Status of Cardiovascular Health in US Adults

Abstract

Background The American Heart Association's 2020 Strategic Impact Goals define a new concept, “cardiovascular (CV) health”; however, current prevalence estimates of the status of CV health in U.S. adults according to age, sex and race/ethnicity have not been published. Methods and Results We included 14,515 adults (≥20 years) from the 2003-2008 National Health and Nutrition Examination Surveys. Participants were stratified by young (20-39 years), middle (40-64 years), and older ages (65+ years). CV health behaviors (diet, physical activity, body mass index, smoking) and CV health factors (blood pressure, total cholesterol, fasting blood glucose, smoking) were defined as poor, intermediate, or ideal. Less than 1% of adults exhibited ideal CV health for all 7 metrics. For CV health behaviors, non-smoking was most prevalent (range:60.2-90.4%) while ideal Healthy Diet Score was least prevalent (range:0.2-2.6%) across groups. Prevalence of ideal BMI (range:36.5-45.3%) and ideal physical activity levels (range:50.2-58.8%) were higher in young adults compared to middle or older ages. Ideal total cholesterol (range:23.7-36.2%), blood pressure (range:11.9-16.3%) and fasting blood glucose (range:31.2-42.9%) were lower in older adults compared with young and middle age adults.Prevalence of poor CV health factors was lowest in young age but higher at middle and older ages. Prevalence estimates by age and sex were consistent across race/ethnic groups. Conclusions These prevalence estimates of CV health represent a starting point from which effectiveness of efforts to promote CV health and prevent CV disease can be monitored and compared in U.S. adult populations.

Ideal Cardiovascular Health and Incident Cardiovascular Disease: Heterogeneity Across Event Subtypes and Mediating Effect of Blood Biomarkers: The PRIME Study

“…The 7% of middle‐aged men in ideal CVH is consistent with rates reported in the literature 3, 27, 28. We did observe some heterogeneity in the prevalence of ideal CVH across study centers.…”

“…Beyond the fact that we did not evaluate the same blood biomarkers (except hs‐CRP), these differences may also partly be because of the fact that our study sample comprised exclusively men, unlike the Framingham study. Indeed, women are twice to 4 times more likely to have ideal CVH28, 30 but often have higher concentrations of inflammatory and hemostatic blood biomarkers than men. Compared with the Framingham study, we investigated the impact of IL‐6, which is a strong and potentially causal predictor of CVD, and additionally provided a mediation analysis.…”

Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

“…Previous studies also have noted cross‐sectional differences in CVH by race/ethnicity with NH whites having higher mean number of ideal health factors and behaviors compared with NH blacks and Hispanics in aggregate 10, 11, 12, 14. One article looking at US trends over time in mean number of ideal factors and behaviors by racial/ethnic category showed persistent gaps between NH whites and both NH blacks and Hispanics 12.…”

“…CVH was defined as in previous publications 14, 15. Each health behavior and factor was assigned a score of 0, 1, or 2, based on the criteria outlined in Table 1, corresponding to poor, intermediate, or ideal health as outlined in the AHA Strategic Impact Goals 6.…”

The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study

“…Three quarters of participants met only 1 or 2 ideal CVH metrics goals. Previous studies have reported lower prevalence values especially for persons with 1 or 2 ideal CVH metrics 7, 25, 26, 27. Folsom et al, using data from the ARIC study,9 reported that around 54% of black men and 55% of black women had between 1 and 2 ideal CVH metrics.…”