USA (2001-2010). Individuals were categorized as noncarriers (n = 722), heterozygote (n = 771), or homozygote carriers (n = 231) of APOL1 risk alleles. Multivariable logistic regression and Cox proportional hazards models adjusted for CVD risk factors were used to assess the association between APOL1 risk variants and prevalent and incident CKD, prevalent coronary artery disease (CAD), incident CVD events, and mortality. Results: The previously identified association between APOL1 variants and prevalent CKD was confirmed (OR: 1.85, 95% CI: 1.33-2.57, p = 0.0002). No statistically significant associations were detected between APOL1 variants and incident CKD or prevalent CAD, incident CVD events or mortality. Age, type 2 diabetes, and ejection fraction at baseline were significant clinical factors that predicted the risk of incident CKD in a subgroup analysis of APOL1 homozygous individuals. Conclusion:APOL1 genetic variants are not associated with CAD or incident CVD events in a cohort of individuals with a high burden of cardiometabolic risk factors. In individuals with homozygous APOL1 status, factors that predicted subsequent CKD included age, presence of type 2 diabetes, and ejection fraction at baseline.

Metabolic abnormalities in patients with inflammatory rheumatic diseases.

Patients with rheumatoid arthritis (RA) experience an increased cardiometabolic risk factor burden that is substantially driven by systemic inflammation. This occurs less consistently in patients with ankylosing spondylitis (AS). Psoriatic arthritis most strongly associates with excess adiposity and metabolic risk. RA patients also often have systemic inflammation-induced proinflammatory high-density lipoprotein (HDL) cholesterol particles and lean/muscle mass loss in association with increased adiposity, a condition termed rheumatoid cachexia, which further enhances cardiovascular risk. The presence of proinflammatory HDL and lean mass loss was also reported in patients with AS. Individualized aerobic and resistance exercise programs can improve body composition and metabolic risk factor profiles in RA and AS. Future studies should assess how long-term lifestyle changes can be effectuated and if these can influence cardiovascular events in inflammatory rheumatic diseases. Herein, we review the current evidence on metabolic abnormalities in inflammatory arthritis. We propose management strategies and a research agenda.

High prevalence of cardiometabolic risk factors in young employees of Information Technology industry.

Background:We assessed the burden of cardiometabolic risk factors in Information Technology (IT) employees as they are exposed to adverse lifestyle.Materials and Methods:In this cross-sectional study, health records were obtained from two IT industries in Pune. Prevalence of cardiometabolic risk factors [hyperglycemia, high blood pressure (BP), hypertriglyceridemia, high low-density lipoprotein (LDL)-cholesterol, low high-density lipoprotein (HDL)-cholesterol, and overweight/obesity] was determined using standard cutoffs. We also examined clustering of risk factors (≥two risk factors).Results:Data were available on 1,350 of 5,800 employees (mean age: 33 ± 6 years, 78% men). Prevalence of diabetes and hypertension was 2.5% and 13.5%, respectively. Prevalence of prediabetes, borderline high BP, hypertriglyceridemia, high LDL-cholesterol, low HDL-cholesterol, and overweight/obesity was 6.5%, 20.3%, 21%, 22.1%, 70.1%, and 51.4%, respectively. Risk factor clustering was observed in 63.5% that increased with age (P < 0.001).Conclusion:Given the high burden of risk factors at relatively young age, spreading awareness and promoting healthy lifestyle through workplace interventions are warranted.

Association between Vitamin D Status and Cardio-Metabolic Risk Factors among Adults with and without Coronary Heart Disease in Saudi Arabia

Objective: Recent literature has suggested an association between low serum vitamin D levels and the burden of cardio-metabolic risk factors (obesity, diabetes, hypertension, and hypercholesterolemia). In the context of the high prevalence of vitamin D deficiency and cardio-metabolic risk factors in Saudi Arabia, this study was designed to examine the association between vitamin D deficiency and cardio-metabolic risk factors among adults with coronary heart disease (CHD) and without CHD in Saudi Arabia. Methods: A total of 130 CHD subjects and 195 subjects without CHD were recruited from three hospitals in the western region of the Kingdom. Fasting blood samples were collected from each subject to measure serum levels of vitamin D, glucose, and total cholesterol. Anthropometric and blood pressure were also measured. Results: Subjects with CHD had a higher prevalence of diabetes (35.4% and 14%, respectively) and obesity (44% and 22%, respectively) compared with subjects without CHD. However, subjects without CHD had a higher prevalence of cholesterol (13.3% and 5.4%, respectively) and overweight (45% and 24.4%, respectively) than subjects with CHD. The results indicated that vitamin D deficiency [serum 25(OH)D<20 ng/mL] was associated with increased risk of diabetes in CHD subjects (OR: 2.9, 95% CI: 1.02-8.5, p=0.04), while there was no association observed in subjects without CHD (OR:1.4, 95% CI: 0.5-3.8, p=0.616). No significant associations were found between vitamin D deficiency and other cardio-metabolic risk factors including obesity, hypertension, and hypercholesterolemia, in either group. Conclusion: The present study reveals that vitamin D deficiency was associated with a higher risk of diabetes only in subjects with CHD, but not in subjects without CHD. However, this differential association between vitamin D deficiency and other cardio-metabolic risk factors was not observed. Further studies are needed to confirm these findings.

