Open Access Highly Accessed Research article

Prevalence of obesity and associated cardiovascular risk: the DARIOS study

Francisco Javier Félix-Redondo12, María Grau3*, José Miguel Baena-Díez34, Irene R Dégano3, Antonio Cabrera de León5, Maria Jesús Guembe6, María Teresa Alzamora78, Tomás Vega-Alonso9, Nicolás R Robles102, Honorato Ortiz11, Fernando Rigo12, Eduardo Mayoral-Sanchez13, Maria José Tormo14, Antonio Segura-Fragoso15 and Daniel Fernández-Bergés162

Author affiliations

1 Centro de Salud Villanueva Norte, Servicio Extremeño de Salud, Villanueva de la Serena, Badajoz, Spain

2 Unidad de Investigación Grimex. Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, Spain

3 Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), Barcelona, Spain

4 Centre d’Atenció Primària La Marina. Unitat de Recerca Barcelona Ciutat, Institut de Recerca en Atenció Primària Jordi Gol, Institut Català de la Salut, Barcelona, Spain

5 Unidad de Investigación de Atención Primaria y del Hospital Universitario Señora de Candelaria. Medicina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, Spain

6 Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Servicio de Investigación, Innovación y Formación Sanitaria, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain

7 Centro de Salud Riu Nord- Riu Sud, Santa Coloma de Gramenet, Barcelona

8 USR Metropolitana Nord, IDIAP Jordi Gol, Mataró, Spain

9 Dirección General de Salud Pública e Investigación, Desarrollo e Innovación, Consejería de Sanidad de la Junta de Castilla y León, Valladolid, Spain

10 Hospital Universitario Infanta Cristina, Badajoz, Spain

11 Servicio de Epidemiologia, Dirección General de Atención Primaria, Consejería de Sanidad Comunidad de Madrid, Madrid, Spain

12 Grupo Cardiovascular de Baleares redIAPP, UB Génova. C. S. Sana Agustín, Palma de Mallorca, Baleares, Spain

13 Plan Integral de Diabetes de Andalucía, Servicio Andaluz de Salud. CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain

14 Servicio de Epidemiología, Consejería de Sanidad y Política Social de Murcia, Departamento de Ciencias Sociosanitarias, Universidad de Murcia.CIBER de Epidemiologia y Salud Pública (CIBERESP), Murcia, Spain

15 Instituto de Ciencias de la Salud, Talavera de la Reina, Toledo, Spain

16 Hospital Don Benito-Villanueva, Don Benito, Badajoz, Spain

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Citation and License

BMC Public Health 2013, 13:542  doi:10.1186/1471-2458-13-542

Published: 5 June 2013



To estimate the prevalence of overweight and obesity in the Spanish population as measured with body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR) and to determine the associated cardiovascular risk factors.


Pooled analysis with individual data from 11 studies conducted in the first decade of the 21st century. Participants aged 35–74 years were asked about the history of cardiovascular diseases, hypertension, diabetes and hypercholesterolemia. Height, weight, WC, blood pressure, glycaemia, total cholesterol, low-density and high-density lipoprotein cholesterol and coronary risk were measured. The prevalence of overweight (BMI 25–29.9 kg/m2), general obesity (BMI ≥30 kg/m2), suboptimal WC (≥ 80 cm and < 88 in women, ≥ 94 and < 102 in men), abdominal obesity (WC ≥88 cm ≥102 cm in women and men, respectively) and WHtR ≥0.5 was estimated, standardized for the European population.


We included 28,743 individuals. The prevalence of overweight and suboptimal WC was 51% and 30% in men and 36% and 22% in women, respectively; general obesity was 28% in both sexes and abdominal obesity 36% in men and 55% in women. The prevalence of WHtR ≥0.5 was 89% and 77% in men and women, respectively. All cardiovascular risk factors were significantly associated with abnormal increased values of BMI, WC and WHtR. Hypertension showed the strongest association with overweight [OR = 1.99 (95% confidence interval 1.81-2.21) and OR = 2.10 (1.91-2.31)]; suboptimal WC [OR = 1.78 (1.60-1.97) and OR = 1.45 (1.26-1.66)], with general obesity [OR = 4.50 (4.02-5.04), and OR = 5.20 (4.70-5.75)] and with WHtR ≥0.5 [OR = 2.94 (2.52-3.43), and OR = 3.02 (2.66-3.42)] in men and women respectively, besides abdominal obesity in men only [OR = 3.51 (3.18-3.88)]. Diabetes showed the strongest association with abdominal obesity in women [OR = 3,86 (3,09-4,89).


The prevalence of obesity in Spain was high. Overweight, suboptimal WC, general, abdominal obesity and WHtR ≥0.5 was significantly associated with diabetes, hypertension, hypercholesterolemia and coronary risk. The use of lower cut-off points for both BMI and particularly WC and could help to better identify the population at risk and therefore achieve more effective preventive measures.

Cardiovascular diseases; Obesity; Prevalence; Risk factors