Abstract 13976: Trends in Cardiovascular Health Status During Early vs Late Adolescence, 2007-2018

Abstract

Introduction: Identification of factors associated with preservation of cardiovascular health (CVH) during adolescence may inform strategies to reduce CV disease burden in adulthood. Hypothesis: CVH status is worse in later (16-18 years) vs early (13-15 years) adolescence and is influenced by socioeconomic factors. Methods: National Health and Nutrition Examination Survey (NHANES) 2007 to 2018 data (6 most recent complete survey cycles) analyzed. CVH status was characterized by AHA Life Simple 7 score (AHAS7). A representative sample (N=5874) of the US adolescent population was analyzed and weights used to estimate trends for the entire US adolescent population. The proportion of US adolescents with ideal (AHAS7 score 12-14), intermediate (8-11), and poor (0-7) CVH status calculated. Consecutive 2-year NHANES cycles were rescaled to consecutive integers to assess change in CVH score over time. Regression models were used to assess trend in CVH score over time and separately by age. Nonlinearity of secular trend was tested by assessing the significance of adding a quadratic term to the regression model (significance, p<0.01). CVH status by early vs late adolescence was assessed via categorical analysis as was the association between CVH status in early vs late adolescence and social determinants such as insurance status, poverty status (above and below 5x’s the national poverty level) and household reference (e.g., parent) education level. Results: CVH scores improved from 2007 to 2018 ( p<0.0001 ), however, the proportion of youth with ideal CVH status declined with age and was highest in early and lowest in later adolescence (early 59% vs later 41%) ( p<0.0001 ). The proportion of adolescents with ideal physical activity, smoking status, blood pressure, and cholesterol was lowest among older adolescents. Older adolescents are more likely to have no insurance (early 44% vs later 56%, p<0.0001 ). Other social determinants were not significantly different. Conclusions: Efforts to improve CVH status should begin no later than adolescence. Greater focus on preserved physical activity, BP and cholesterol management, reduced smoking and maintenance of health insurance coverage may lead to sustained CVH status throughout adolescence.