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. UK Medical Research Council, US National Institutes of Health.

PM175 Reproducibility of dermal microvascular blood flow changes in response to reactive and thermal hyperaemia utilising laser skin doppler

O ST E R A B ST R A C T S adiposity, smoking, systolic blood pressure, and metabolic syndrome were inversely associated with endothelial function after adjustment for age and sex (Table). However, there were no associations between early life growth and endothelial function. Conclusion: These are the first prospective data from India showing that cardiometabolic risk factors, but not early life growth, are inversely associated with endothelial function. The high cardiometabolic risk factor burden in this cohort may have attenuated any potential associations between early life growth and endothelial function. Disclosure of Interest: None Declared

National and sub-national prevalence, trend, and burden of cardiometabolic risk factors in Iranian children and adolescents, 1990 - 2013.

Non-communicable diseases (NCDs) and their risk factors are a major health threat at the global level, notably for developing countries. The tracking of cardiometabolic risk factors from childhood to adulthood is well documented. Therefore, more attention needs to be directed at primordial and primary prevention of NCDs. Given the high prevalence of NCDs and their risk factors in Iranian population, a study was designed to determine the attributable burden of cardiometabolic risk factors in Iranian pediatric population during past decades. This paper explains the definitions, organization, data sources, methods of data gathering or generating, data analyses, and the trend analysis of the study. A national expert working group addressed unmet needs and offered consultations on the selection of risk factors and the practical definition of disease. In the later stages, during the course of the study, they will supervise the statistical modeling methods, the interpretation of results, and the publication strategy. Also an international expert advisory group will collaborate with the project team. The findings of this study could provide basic information regarding NCD related risk factors, and their burden and trends in children, which is necessary for health policy decisions to reduce the burden of disease and to plan cost-effective preventive strategies.

Increased burden and severity of metabolic syndrome and arterial stiffness in treatment na&amp;iuml;ve HIV+&amp;nbsp;patients from Cameroon

BackgroundHuman immunodeficiency virus (HIV) and its therapy are associated with increased aortic stiffness and metabolic syndrome (MetS) phenotype in Caucasian patients. We hypothesized that, independently of antiretroviral therapy, HIV infection in native black African patients is associated with increased burden of cardiometabolic risk factors that may accelerate arterial structural damage and translate into increased aortic stiffness.Patients and methodsNinety-six apparently healthy Cameroonian subjects (controls) were compared to 108 untreated Cameroonian HIV+ patients (HIV-UT) of similar age. In each participant, pulse wave velocity (Complior), aortic augmentation index (SphygmoCor), brachial blood pressure (Omron 705 IT), fasting plasma glucose (FPG), and lipids were recorded, as well as the prevalence and severity of MetS, based on the American Heart Association/National Heart, Lung, and Blood Institute score ≥3/5.ResultsPrevalence of impaired fasting glucose (FPG 100–125 mg · dL−1) and of diabetes (FPG > 125 mg · dL−1) was higher in HIV-UT than in controls (47% versus 27%, and 26% versus 1%, respectively; both P < 0.01). Fasting triglycerides and the atherogenic dyslipidemia ratio were significantly higher in HIV-UT than in controls. Hypertension prevalence was high and comparable in both groups (41% versus 44%, respectively; not significant). HIV-UT patients exhibited a twice-higher prevalence of MetS than controls (47% versus 21%; P = 0.02). Age- and sex-adjusted pulse wave velocity was higher in HIV-UT than in controls (7.5 ± 2.2 m/s versus 6.9 ± 1.7 m/s, respectively; P = 0.02), whereas aortic augmentation index was significantly lower (6% ± 4% versus 8% ± 7%, respectively; P = 0.01).ConclusionSimilar to Caucasian populations, native Cameroonian HIV-UT patients showed a higher prevalence of MetS and its phenotype, associated with increased aortic stiffness, an early marker of atherosclerosis.

OP60 Risk of Future Depression in People who Are Obese but Metabolically Healthy: The English Longitudinal Study of Ageing

BackgroundThere is some evidence to suggest that obesity is a risk factor for the development of depression, although this is not a universal finding. This discordance might be ascribed to...

Risk of future depression in people who are obese but metabolically healthy: the English longitudinal study of ageing

