Table 1. Definition of Cardiometabolic Stress Index and Its 9 Components in the Boston Puerto Rican Health Study.
| Criteriaa | Definition |
|---|---|
| Blood pressure and antihypertensive medication use | |
| 0 | SBP ≤140 mm Hg, DBP ≤90 mm Hg, and no antihypertensive medication use reported |
| 1 | All others |
| 2 | SBP >140 mm Hg and DBP >90 mm Hg |
| Waist circumference | |
| 0 | Other |
| 1 | >102 cm for Male patients; >88 cm for female patients |
| Dyslipidemia or use of medications for lipids | |
| 0 | HDL-C ≥40 mg/dL, total cholesterol <240 mg/dL, and no antilipidemic medications reported |
| 1 | All others |
| 2 | HDL-C <40 mg/dL and total cholesterol ≥240 mg/dL (regardless of medication) or HDL-C <40 mg/dL and total cholesterol ≤240 mg/dL with medication use |
| HbA1c and antidiabetes medication use | |
| 0 | HbA1c ≤7% and no antidiabetes medication use reported |
| 1 | HbA1c >7% or antidiabetes medication use reported |
| Urinary cortisol | |
| 0 | <41.5 μg/g Creatinine for male patients or <49.5 μg/g creatinine for female patients |
| 1 | All others |
| Urinary epinephrine | |
| 0 | <2.8 μg/g Creatinine for male patients or <3.6 μg/g creatinine for female patients |
| 1 | All others |
| Urinary norepinephrine | |
| 0 | <30.5 μg/g Creatinine for male patients or <46.9 μg/g creatinine for female patients |
| 1 | All others |
| Serum DHEA-S | |
| 0 | All others |
| 1 | ≤589.5 ng/mL or Taking androgens for male patients or ≤368.5 ng/mL or taking androgens for female patients |
| C-reactive protein | |
| 0 | All others |
| 1 | >3 mg/L |
Abbreviations: DHEA-S, dehydroepiandrosterone sulfate; DBP, diastolic blood pressure; HbA1c, hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; SBP, systolic blood pressure.
SI conversion factors: To convert total cholesterol and HDL-C to millimoles per liter, multiply by 0.0259; HbA1c to proportion of total hemoglobin, multiply by 0.01.
a
Components are given a score of 0, 1, or 2, which are then summed across all 9 components to generate a score from 0 to 11 that reflects cardiometabolic stress. All medication use was self-reported. Blood pressures and waist circumference were the mean of multiple measurements.