Given the associations between obesity and cardiovascular disease (CVD), we evaluated a related but less well-established association between waist circumference and brachial artery reactivity (BAR), a functional measurement of subclinical CVD, where lower levels indicate dysfunction. Regression models examined trends in mean BAR across waist circumference tertiles in police officers, a high-stress occupational group with increased risk for CVD. Mean BAR decreased across increasing waist tertiles among men, but not women, and this association was stronger among officers who consumed more alcohol. Larger waist circumference may be associated with lower BAR, providing an opportunity for intervention prior to disease development. 1. Objective Policing in the United States presently consists of over 794,000 sworn officers and is projected to rise to 853,000 officers by 2020 [1]. Police officers have high rates of cardiovascular disease (CVD), yet reasons for this finding are not fully understood. Evidence suggests that overweight and obesity may be even more common among police officers than in the general population [2]. As this excess may partly explain the high rates of CVD, we evaluated the association between waist circumference, an indicator of central adiposity, and brachial artery reactivity (BAR), a subclinical marker of CVD. BAR is a measure of the dilation of the brachial artery after occlusion using a blood pressure cuff. Lower BAR indicates dysfunction and early-stage atherosclerosis [3]. Knowledge of associations between obesity and CVD [4–7] leads us to hypothesize that larger waist circumference may be associated with lower BAR. 2. Methods Our study combined data from two cross-sectional studies of police officers in a midsized urban department. The first study, in 1999-2000, included a random sample of 115 officers from 934 employed officers, with oversampling for women. Participation was 100%. The second study, in 2001–2003, included 100 officers, 87 of whom were examined previously. Participants were sworn officers and willing to participate. The studies were approved by The State University of New York at Buffalo Institutional Review Board and the National Institute for Occupational Safety and Health Human Subjects Review Board [8]. Our sample included 70 officers, after excluding 17 officers with missing data for waist circumference or BAR. Data were from 1999-2000, except for BAR which was measured during the second study. Waist circumference was the mean of two measurements, in centimeters (cm), taken while standing and after
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