Associations of adiposity with prevalent coronary heart disease among elderly men: the Honolulu Heart Program.
OBJECTIVE
To assess associations of adiposity with prevalent coronary heart disease (CHD) among elderly men.


METHODS
A cross-sectional epidemiologic study conducted between 1991 and 1993.


METHODS
3741 Japanese-American men from the Honolulu Heart Program who were 71-93 y of age.


METHODS
CHD included documented myocardial infarction (electrocardiographic and enzyme criteria), acute coronary insufficiency, angina pectoris leading to surgical treatment identified through hospital surveillance, and reported history of heart attach or angina pectoris requiring hospitalization or surgical treatment. BMI was calculated as weight in kg divided by height in square meters. Waist circumference was measured at the horizontal level of the umbilicus and WHR was a ratio of waist circumference to hip circumference measured at the horizontal level of the maximal protrusion of the gluteal muscles.


RESULTS
An elevated prevalence of CHD was observed in the elderly men with high BMI, WHR and waist circumference. The significant associations of BMI and waist circumference with CHD persisted after adjustment for fasting glucose, physical activity and pack-years of cigarette smoking but were no longer significant (odds ration (OR) = 1.03, 95% confidence level (CI) 0.94-1.12 and OR = 1.09, CI = 0.99-1.20, respectively) after adjustment for high density lipoprotein cholesterol (HDL-C). Also, the association of BMI with CHD was not found to be independent of abdominal adiposity. However, the associations of WHR and waist circumference remained significant (OR = 1.20, CI = 1.08-1.33 and OR = 1.17, CI = 1.01-1.37, respectively) after additional adjustment for BMI. In addition, the association of WHR with CHD was consistently significant and independent of fasting glucose, physical activity, smoking and HDL-C (OR = 1.11, CI = 1.00-1.23).


CONCLUSIONS
WHR is associated with CHD independent of HDL-C and BMI, whereas the relation of BMI and waist circumference with CHD may be mediated through a relation of BMI and waist circumference with HDL-C level.
Huang
B
B
Honolulu Heart Program, Research Corporation of the University of Hawaii, Division of Clinical Epidemiology, School of Medicine 96817, USA.
Rodreiguez
B L
BL
Burchfiel
C M
CM
Chyou
P H
PH
Curb
J D
JD
Sharp
D S
DS
D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D001824:Body Constitution; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D016001:Confidence Intervals; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors
D008076:Cholesterol, HDL