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Author Notes:

Saria Hassan, Email: saria.hassan@emory.edu

SH produced initial draft and incorporated revisions. CO made substantial contributions to the manuscript. DG conducted statistical analyses. OA, RM, CN, MN, MNS revised the manuscript. All authors have read and approved the manuscript.

We would like to acknowledge ECHORN Cohort Study site staff and participants for their continued dedication to the project and furthering our understanding early predictors and risk factors for non-communicable diseases among adults in the Eastern Caribbean. This paper was written on behalf of the ECHORN Writing Group.

All authors declare that they have no competing interests.


Research Funding:

All authors are supported in part by the following grants from the National Institutes of Health/National Institute on Minority Health and Health Disparities: U24MD006939 and U54MD010711. The work was also supported by Yale CTSA grant number UL1TR000142. SH was supported for this work by a grant from the National Institutes of Health/National Heart Lung and Blood Institute: 5K12HL138037. Views expressed are those of the authors and do not represent those of the funding sources.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health

Anthropometric measures of obesity and associated cardiovascular disease risk in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study


Journal Title:



Volume 21, Number 1


, Pages 399-399

Type of Work:

Article | Final Publisher PDF


Background: Accurately defining obesity using anthropometric measures that best capture obesity-related risk is important for identifying high risk groups for intervention. The purpose of this study is to compare the association of different anthropometric measures of obesity with 10-year cardiovascular disease (CVD) risk in adults in the Eastern Caribbean. Methods: Data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study (ECS) were analyzed. The ECS is comprised of adults aged 40 and older residing in the US Virgin Islands, Puerto Rico, Barbados, and Trinidad. 10-year CVD risk was calculated using the American Heart Association (ACC/AHA) ASCVD Risk Algorithm and categorized in the following high-risk groups: > 7.5, > 10, and > 20%. Logistic regression was used to examine associations between four anthropometric measures of obesity (BMI, waist circumference, waist-to-hip ratio, waist-to height ratio) and 10-year CVD risk. Results: Mean age (SD) of participants (n = 1617) was 56.6 years (±10.2), 64% were women, 74% were overweight/obese, and 24% had an ASCVD risk score above 10%. Elevated body mass index (BMI, > 30 kg/m2) and waist circumference were not associated with CVD risk. Elevated waist-to-hip ratio (WHR, > 0.9 men, > 0.85 women) and elevated waist-to-height ratio (> 0.5) were associated with all three categories of CVD risk. Area under the receiver curve was highest for WHR for each category of CVD risk. Elevated WHR demonstrated odds of 2.39, 2.58, and 3.32 (p < 0.0001) for CVD risk of > 7.5, > 10 and > 20% respectively. Conclusion: Findings suggest that WHR is a better indicator than BMI of obesity-related CVD risk and should be used to target adults in the Caribbean, and of Caribbean-descent, for interventions.

Copyright information:

© The Author(s) 2021

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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