THE ASSOCIATION OF CARDIOVASCULAR-DISEASE RISK-FACTORS WITH ABDOMINALOBESITY IN CANADA

Objective: To assess the degree of association of abdominal obesity wi th blood pressure and plasma lipid levels and to determine which anthr opometric measures of obesity are most closely associated with these c ardiovascular risk factors. Design: Population-based, cross-sectional surveys. Setting: Five Canadian provinces (Alberta, Manitoba, Ontario, Quebec and Saskatchewan) between 1989 and 1992. Participants: A proba bility sample of 16 007 men and women aged 18 to 74 was selected using health insurance registration files in each province and invited to p articipate. A complete set of measurements was available for 8974 (56% ) adults. Outcome measures: Initially, simple correlation analyses by age and sex were performed between the anthropometric variables - body mass index, waist circumference (WC), hip circumference (HC), ratio o f waist to hip circumference (WHR) - and cardiovascular disease risk v ariables - systolic blood pressure (SBP), diastolic blood pressure (DB P), levels of total cholesterol (TC), low density lipoprotein (LDL) ch olesterol, high density lipoprotein (HDL) cholesterol and triglyceride s (TRIG) and the TC/HDL ratio. Canonical correlation analyses were per formed to determine the multivariate associations between the anthropo metric and risk variables. Results: The simple correlations between an thropometric variables and cardiovascular disease risk variables were highest for SBP; moderate for DBP, HDL, TRIG and TC/HDL; and lowest fo r LDL and TC. Of the anthropometric variables, WC demonstrated the gre atest correlations with the risk variables. The first canonical correl ations were significant (p < 0.0001) in men (0.58) and women (0.61) of all ages. Of the anthropometric variables, WC consistently demonstrat ed the highest loading values in the first canonical variable in men ( 0.56) and women (0.59). Of the risk variables in both sexes, the loadi ngs of TRIG were generally the largest, those of HDL SBP, DBP intermed iate and those of LDL the smallest. In men, the strength of these asso ciations generally decreased with age, whereas in women they peaked in the 35-54 year age group. Conclusion: Considerable association was se en between measures of abdominal obesity and blood pressure and plasma lipid levels. WC is the measure of abdominal obesity most highly corr elated with these cardiovascular disease risk factors.