Relationship between obesity and cardiovascular risk factors: findings from a multi-state screening project in the United States

Abstract

Objective: This study examined the impact of body mass index (BMI) category on cardiovascular risk factors such as systolic blood pressure (SBP), high-density lipoprotein (HDL) and total cholesterol (TC). Methods: Voluntary coronary heart disease (CHD) risk screenings were conducted in 18 states. A mobile screening unit and team were used to collect data. Respondents were classified as per World Health Organization (WHO) guidelines based on BMI as non-overweight (BMI ≤ 25); overweight (BMI > 25 and ≤ 30); obese (BMI > 30 and ≤ 35); and severely obese (BMI > 35). Hierarchical multiple linear regression analyses were used to measure the impact of BMI on SBP, HDL, and TC after adjusting for age, race, gender, smoking, self-reported prevalence of hypertension and hyperlipidemia, presence of diabetes/CHD event. Results: Of the 12 573 screened, 36% were overweight, 16.9% were obese and 7.9% were severely obese. Diabetes and prior CHD event were reported in 5.8% and 12.5% of the respondents, respectively. Mean 10‐year CHD risk scores were significantly higher in males (10.4 ± 9.3) than females (3.2 ± 4.8) ( p < 0.001). Compared to non-overweight respondents, SBP increased by 13.2 mmHg for severely obese ( p < 0.001); by 8.9 mmHg for obese ( p < 0.001), and by 5.2 mmHg ( p < 0.001) for overweight respondents, respectively. TC was 6.8 mg/dL higher in obese ( p < 0.01) and 6.9 mg/dL higher in overweight respondents ( p < 0.001) as compared to non-overweight respondents. As compared to non-obese respondents, HDL was 9.8 mg/dL lower in severely obese ( p < 0.001), 7.6 mg/dL lower in obese ( p < 0.001), and 4.6 mg/dL lower in overweight respondents ( p < 0.001). Conclusions: Our results demonstrate a significant impact of increasing BMI category on the CHD risk factors of SBP and HDL in a US population. These data illustrate the importance of weight reduction in cardiovascular health.