There is some evidence to suggest that obesity is a risk factor for the development of depression, although this is not a universal finding. This discordance might be ascribed to the existence of a ‘healthy obese phenotype’– that is, obesity in the absence of the associated burden of cardio-metabolic risk factors. We examined whether the association of obesity with depressive symptoms is dependent on the individual’s metabolic health. Participants were 3851 men and women (aged 63.0 ± 8.9 yrs, 45.1% men) from the English Longitudinal Study of Ageing, a prospective study of community dwelling older adults. Obesity was defined as body mass index ≥ 30 kg/m2. Based on blood pressure, HDL-cholesterol, triglycerides, glycated haemoglobin, and C-reactive protein, participants were classified as ‘metabolically healthy’ (0 or 1 metabolic abnormality) or ‘unhealthy’ (≥ 2 metabolic abnormalities). Depressive symptoms were assessed at baseline and at 2 years follow up using the 8-item Centre of Epidemiological Studies Depression (CES-D) scale. Obesity prevalence was 27.5%, but 34.3% of this group was categorized as metabolically healthy at baseline. Relative to non-obese healthy participants, after adjustment for baseline CES-D score and other covariates, the metabolically unhealthy obese participants had elevated risk of depressive symptoms at follow-up (odds ratio [OR] = 1.50, 95% CI, 1.05–2.15), although the metabolically healthy obese did not (OR = 1.38, 95% CI, 0.88–2.17). The association between obesity and risk of depressive symptoms appears to be partly dependent on metabolic health, although further work is required to confirm these findings.

Abstract 16791: Elevated Post-Prandial Triglyceride Concentrations Are Associated with an Unfavorable Cardiometabolic Risk Factor Profile in Patients with Coronary Artery Disease

Background: The role of the post-prandial triglyceride (ppTG) metabolism for cardiovascular risk has not been studied prospectively. Study design: The cohort of this prospective study consisted of N=514 consecutive patients with documented stable coronary artery disease (CAD) (83% male, 17% female, age 66±0.4 years), who were subjected to a novel sequential oral triglyceride and glucose tolerance test (OTT / OGT). The test protocol (75g cream fat given 3 hours prior to 75g glucose) was previously characterized and validated. Results: Patients with normal glucose tolerance (N=126) had the lowest fasting (fTG) (108±4mg/dl) and ppTG (195±7mg/dl) concentrations, whereas patients with pathologic glucose tolerance (n=150; fTG 167±10mg/dl vs. ppTG 293±14mg/dl) and patients with diabetes (n=238; fTG 175±11mg/dl vs. ppTG 297±12mg/dl) were characterized by elevated fTG and ppTG. The mean relative TG increase (% vs. baseline) was comparable between subgroups. However, patients showed a large inter-individual variability with respect to ppTG metabolism within each group. Patients in the upper compared to the lower ppTG tertile were younger and had a more severe cardiovascular risk profile (e.g. more active smokers, higher blood pressure, higher body mass index and waist-to-hip-ratio). There were no differences in the angiographic extent of CAD, heart rate or medication. Patients in the upper ppTG tertile had higher concentrations of fasting glucose and insulin, HbA1c, total and LDL cholesterol, whereas HDL was lower. Markers of ppTG metabolism including area under the curve and maximal TG increase per hour were significantly elevated in these patients (p&lt;0.01, Chi 2 or ANOVA where indicated). Underscoring these findings, 53% of patients in ppTG tertile 3 vs. 38% in tertile 1 had diabetes and 76% vs. 32% in tertile 1 met the WHO definition criteria of the metabolic syndrome. Conclusions: Elevated ppTG concentrations characterize CAD patients with a high burden of cardiometabolic risk factors. Interestingly, patients differed strongly in the individual ppTG response. Multivariable analyses of cardiovascular events after the 12-months follow-up show that assessment of ppTG metabolism improves risk stratification in CAD patients.

Abdominal obesity and the spectrum of global cardiometabolic risks in US adults

To compare the association of obesity and abdominal obesity with cardiometabolic risk factor burden and global estimated coronary heart disease (CHD) risk among multiethnic US adults. Cross-sectional, survey study. A total of 4456 participants (representing 194.9 million adults) aged 20-79 years in the 2003-2004 National Health and Nutrition Examination Survey (NHANES). Body mass index (BMI) and waist circumference (WC) measures, CHD risk factors and a 10-year estimated CHD risk based on Framingham algorithms. Obesity was defined as a BMI >or=30 kg/m(2) and abdominal obesity as a WC >88 cm in women and >102 cm in men. High CHD risk status included diabetes, cardiovascular disease (CVD) or a 10-year Framingham risk score of >20%. Overall, abdominal obesity was present in 42.3% of men and 62.5% of women and in 53.6% of whites, 56.9% of blacks and 50.5% of Hispanics (P<0.001 between gender and ethnicity). However, using International Diabetes Federation (IDF)-recommended WC cut points for Hispanics, the prevalence of abdominal obesity was 78.3%. Mean levels of low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure, fasting glucose and C-reactive protein increased, and high-density lipoprotein cholesterol (HDL-C) decreased (P<0.001) according to BMI and WC categories, although these associations were attenuated in blacks for blood pressure, LDL-C, HDL-C and triglycerides. Of those with high WC, 25-35% had >or=3 cardiometabolic risk factors. High CHD risk among those with high WC was most common in men (27.9%) and non-Hispanic whites (23.9%). Persons with a high vs normal WC, adjusted for age, gender, ethnicity and BMI were more likely to have >or=3 cardiometabolic risk factors (odds ratio (OR)=5.1, 95% confidence interval (CI)=3.9-6.6) and were classified as high CHD risk (OR=1.5, 95% CI=1.1-2.0). The association of abdominal obesity with risk factors varies by ethnicity and is independently associated with high CHD risk status, further validating its clinical significance.