Cardiovascular Health Behavior and Health Factor Changes (1988-2008) and Projections to 2020: Results from the National Health and Nutrition Examination Surveys (NHANES)
Background—The American Heart Association's (AHA) 2020 Strategic Impact Goals target a 20% relative improvement in overall cardiovascular health using 4 health behavior (smoking, diet, physical activity, body mass) and 3 health factor (plasma glucose, cholesterol, blood pressure) metrics. We sought to define current trends and forward projections to 2020 in cardiovascular health.
Methods and Results—We included 35,059 CVD-free adults (≥20 years old) from the National Health and Nutrition Examination Survey 1988-94 and subsequent 2-year cycles from 1999 to 2008. We calculated population prevalence of poor, intermediate, and ideal health behaviors and factors, and also computed a composite, individual-level Cardiovascular Health Score for all 7 metrics (poor=0 points; intermediate=1 point; ideal=2 points; total range 0-14 points). Prevalence of current and former smoking, hypercholesterolemia, and hypertension declined, whereas prevalence of obesity and dysglycemia increased through 2008. Physical activity levels and low diet quality scores changed minimally. Projections to 2020 suggest that obesity and impaired fasting glucose/diabetes could increase to affect 43% and 77% of US men, and 42% and 53% of US women, respectively. Overall, population-level cardiovascular health is projected to improve by 6% overall by 2020 if current trends continue. Individual-level Cardiovascular Health Score projections to 2020 (men = 7.4 [95% CI, 5.7, 9.1]; women = 8.8 [95% CI, 7.6, 9.9]) fall well below the level needed to achieve a 20% improvement (men = 9.4; women = 10.1).
Conclusions—The AHA 2020 target of improving CV health by 20% by 2020 will not be reached if current trends continue.
- Received September 29, 2011.
- Accepted March 19, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited