Background Epidemiological studies on body mass index (BMI) and non-invasive cardiovascular parameters are limited and inconsistent. 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 North Carolina Appalachian adults.

Methods A total of 71 participants were included in this 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. Logistic regression models were used for analysis.

Results Every unit (kg/m2) increase in BMI was associated with a 25% statistically significant increased multivariable-adjusted odds of higher central arterial stiffness (odds ratio: 1.25; 95% confidence interval: 1.04-1.51), a 31% increased adjusted odds of higher peripheral arterial stiffness, a 23% statistically significant increased adjusted odds of worse left ventricular performance, and a 25% statistically significant increased adjusted odds of worse coronary microvascular circulation. Overweight/obesity was associated with a 532% statistically significant increased odds of higher arterial stiffness (6.32; 1.42-28.09), and a 704% statistically significant increased odds of worse left ventricular performance after adjusting for age, sex, physical activity, and body fat percentage.

Conclusion Increased BMI, especially overweight/obesity, was significantly associated with the increased risk of worse cardiovascular health, measured by non-invasive cardiovascular parameters. Efforts need to be focused on improving interventions to lower BMI/reduce overweight and obesity in North Carolina, especially in Appalachian populations.

The authors have declared no competing interest.

No funding was received for this work.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study received approval from the Appalachian State University Institutional Review Board review (IRB# 21-0167).

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The data that support the findings of this study are available on request from the author MM. The data are not publicly available due to privacy or ethical restrictions.