Body mass index, waist/hip ratio, and coronary heart disease incidence in African Americans and whites

To study the relation of the amount and distribution of body fat with incid ent coronary heart disease in two ethnic groups, the authors analyzed prosp ective data from the Atherosclerosis Risk in Communities Study. Among 14,04 0 participants aged 45-64 years and free of coronary disease at baseline in 1987-1989, we identified 398 events through 1994, an average of 6.2 years of follow-up, Among African-American women, the multivariable-adjusted rela tive risks of coronary heart disease across quartiles of body mass index we re 1.0, 1.91, 1.54, and 2.15 (p for trend = 0.27), and those for waist/hip ratio were 1.0, 2.07, 2.33, and 4.22 (p for trend = 0.02). Among African-Am erican men, these respective relative risks were 1.0, 1.03, 0.83, and 1.20 (p for trend = 0.76) for body mass index and 1.0, 1.08, 1.87, and 1.68 (p f or trend = 0.06) for waist/hip ratio. Relative risks for whites were genera lly similar to those for African Americans. Relative risks were stronger fo r never smokers than for the overall cohort. Unlike some previous studies, our results suggest that Africa Americans, like whites, are not spared from the coronary heart disease risks accompanying obesity.