Cardiovascular Health Behavior and Health Factor Changes (1988–2008) and Projections to 2020: Results From the National Health and Nutrition Examination Surveys
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Background—: The American Heart Association's 2020 Strategic Impact Goals target a 20% relative improvement in overall cardiovascular health with the use of 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 cardiovascular disease–free adults (aged ≥20 years) from the National Health and Nutrition Examination Survey 1988–1994 and subsequent 2-year cycles during 1999–2008. 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 mellitus 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% confidence interval, 5.7–9.1]; women=8.8 [95% confidence interval, 7.6–9.9]) fall well below the level needed to achieve a 20% improvement (men=9.4; women=10.1). Conclusions—: The American Heart Association 2020 target of improving cardiovascular health by 20% by 2020 will not be reached if current trends continue.
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Obese adolescents had a 16-fold increased risk of becoming severely obese adults compared with those with normal weight or overweight.
“Obese adolescents had a 16-fold increased risk of becoming severely obese adults compared with those with normal weight or those who were overweight.8”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
History of stroke in a first-degree relative increased the odds of stroke in men and women by approximately 50%.
“a history of stroke in a first-degree relative increased the odds of stroke in men and women by ≈50%.8”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
From 1999 to 2006, the prevalence of elevated LDL cholesterol levels in US adults 20 years of age or older decreased by about 33%.
“According to data from NHANES, from 1999 to 2006, the prevalence of elevated LDL cholesterol levels (as defined by levels higher than the specified Adult Treatment Panel III risk category) in adults ≥20 years of age has decreased by ≈33%.8”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
Ever-diagnosed heart disease was more prevalent among older men (37%) than older women (26%).
“Ever-diagnosed conditions that were more prevalent among older men than older women included HD (37% for men, 26% for women) and DM (24% for men, 18% for women), on the basis of data from NHIS/NCHS.8”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
In 2009-2010, hypertension was more prevalent among older women (57%) than older men (54%).
“In 2009 to 2010, hypertension was among the diagnosed chronic conditions that were more prevalent among older (≥65 years of age) women than older men (57% for women, 54% for men).”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
The mean LDL cholesterol level for US adults 20 years of age or older was 115.8 mg/dL in 2007-2010.
“The mean level of LDL cholesterol for American adults ≥20 years of age was 115.8 mg/dL in 2007 to 2010.8”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
Ever-diagnosed diabetes was more prevalent among older men (24%) than older women (18%).
“Ever-diagnosed conditions that were more prevalent among older men than older women included HD (37% for men, 26% for women) and DM (24% for men, 18% for women), on the basis of data from NHIS/NCHS.8”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [8]
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Cites
Global status report on noncommunicable diseases 2010.
Alwan, A. (2011) · Cited by 8,494 · see citing works
Prevalence and Trends in Obesity Among US Adults, 1999-2008
Flegal, K. M. (2010) · JAMA · doi:10.1001/jama.2009.2014 · Cited by 7,580 · see citing works
Lloyd-Jones, D. M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L. J., Van Horn, L., Greenlund, K., Daniels, S., Nichol, G., Tomaselli, G. F., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.192703 · Cited by 4,750 · see citing works
Self-citationHeidenreich, P. A., Trogdon, J. G., Khavjou, O. A., Butler, J., Dracup, K., Ezekowitz, M. D., Finkelstein, E. A., Hong, Y., Johnston, S. C., Khera, A., et al. (2011) · Circulation · doi:10.1161/cir.0b013e31820a55f5 · Cited by 3,208 · see citing works
Self-citationUS trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008
Egan, B. M. (2010) · JAMA · doi:10.1001/jama.2010.650 · Cited by 2,197 · see citing works
National Health and Nutrition Examination Survey
Rothwell, C. J. (2009) · Springer eBooks · doi:10.1007/978-0-387-78665-0_6177 · Cited by 2,087 · see citing works
Dietary Guidelines for Americans, 2010
(2011) · Choice Reviews Online · doi:10.5860/choice.49-0615 · Cited by 1,571 · see citing works
Writing Group Members, Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., et al. (2012) · Circulation · doi:10.1161/cir.0b013e3182456d46 · Cited by 1,512 · see citing works
Self-citationDietary Guidelines for Americans, 2010
Marshall, T. A. (2011) · The Journal of the American Dental Association · doi:10.14219/jada.archive.2011.0248 · Cited by 1,401 · see citing works
Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age
