Vibhu Parcha1, Rajat Kalra2, Sarabjeet S Suri1, Gargya Malla3, Thomas J Wang4, Garima Arora1, Pankaj Arora5. 1. Division of Cardiovascular Disease, University of Alabama at Birmingham. 2. Cardiovascular Division, University of Minnesota, Minneapolis. 3. Department of Epidemiology, University of Alabama at Birmingham. 4. Department of Internal Medicine, University of Texas Southwestern, Dallas. 5. Division of Cardiovascular Disease, University of Alabama at Birmingham; Section of Cardiology, Birmingham Veterans Affairs Medical Center, AL. Electronic address: parora@uabmc.edu.
Abstract
OBJECTIVE: To evaluate the contemporary geographic trends in cardiovascular health in the United States and its relationship with geographic distribution of cardiovascular mortality. METHODS: By use of a retrospective cross-sectional design, the 2011-2017 Behavioral Risk Factor Surveillance System (BRFSS) was queried to determine the age-adjusted prevalence of cardiovascular health index (CVHI) metrics (sum of ideal blood pressure, blood glucose concentration, lipid levels, body mass index, smoking, physical activity, and diet). Cardiovascular health was estimated as both continuous (0 to 7 points) and categorical (ideal, intermediate, poor) variables from the BRFSS. Age-adjusted cardiovascular mortality for 2017 was obtained from the Centers for Disease Control and Prevention WONDER database. RESULTS: Among 1,362,529 American adult participants of the BRFSS 2011-2017 and all American residents in 2017, the CVHI score increased from 3.89±0.004 in 2011 to 3.96±0.005 in 2017 (Ptrend<.001) nationally, with modest improvement across all regions (Ptrend<.05 for all). Ideal cardiovascular health prevalence improved in the northeastern (Ptrend=.03) and southern regions (Ptrend=.002). In 2017, the prevalence of coronary heart disease (6.8%; 95% CI, 6.5% to 7.1%) and stroke (3.7%; 95% CI, 3.4% to 3.9%) was highest in the southern region. The CVHI score (3.81±0.01) and the prevalence of ideal cardiovascular health (12.2%; 95% CI, 11.7% to 12.7%) were lowest in the southern United States. This corresponded to the higher cardiovascular mortality in the southern region (233.0 [95% CI, 232.2- to 33.8] per 100,000 persons). CONCLUSION: Despite a modest improvement in CVHI, only 1 in 6 Americans has ideal cardiovascular health with significant geographic differences. These differences correlate with the geographic distribution of cardiovascular mortality. An urgent unmet need exists to mitigate the geographic disparities in cardiovascular morbidity and mortality.
OBJECTIVE: To evaluate the contemporary geographic trends in cardiovascular health in the United States and its relationship with geographic distribution of cardiovascular mortality. METHODS: By use of a retrospective cross-sectional design, the 2011-2017 Behavioral Risk Factor Surveillance System (BRFSS) was queried to determine the age-adjusted prevalence of cardiovascular health index (CVHI) metrics (sum of ideal blood pressure, blood glucose concentration, lipid levels, body mass index, smoking, physical activity, and diet). Cardiovascular health was estimated as both continuous (0 to 7 points) and categorical (ideal, intermediate, poor) variables from the BRFSS. Age-adjusted cardiovascular mortality for 2017 was obtained from the Centers for Disease Control and Prevention WONDER database. RESULTS: Among 1,362,529 American adult participants of the BRFSS 2011-2017 and all American residents in 2017, the CVHI score increased from 3.89±0.004 in 2011 to 3.96±0.005 in 2017 (Ptrend<.001) nationally, with modest improvement across all regions (Ptrend<.05 for all). Ideal cardiovascular health prevalence improved in the northeastern (Ptrend=.03) and southern regions (Ptrend=.002). In 2017, the prevalence of coronary heart disease (6.8%; 95% CI, 6.5% to 7.1%) and stroke (3.7%; 95% CI, 3.4% to 3.9%) was highest in the southern region. The CVHI score (3.81±0.01) and the prevalence of ideal cardiovascular health (12.2%; 95% CI, 11.7% to 12.7%) were lowest in the southern United States. This corresponded to the higher cardiovascular mortality in the southern region (233.0 [95% CI, 232.2- to 33.8] per 100,000 persons). CONCLUSION: Despite a modest improvement in CVHI, only 1 in 6 Americans has ideal cardiovascular health with significant geographic differences. These differences correlate with the geographic distribution of cardiovascular mortality. An urgent unmet need exists to mitigate the geographic disparities in cardiovascular morbidity and mortality.
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Authors: Vibhu Parcha; Gargya Malla; Sarabjeet S Suri; Rajat Kalra; Brittain Heindl; Lorenzo Berra; Mona N Fouad; Garima Arora; Pankaj Arora Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-10-06
Authors: Vibhu Parcha; Brittain Heindl; Rajat Kalra; Adam Bress; Shreya Rao; Ambarish Pandey; Barbara Gower; Marguerite R Irvin; Merry-Lynn N McDonald; Peng Li; Garima Arora; Pankaj Arora Journal: Circ Genom Precis Med Date: 2022-01-28
Authors: Avirup Guha; Xiaoling Wang; Ryan A Harris; Anna-Gay Nelson; David Stepp; Zachary Klaassen; Priyanka Raval; Jorge Cortes; Steven S Coughlin; Vladimir Y Bogdanov; Justin X Moore; Nihar Desai; D Douglas Miller; Xin-Yun Lu; Ha Won Kim; Neal L Weintraub Journal: Front Cardiovasc Med Date: 2021-10-18