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

Area of Science:

• Cardiology
• Anthropometry
• Public Health

Background:

• Body Mass Index (BMI) often misclassifies cardiometabolic risk in sub-Saharan Africa (SSA).
• Central obesity measures are recognized as superior indicators of cardiovascular disease (CVD) risk.
• This study addresses the need for accurate anthropometric indices in SSA populations.

Purpose of the Study:

• To compare the predictive ability of BMI, waist-to-hip ratio (WHR), and abdominal height (AH) for cardiovascular disease risk in sub-Saharan Africa.
• To evaluate the sensitivity and specificity of these anthropometric indices in identifying individuals requiring intervention.
• To determine the most effective anthropometric measure for assessing CVD risk in this population.

Main Methods:

• A study involving 1,508 adults (728 males, 780 females) in sub-Saharan Africa.
• Measurements included blood pressure, BMI, WHR, and abdominal height (AH) using a locally fabricated abdominometer.
• Statistical analysis employed sensitivity, specificity, and area under the receiver operator characteristic curve (AUROC) to assess predictive capabilities.

Main Results:

• Abdominal height (AH) showed a higher area under the receiver operator curve (0.745) compared to BMI (0.604) and WHR (0.554) in predicting blood pressure abnormalities.
• AH demonstrated superior sensitivity (82.6%) compared to WHR (males: 80.7%, females: 62.0%) when using BMI as a reference.
• The study identified significant variations in the predictive accuracy of different anthropometric indices across genders.

Conclusions:

• Abdominometer-derived abdominal height (AH) is a more sensitive and effective anthropometric index for assessing cardiovascular risk in the sub-Saharan African population.
• AH surpasses both BMI and WHR in its ability to predict cardiometabolic risk, as indicated by its higher AUROC.
• The findings suggest AH as a valuable tool for public health interventions aimed at managing cardiovascular disease risk in SSA.