Abstract P397: Cardiovascular Health Among US Adults In Metropolitan And Micropolitan Statistical Areas

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in the US and primary risk factors for CVD are well known. Promoting the ideal state of cardiovascular (CV) health factors and behaviors has been previously defined as CV health. The objective of this study is to assess CV health among US adults in urban areas. Methods: Data from the Behavior Risk Factor Surveillance System (BRFSS) 2011 were used for analysis and included 307,101 participants from 198 metropolitan and micropolitan statistical areas (MMSA) with an adequate sample size for estimates (range: 493 to 9,241 participants). Seven indicators were used to define ideal levels of CV health using self-reported data: no hypertension, no diabetes, no high cholesterol, no current smoking, no obesity, and meeting physical activity guidelines and fruit and vegetable consumption targets. Each metric was given a score (0=no, 1=yes) and summed. The percentage achieving ideal CV health (all 7 metrics at ideal level), good CV health (6-7 metrics at ideal levels), poor CV health (0-2 metrics at ideal levels), and the mean CV health score were calculated for each MMSA. Estimates and 95% confidence intervals were age-standardized. Results: Overall, 16.7% (16.4-17.1) and 11.5% (11.2-11.8) of participants among the 198 MMSAs had good and poor CV health, respectively. Few respondents in MMSAs met all ideal CV health standards (<1%), likely driven by the limited number of participants meeting fruit and vegetable consumption targets (5.7%) in this sample. The overall mean CV health score was 3.91 (3.90-3.92). The percentage of participants with good CV health varied from 3.0% (1.5-5.8) (Mobile, AL) to 23.8% (17.0-32.3) (Kalispell, MT). The percentage of participants with poor CV health varied from 6.1% (4.2-8.6) (Boulder, CO) to 26.5% (18.2-36.8) (Kingsport-Bristol-Bristol, TN-VA). The mean CV health score ranged from 3.44 (3.2-3.7) (Kingsport-Bristol-Bristol, TN-VA) to 4.7 (4.5-4.9) (Boulder, CO). Conclusions: Across select US MMSAs, few adults met ideal CV health standards, and only 16% had good CV health. CV health varied significantly across MMSAs. Reducing the burden and mitigating the deleterious effects of CVD can be achieved through the promotion of CV health. Local clinical and public health agencies have the unique opportunity to tailor evidenced-based interventions to promote CV health in their populations. The methodology and findings used in this study can be utilized by local jurisdictions to target lagging health indicators with focused interventions.