A comparative analysis of weight to height and waist to hip circumference indices as indicators of the presence of cardiovascular disease risk factors. Canadian Heart Health Surveys Research Group.

OBJECTIVE

To determine the mathematic formula for weight, height and waist and hip circumference that is most closely correlated to cardiovascular disease risk factors.

DESIGN

Population-based, cross-sectional surveys.

SETTING

Five Canadian provinces, between 1990 and 1992.

PARTICIPANTS

A probability sample of 16,007 men and women aged 18 to 74 years was selected using health insurance registration files in each province. Anthropometry was performed on 10,054 (63%) of these adults.

OUTCOME MEASURES

The power of height in the body mass index (BMI, kg/m2) and of hip circumference in the ratio of waist to hip circumference (WC/HC) was varied from 0 to 3. Simple linear regression analysis for each age-sex group was used to examine the relation of each index to systolic and diastolic blood pressure (SBP and DBP), levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL), triglycerides (TRIG) and the ratio of TC to HDL. Values for the coefficient of determination (r2) were used to compare the fits of the models.

RESULTS

The r2 values were generally low (< 0.27), but were greatest in the younger age groups (18-24 and 35-54 years) and in women. Waist circumference alone (WC/HC0) showed the best fit with SBP and DBP, whereas WC/HC0.5 was most closely related to HDL, TC/HDL and TRIG. None of the indices was closely associated with TC or LDL. Whatever the power of height used, the weight-height ratios showed weaker associations with the risk factors than the waist-hip ratios.

CONCLUSIONS

WC and BMI correlate most closely with blood pressure and plasma lipid and may be the best simple anthropometric indices to include in the routine clinical examination of adults.