Monitoring Cardiovascular Disease Research Articles

Abstract P354: Reported Prevalence of High Blood Pressure and Cholesterol among US Adults - Behavioral Risk Factor Surveillance System, 2011

Background: High blood pressure and cholesterol are leading risk factors for cardiovascular disease (CVD). The Behavioral Risk Factor Surveillance System (BRFSS) is currently the only system that can provide state-level estimates of high blood pressure and cholesterol, and states frequently use the BRFSS when monitoring CVD risk factors. Several methodological changes to the BRFSS were instituted in 2011, to account for rising rates of cellular phone only households and declining response rates. The improvements may result in shifts to state-level estimates, and comparisons with previous years may represent methodological changes, rather than risk factor improvement or worsening. New baseline data are needed and this study uses the most recent data to report high blood pressure and cholesterol estimates among US states. Methods: The BRFSS is a state-based, random-digit-dialed telephone survey of non-institutionalized US adults aged ≥18 years. High blood pressure and cholesterol are assessed in odd years, using: “Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure [¼your high blood cholesterol is high]?” Data were analyzed by age, sex, race/ethnicity, education, and state. All estimates were age standardized using the 2000 US standard projected population. Analyses were conducted using SAS-callable SUDAAN to account for the complex sampling design. Within group differences were assessed using pairwise comparisons. The analytic sample was 498,201. Results: Overall, 30.3% (95% Confidence Interval: 30.0-30.5%) reported high blood pressure and 34.0% (33.7-34.3%) high cholesterol. Compared with other demographic groups, higher estimates of high blood pressure were reported among males, those with < a high school education, non-Hispanic blacks, and those ≥65 years. In parallel, high cholesterol was most commonly reported among males, those with < a high school education, and those ≥65 years, with non-Hispanic blacks reporting the lowest prevalence, compared with other demographic groups. By state, reported high blood pressure ranged from 24.7% (Colorado) to 38.3% (Mississippi) and high cholesterol from 28.0% (Montana) to 37.8% (Texas). Conclusions: In 2011, about 1 in 3 US adults reported high blood pressure and high cholesterol. Marked demographic and geographic disparities were found. Coordinated community and clinical interventions are needed to address the high burden of high blood pressure and cholesterol. For example, the Million Hearts TM initiative, a public-private partnership, seeks to align, coordinate, and enhance activities across the US, with prevention and treatment of high blood pressure and cholesterol being key components of the initiative.

Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland.

There is increasing evidence that blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen) are associated with an increased risk of incident cardiovascular events; however, their associations with mortality are not established. We therefore studied the associations of these variables with cardiovascular events and total mortality in 1238 men and women aged 25-64 years, followed for 13 years in the first North Glasgow MONICA (MONItoring CArdiovascular disease) survey and West of Scotland centres in the Scottish Heart Health Study. After adjustment for age and sex, increasing whole blood viscosity, plasma viscosity, haematocrit and fibrinogen (analysed by both von Clauss and heat precipitation assays) were significantly associated with mortality. Only the association for fibrinogen (von Clauss assay) remained significant after adjustment for major cardiovascular risk factors. We conclude that clottable fibrinogen may be independently associated with mortality. However, the significance of this association, and the extent to which viscosity is associated with mortality, remain to be established in larger studies and meta-analyses.