Abstract 1467: Influence of Obesity on Cardiovascular Risk Factor Profiles in the US Population Over the Past 2 Decades: Observations From NHANES 1988–2006
Objective: To assess temporal trends in cardiac risk factor (RF) profiles in the general population in the context of increasing obesity.
Methods: Subjects ages 20 – 85 from NHANES III (1988 –1994; (n=6677) and NHANES 2005–2006 (n=1587) with complete RF data were evaluated. Borderline RF were defined as: no therapy and
BP 120 –139/80 – 89mmHg;
LDL 100 –129mg/dL;
fasting glucose (FG) 100 –125mg/dL; and
prior tobacco use.
Elevated (↑) RF were defined as on therapy or:
FG ≥126mg/dL; or
Participants were grouped as:
Optimal= all RF optimal;
Borderline= ≥1 borderline but no ↑ RF;
Elevated= ≥1 ↑ RF.
All data were sample-weight adjusted.
Results: In the NHANES III cohort (mean age 44; 50% men, 17% nonWhite), only 5.9% were Optimal and 36.5% Borderline. The Optimal profile was more common in women than in men (9.0% v. 2.5%, p=<0.01) with no difference in Borderline groups (p=0.7). Between NHANES III and 2005–2006, in the setting of increasing mean BMI (26.5 to 28.8 kg/m2; p<0.01), there was no net change in risk factor profile distribution (Figure⇓). Increases in prevalence of optimal LDL (22% to 28%; p<0.01) and non-smoking (45% to 50%, p=0.05) were countered by adverse trends in optimal BP (48% to 43%; p=0.08) and optimal FG (67% to 58%; p<0.01)).
Conclusions: Despite focused public health efforts, no net improvement in overall CV risk profile is detectable over the past 2 decades in the US population. The decreasing prevalence of optimal BP and FG, both closely associated with obesity, appear to undermine improved LDL and smoking, thus underscoring the need to reverse the obesity trend.