Cardiovascular Anthropometry: What Is Best Suited for Large-Scale Population Screening in Sub-Saharan Africa?

Hadiza A. Agbo, Ayuba I. Zoakah, Christian O. Isichei, Atiene S. Sagay, Chad J. Achenbach, Basil N. Okeahialam*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background : Body mass index (BMI) measures overweight/obesity. It, however, especially in sub-Saharan Africa (SSA), misclassifies cardiometabolic risk. Central obesity measures are superior. We therefore sought to compare BMI, waist-to-hip ratio (WHR) and abdominal height (AH) in predicting cardiovascular disease risk in sub-Saharan Africa. Methods : Subjects had blood pressures, BMI, and WHR determined. Blood pressure was taken, weight and height measured to generate BMI, and AH measured with a new locally fabricated abdominometer. The ability of the anthropometric indices in identifying abnormal individuals needing intervention was assessed with sensitivity, specificity, and area under the receiver operator characteristic curve. Results : Adults totaling 1,508 (728 M/780 F) adults were studied. For BMI, 985 (65.3%) were normal, while 375 (24.9%), consisting of 233 males and 142 females, had normal WHR. Blood pressure was normal in 525 (34.8%) and 317 (21.0%) for systolic and diastolic blood pressures, respectively. Using BMI as gold standard, sensitivity, specificity, positive, and negative predictive values for WHR in males were 80.7, 37.5, 62.5, and 19.3%, respectively. For females and in the same order, they were 62.0, 34.3, 65.7, and 38.0%. For AH, it was equal in both genders at 82.6, 39.2, 60.8, and 17.4%. By receiver operating curves comparing AH, WHR, and BMI against blood pressure detection, the area under the curve was 0.745, 0.604, and 0.554 for AH, BMI, and WHR, respectively. Conclusion : Abdominometer-derived AH has a better sensitivity and greater area under the receiver operator curve compared with BMI and WHR in this sub-Sahara African population; implying superiority as a cardiovascular anthropometric index.

Original languageEnglish (US)
Article number522123
JournalFrontiers in Cardiovascular Medicine
Volume7
DOIs
StatePublished - Dec 3 2020

Funding

We extend our gratitude to our field research staff and the technologists at the base laboratory. The enthusiasm with which the subjects turned out for the study is also appreciated. The Adminstrative staff of Stamina were also helpful at difficult stages of the grant administration. Funding. Research reported in this publication was supported by the Fogarty International Center (FIC) of the National Institutes of Health and also the Office of the Director, National Institutes of Health (OD), National Institutes of Nursing Research (NINR), and the National Institutes of Neurological Disorders and Stroke (NINDS). The award goes by the number D43TW010130.

Keywords

  • abdominal height
  • anthropmetry
  • body mass index
  • cardiovascular disease
  • prediction
  • waist to hip ratio

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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