Waist: height ratio: a superior index in estimating cardiovascular risks in Turkish adults

Objective: To determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist: hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR. Design: Population-based cross-sectional study. Setting: Balcova, Izmir, Turkey. Subjects: Individuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10% were defined as 'medium or high risk'. Results: Among the participants, 67.7% were female, 38.2% were obese, 24.5% had high blood pressure, 9.2% had diabetes, 1.5% had undiagnosed diabetes (>= 126 mg/dl), 22.0% had high total cholesterol and 45.9% had low HDL-cholesterol. According to Framingham risk score, 32.7% of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0.55 was the optimal cut-off point for WHtR for CHD risk. Conclusions: BMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of '0.5' can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.