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

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 screenings 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 < or = 25); overweight (BMI > 25 and < or = 30); obese (BMI > 30 and < or = 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 12573 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-years 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.