Body mass index is positively associated with cardiovascular risk measured by non-invasive cardiovascular parameters: a cross-sectional study

Epidemiological studies on body mass index (BMI) and novel non-invasive cardiovascular parameters that measure cardiovascular risk are limited and inconsistent, particularly for rural U.S. adults. To provide more informative data for further prevention and control, we examined associations between BMI, as well as overweight/obesity, and non-invasive cardiovascular parameters and their dose-response relationships in adults from the rural Appalachian Region of North Carolina. A total of 71 participants were included in this cross-sectional analysis. Non-invasive cardiovascular parameters included carotid-femoral pulse wave velocity for measuring central arterial stiffness, augmentation index at 75 bpm for gauging peripheral arterial stiffness, ejection time for indicating left ventricular performance, and Buckberg index for measuring coronary microvascular circulation. When most cardiovascular values were below clinical cutoff points, variables were dichotomized at the sample median to facilitate direct clinical and practical decision-making. Penalized logistic regression models were used as a primary analysis. Every unit (kg/m 2 ) increase in BMI was associated with 21% statistically significant increased multivariable-adjusted odds of higher central arterial stiffness (odds ratio: 1.21; 95% confidence interval: 1.04–1.46), and 19% statistically significant increased adjusted odds of worse coronary microvascular circulation. Overweight/obesity was associated with 447% statistically significant increased odds of higher arterial stiffness (5.47; 1.62–22.46), and 408% statistically significant increased odds of worse left ventricular performance after adjusting for age, sex, and physical activity. Increased BMI, especially overweight/obesity, was significantly associated with an increased risk of worse cardiovascular health, as measured by non-invasive cardiovascular parameters. However, these findings should be interpreted with caution given the small sample size and potential instability of estimates. Further studies in larger, adequately powered prospective cohorts are needed to confirm these relationships and clarify their clinical relevance.