Objective:Whether general or abdominal obesity are associated with atherosclerotic cardiovascular disease(ASCVD)is unclear in elderly Chinese populations.We examined obesity indices and their relationship with ASCVD and its risk factors in Shanghai residents aged≥65 years.Methods:ASCVD and its risk factors were determined and their associations with obesity indices were analyzed by multivariate logistic regression.The optimal waist-to-height ratio(WHtR)cut-off value to predict ASCVD risk was assessed by receiver operating characteristic(ROC)analysis.Results:Theoptimal cut-off for WHtR to predict ASCVD risk was 0.53.Among the 3950 participants,55.8%had WHtR≥0.53,56.2%had body mass index(BMI)≥24 kg/m2 and 21.5%had ASCVD.With increasing age there were significant increases of WHtR in men and women,increases in waist circumference(WC)in women and decreases in BMI in men.A WHtR≥0.53 showed a higher odds ratio(OR)than high WC for the risk of ASCVD and high BMI was not significantly associated(OR=1.12,P=0.199).All three indices predicted high glucose,triglycerides and hsCRP levels but WHtR≥0.53 wasthe only obesity index showing significant association with physical activity.Conclusions:Central obesity with WHtR≥0.53 was strongly associated with ASCVD in this elderly community-dwelling Chinese population.