Sex Differences in Temporal Trends of Cardiovascular Health in Young US Adults

Abstract

Background Favorable cardiovascular health (CVH) in young adulthood has been associated with lower future cardiovascular risk. We determined whether CVH and its sex differences in young adults have changed from 2007 to 2018. Methods and Results We identified 10 206 individuals, aged 20 to 39 years, from the National Health Examination and Nutrition Survey data. CVH was assessed on the basis of the American Heart Association’s Life’s Simple 7 metrics (of 7). Changes in the mean number of ideal CVH components and the ideal proportion of individual components were calculated using linear regression analysis. Changes in sex difference trends were assessed with an interaction term between sex and calendar year. The mean (SD) age of the study population was 29.3 (5.8) years, and 5260 (51.5%) individuals were women. The mean (SD) ideal CVH component remained unchanged for both women (4.40 [1.22] to 4.48 [1.15]; P =0.94) and men (3.97 [1.27] to 3.93 [1.24]; P =0.87), with stable sex differences ( P for interaction=0.94). Nonetheless, sex differences in blood pressure widened as ideal blood pressure decreased in men (54.0% to 46.9%; P =0.03) but not in women ( P for interaction <0.001). Concurrently, the proportion with ideal physical activity declined in women (57.3% to 49.4%; P =0.04) but remained stable in men ( P for interaction=0.03). Nonsmoking increased to a greater extent in women (64.1% to 70.5%; P =0.05) than in men ( P for interaction=0.01). Conclusions Sex disparities in CVH have persisted with exacerbated differences in blood pressure, physical activity, and smoking. These insights provide opportunities to promote equitable CVH.

Using the New “Life’s Essential 8” Metrics to Evaluate Trends in Cardiovascular Health Among US Adults From 2005 to 2018: Analysis of Serial Cross-sectional Studies

“…One important reason for this deceleration of the CVD decline may be that some CVD risk factors have not significantly improved or even deteriorated. This is consistent with other studies, which showed that the mean number of ideal CVH metrics based on the LS7 had not significantly changed in the past years [ 22 , 23 ]. For example, the Behavioral Risk Factor Surveillance System data showed a nonsignificant change in the mean number of ideal CVH metrics from 3.89 in 2011 to 3.96 in 2017 [ 22 ].…”

“…For example, the Behavioral Risk Factor Surveillance System data showed a nonsignificant change in the mean number of ideal CVH metrics from 3.89 in 2011 to 3.96 in 2017 [ 22 ]. Another NHANES study among US adults showed that the mean number of ideal CVH components did not significantly change from 2007 to 2018 in both female participants (4.40 to 4.48) and male participants (3.97 to 3.93) [ 23 ]. In addition, previous studies among adults based on the LS7 also showed that there was no significant improvement in CVH among US adults [ 24 , 25 ].…”

Temporal trends in cardiovascular health among Chinese urban children and adolescents, 2004–2019 pre-pandemic COVID-19

“…Consistent with previous studies (7)(8)(9)(31)(32)(33), sex disparities in CVH among Chinese urban children were persistently observed over time. Relative to boys, the ideal CVH metrics of girls were better in smoking, BMI, BP, and FBG, whereas they were worse in physical activity and TC.…”

Cardiovascular Disease Risk Screening for Commercial Drivers Examined in Occupational Practice: Implementing Evidence-Based Practice to Champion the Health of Essential Workers

“…With continuing implementation, a shift in the 10-year CVD risk scores of participants has been noted with more scores falling in the intermediate risk category during the past few years. This shift could be due to decreased smoking rates and longer periods of physical activity noted for men; although e-cigarettes and vaping need to be considered regarding long-term, adverse CVD effects for this population (Cho et al, 2022; Münzel et al, 2020).…”

“…Of note, the federal Medical Examination Report Form MCSA-5875 (FMCSA, n.d.) for commercial drivers no longer requires identification of gender, although sex disparities have increased among younger adults due to “worsening BP (i.e., blood pressure) and smoking status for men, and worsening physical activity for women” that could significantly affect CVD risk (Cho et al, 2022, p. 6). However, review of social determinants of health (SDOH) such as socioeconomic status and access to care along with promoting early adoption of health behaviors (i.e., physical activity, stress reduction, social support, not smoking) promote gender equality in CVD risk reduction efforts as providers also consider the impact of biological research (O’Neill et al, 2018).…”