Relationships of BMI to Cardiovascular Risk Factors Differ by Ethnicity |
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Authors: | Herman A. Taylor Jr Sean A. Coady Daniel Levy Evelyn R. Walker Ramachandran S. Vasan Jiankang Liu Ermeg L. Akylbekova Robert J. Garrison Caroline Fox |
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Affiliation: | 1. Jackson Heart Study, University of Mississippi Medical Center, Jackson, Mississippi, USA;2. Jackson State University, Jackson, Mississippi, USA;3. Tougaloo College, Tougaloo, Mississippi, USA;4. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA;5. Framingham Heart Study, Center for Population Studies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA;6. Jackson Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA;7. Framingham Heart Study, National Institutes of Health, Bethesda, Maryland, USA |
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Abstract: | The burden of cardiovascular risk associated with obesity disproportionately affects African Americans and little is known about ethnic/racial differences in the relationship of obesity to cardiometabolic risk. This report assesses whether obesity is similarly associated with cardiometabolic risk factors in African Americans and whites of European ancestry. Cross‐sectional observational data from the Jackson Heart Study (JHS) and the Framingham Heart Study (FHS) were compared. This analysis uses participants aged 35–74 years with BMI >18.5 kg/m2, and free of prevalent cardiovascular disease (CVD), from the initial JHS clinical examination (2000–2004) and the FHS Offspring (1998–2001) and Third Generation (2002–2005) cohorts. Participants were evaluated for the presence of lipid abnormalities, hypertension, and diabetes. Overall, 4,030 JHS (mean age 54 years, 64% women) and 5,245 FHS (mean age 51 years, 54% women) participants were available for analysis. The prevalence of all risk factors except high triglycerides and low high‐density lipoprotein (HDL) was substantially higher in JHS (all P < 0.001) and BMI was associated with increasing prevalence of most CVD risk factors within each race. For diabetes mellitus, hypertension, and low HDL, steeper relationships to BMI were observed in FHS than in JHS (P values <0.001–0.016). There were larger proportional increases in risk factor prevalence with increasing BMI in whites than in African Americans. The higher prevalence rates of cardiometabolic risk factors at nearly all levels of BMI in African Americans, however, suggest that additional factors contribute to the burden of CVD risk in African Americans. |
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