Abstract
Introduction: The American Heart Association (AHA) promotes ideal cardiovascular health (CVH) to reduce the risk of heart disease and stroke by achieving seven metrics (normal weight, not smoking, ≥5 fruits and vegetables daily, physical activity ≥150 minutes per week, no diabetes, no high blood pressure, and no high cholesterol). Overall, about 5% of the adult population report ideal CVH. Characterizing CVH among women of reproductive age (WRA; 18-44 years of age) offers opportunities to promote overall cardiovascular and preventive health along the life course. Methods: Data from the 2019 Behavioral Risk Factor Surveillance System was used to estimate define CVH categories (poor, intermediate, ideal) among 38,012 WRA from 49 states (New Jersey didn’t meet standards for weighting), District of Columbia, Guam, and Puerto Rico. Per commonly used standards, having > 6 metrics defined ideal CVH, 3-5 metrics defined intermediate, and 0-2 metrics defined poor CVH. A generalized logit model was used to estimate the associations between race/ethnicity and education with CVH (poor vs intermediate CVH, and ideal vs. intermediate CVH), accounting for age and insurance status. Results: Overall, 8.6% (95%CI:8.2-9.1%) of WRA reported poor CVH, 85.4% (95%CI: 84.8-86.1) reported intermediate CVH, and 6.0% (95%CI:5.5-6.5) reported ideal CVH. Non-Hispanic Black (NHB) WRA had higher odds of reporting poor vs. intermediate CVH (AOR=1.34; 95%CI:1.14-1.58) and lower odds of reporting ideal vs. intermediate CVH (AOR=0.47; 95%CI:0.33-0.68) compared to non-Hispanic White WRA. College graduates also had lower odd of reporting poor vs. intermediate CVH (AOR=0.21; 95%CI:0.17-0.27) and higher odds of reporting ideal vs. intermediate CVH (AOR=2.59; 95%CI:1.52-4.43) compared to those with less than a high school education. Conclusion: Most WRA have intermediate CVH, nearly 1 in 10 have poor CVH, and only about 1 in 16 have ideal CVH. The CVH metric used in this study provides evidence of the disproportionate burden of poor CVH among NHB WRA and women with less than a college degree. Understanding the barriers to ideal CVH for WRA, particularly social and structural determinants, may improve cardiovascular health and reduce disparities across the life course.
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