Abstract 11897: Status of Cardiovascular Health among Adult Americans in 50 States and District of Columbia, 2009

Abstract

The American Heart Association (AHA) recently proposed a new metric of cardiovascular health comprised of 7 health behaviors and factors. National estimates of cardiovascular health are available; however, state-level assessments have not been reported. The purpose of this study is to estimate the cardiovascular health status in each US state, using 2009 Behavioral Risk Factor Surveillance System (BRFSS) data from all 50 states and District of Columbia. As data are self-reported, the AHA definition of cardiovascular health was modified using self-reported hypertension, high cholesterol, diabetes, current smoking status, weight classification, physical activity and dietary behavior. Ideal cardiovascular health was defined as meeting current guidelines or standards from each behavior or factor. The percentage of population in each state with ideal cardiovascular health and the adjusted prevalence ratio of ideal cardiovascular health in each state were estimated (adjusted for age, sex, race/ethnicity and levels of education). In 2009, 3.3% reported as ideal cardiovascular health (n = 356,441). Large disparities of ideal cardiovascular health existed by age, sex, race/ethnicity and level of education - the elderly, males, non-Hispanic blacks and those with lower levels of education were less likely to have ideal cardiovascular health. The percentage of population with ideal cardiovascular health varied by state, ranging from 1.2% to 6.9%. The adjusted prevalence ratio of ideal cardiovascular health, ranged from 0.38, 95% confidence interval [CI] 0.29-0.52 (Oklahoma) to 1.91, 95% CI 1.51-2.42 (District of Columbia), with Illinois (median) as reference (Figure). In conclusion, the prevalence of ideal cardiovascular health is very low in the US adult population and varies substantially by state. These estimates can be used by state heart disease and stroke prevention programs to focus communication initiatives and direct limited programmatic resources.