Abstract P148: Association Of Hypertension With Cardiovascular Disease In The United States

Abstract

Background: Hypertension is strongly associated with cardiovascular disease (CVD). Nevertheless, its relative importance compared with other established CVD risk factors among U.S. adults is unclear. Objective: To determine the prevalence of CVD risk factors and compare their association with CVD in a large U.S. population. Methods: The 2017 and 2019 Behavioral Risk Factor Surveillance System queried a representative sample of U.S. adults about hypertension (HTN), diabetes, and high cholesterol based on health professional diagnosis, obesity (BMI ≥30 from self-reported weight and height), smoking, and physical inactivity. We used logistic regression to examine the association between risk factors and CVD (nonfatal stroke and/or nonfatal myocardial infarction). Coefficients were compared using Wald tests. Models were also examined across sex (male vs. female), race (Black vs. White), and age (≥ 65 and <65), using interaction terms. Results: The weighted sample was 21.0% age ≥65 years, 51.3% female, 70.0% Non-Hispanic White, and 11.6% Non-Hispanic Black. While all risk factors were associated with CVD, HTN was most strongly associated with CVD in the fully adjusted model (OR = 2.26; P -values comparing to other coefficients were all <0.001). There was no evidence of effect modification across sex and race (all P -interaction values >0.05), the association between hypertension and CVD was stronger for age <65 years ( P <0.001). Nevertheless, hypertension was still the strongest risk factor among both age groups. Conclusion: In this large U.S. sample, hypertension was the most prevalent and strongest CVD risk factor and should be a primary focus of policy focused on CVD prevention.