Abstract
IntroductionObesity, hypertension, and high cholesterol are risk factors for cardiovascular disease, which accounts for approximately 20% of deaths in Washington State. For most states, self-reports from the Behavioral Risk Factor Surveillance System (BRFSS) provide the primary source of information on these risk factors. The objective of this study was to compare prevalence estimates of self-reported obesity, hypertension, and high cholesterol with examination-based measures of obesity, hypertension, and high-risk lipid profiles.MethodsDuring 2006–2007, the Washington Adult Health Survey (WAHS) included self-reported and examination-based measures of a random sample of 672 Washington State residents aged 25 years or older. We compared WAHS examination-based measures with self-reported measures from WAHS and the 2007 Washington BRFSS (WA-BRFSS).ResultsThe estimated prevalence of obesity from WA-BRFSS (27.1%; 95% confidence interval [CI], 26.3%–27.8%) was lower than estimates derived from WAHS physical measurements (39.2%; 95% CI, 33.6%–45.1%) (P < .001). Prevalence estimates of hypertension based on self-reports from WA-BRFSS (28.1%; 95% CI, 27.4%–28.8%) and WAHS (33.4%; 95% CI, 29.4%–37.7%) were similar to the examination-based estimate (29.4%; 95% CI, 25.8%–33.4%). Prevalence estimates of high cholesterol based on self-reports from WA-BRFSS (38.3%; 95% CI, 37.5%–39.2%) and WAHS (41.8%; 95% CI, 35.8%–48.1%) were similar; both were lower than the examination-based WAHS estimate of high-risk lipid profiles (59.2%; 95% CI, 54.2%–64.2%) (P < .001).ConclusionSelf-reported heights and weights underestimate the prevalence of obesity. The prevalence of self-reported high cholesterol is significantly lower than the prevalence of high-risk lipid profiles. Periodic examination-based measurement provides perspective on routinely collected self-reports.
Highlights
Obesity, hypertension, and high cholesterol are risk factors for cardiovascular disease, which accounts for approximately 20% of deaths in Washington State
Distributions by sex, age, income, marital status, and household size were similar in the weighted Washington Adult Health Survey (WAHS) and Washington BRFSS (WABRFSS) samples
39.2% of WAHS participants were classified as obese based on measured heights and weights, compared with 27.1% of Washington State (WA)-Behavioral Risk Factor Surveillance System (BRFSS) participants based on self-reported heights and weights (z = 4.17, P < .001) (Table 1)
Summary
Hypertension, and high cholesterol are risk factors for cardiovascular disease, which accounts for approximately 20% of deaths in Washington State. The National Health and Nutrition Examination Survey (NHANES) [2] provides national examination-based measures of these risk factors, knowledge about their prevalence and distribution at the state level is limited and based primarily on self-reports from the Behavioral Risk Factor Surveillance System (BRFSS)(3). A few studies have compared self-reports and examination-based measures of risk factors for cardiovascular disease. These studies generally show that self-reports underestimate obesity prevalence [4,5,6,7]. Studies have found underestimation of the prevalence of high cholesterol [5,8,9] and hypertension [4,5,9] based on self-reports, but a recent study in New York City had mixed results [6]
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