Abstract 9760: Population-Level Cardiovascular Health Behavior and Health Factor Trends (1988-2008) and Projections to 2020 in US Men and Women: Results from the National Health and Nutrition Examination Surveys (NHANES)

Abstract

Introduction: The AHA 2020 Impact Goals recently defined 4 health behaviors (smoking, body mass index [BMI], diet, and physical activity) and 3 health factors (cholesterol, blood pressure, and plasma glucose) that serve as population-level metrics for evaluating cardiovascular (CV) health. However, there have been no forward projections of population trends of these metrics to 2020. Methods: We used data from cardiovascular disease-free individuals from NHANES III (1988-1994) and recent 2-year cycles (1999-2000, 2001-2, 2003-4, 2005-6, 2007-8) to provide population-level, sex-specific trends in prevalence of poor, intermediate and ideal levels of CV health behavior/factors. We also performed age-adjusted forward projections to 2020 using weighted linear regression coefficients. Results: The Table describes prevalence of poor, intermediate and ideal CV health behavior/factor levels from 1988-2008, weighted linear regression coefficients β (SE), and 2020 projections for men. Favorable trends from 1988-2008 included declines in prevalence of current and former smoking, hypercholesterolemia, and hypertension. In contrast, there were adverse trends in BMI, and dysglycemia. Prevalence of physical activity levels and remarkably low diet quality scores showed minimal changes over time. Women had generally similar trends in CV health profiles. Projections to 2020 suggest that obesity and impaired fasting glucose/diabetes could increase to affect more than 45% and 75% of US men, respectively, and 42% and 55% of US women. Conclusions: Improvements in prevalence of smoking, hypercholesterolemia and hypertension since 1988 have been offset by increases in adiposity and dysglycemia in US men and women. If current trends in obesity and dysglycemia are not reversed rapidly (likely through improvements in diet and physical activity), achievement of the 2020 Strategic Impact Goals will be difficult.