Lloyd-Jones, D. M., Leip, E. P., Larson, M. G., D’Agostino, R. B., Beiser, A., Wilson, P. W. F., Wolf, P. A., & Levy, D. (2006) · Circulation · doi:10.1161/circulationaha.105.548206 · Cited by 1,298 · see citing works
Self-citationMcGuire, S. (2011) · Advances in Nutrition · doi:10.3945/an.111.000430 · Cited by 1,029 · see citing works
Stamler, J., Stamler, R., Neaton, J. D., Wentworth, D. N., Daviglus, M. L., Garside, D., Dyer, A. R., Liu, K., & Greenland, P. (1999) · JAMA · doi:10.1001/jama.282.21.2012 · Cited by 725 · see citing works
Folsom, A. R., Yatsuya, H., Nettleton, J. A., Lutsey, P. L., Cushman, M., & Rosamond, W. D. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.11.041 · Cited by 713 · see citing works
Coronary Heart Disease Mortality Among Young Adults in the U.S. From 1980 Through 2002
Ford, E. S., & Capewell, S. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.05.056 · Cited by 589 · see citing works
Self-citationXanthakis, V., Enserro, D. M., Murabito, J. M., Polak, J. F., Wollert, K. C., Januzzi, J. L., Wang, T. J., Tofler, G., & Vasan, R. S. (2014) · Circulation · doi:10.1161/circulationaha.114.009273 · Cited by 287 · see citing works
Bambs, C., Kip, K. E., Dinga, A., Mulukutla, S. R., Aiyer, A. N., & Reis, S. E. (2011) · Circulation · doi:10.1161/circulationaha.110.980151 · Cited by 235 · see citing works
Capewell, S., Ford, E. S., Croft, J. B., Critchley, J. A., Greenlund, K. J., & Labarthe, D. R. (2010) · Bulletin of the World Health Organization · doi:10.2471/blt.08.057885 · Cited by 200 · see citing works
Self-citationBarton, P. M., Andronis, L., Briggs, A. H., McPherson, K., & Capewell, S. (2011) · BMJ · doi:10.1136/bmj.d4044 · Cited by 195 · see citing works
Self-citationReflections on Cardiovascular Diseases
Strasser, T. (1978) · Interdisciplinary Science Reviews · doi:10.1179/030801878791925921 · Cited by 191 · see citing works
Daviglus, M. L., Liu, K., Greenland, P., Dyer, A. R., Garside, D. B., Manheim, L. M., Lowe, L. P., Rodin, M. B., Lubitz, J. D., & Stamler, J. (1998) · New England Journal of Medicine · doi:10.1056/nejm199810153391606 · Cited by 159 · see citing works
Cohen, J. D., Cziraky, M. J., Cai, Q., Wallace, A. E., Wasser, T., Crouse, J. R., & Jacobson, T. A. (2010) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2010.05.030 · Cited by 151 · see citing works
Rapid mortality falls after risk-factor changes in populations
Capewell, S., & O'Flaherty, M. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62302-1 · Cited by 149 · see citing works
Self-citationFavorable Cardiovascular Risk Profile in Middle Age and Health-Related Quality of Life in Older Age
Daviglus, M. L., Liu, K., Pirzada, A., Yan, L. L., Garside, D. B., Feinglass, J. M., Guralnik, J. M., Greenland, P., & Stamler, J. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.20.2460 · Cited by 121 · see citing works
O’Flaherty, M., Bishop, J., Redpath, A., McLaughlin, T., Murphy, D., Chalmers, J., & Capewell, S. (2009) · BMJ · doi:10.1136/bmj.b2613 · Cited by 97 · see citing works
Self-citationSchroeder, S. A., & Warner, K. E. (2010) · New England Journal of Medicine · doi:10.1056/nejmp1003883 · Cited by 47 · see citing works
Recent trends in exposure to secondhand smoke in the United States population
Chen, C.-I., Burton, T. M., Baker, C. L., et al. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-359 · Cited by 27 · see citing works
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Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000485 · Cited by 12,591 · see citing works
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175 · see citing works
Self-citationHeart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036 · see citing works
Heart disease and stroke statistics-2018 update: a report from the american heart association
Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., Chiuve, S. E., Cushman, M., Delling, F. N., Deo, R., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000558 · Cited by 7,146 · see citing works
Heart Disease and Stroke Statistics—2015 Update: A Report From the American Heart Association
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., de Ferranti, S., Després, J.-P., Fullerton, H. J., Howard, V. J., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000152 · Cited by 5,797 · see citing works
Self-citationHeart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., Fox, C. S., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31828124ad · Cited by 5,292 · see citing works
Self-citationLloyd-Jones, D. M., Allen, N. B., Anderson, C. A. M., Black, T., Brewer, L. C., Foraker, R. E., Grandner, M. A., Lavretsky, H., Perak, A. M., Sharma, G., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001078 · Cited by 2,785 · see citing works
Self-citationLedwidge, M., Gallagher, J., Conlon, C., Tallon, E., O’Connell, E., Dawkins, I., Watson, C., O’Hanlon, R., Bermingham, M., Patle, A., et al. (2013) · JAMA · doi:10.1001/jama.2013.7588 · Cited by 664 · see citing works
Batty, G. D., Gale, C. R., Kivimäki, M., Deary, I. J., & Bell, S. (2020) · BMJ · doi:10.1136/bmj.m131 · Cited by 635 · see citing works
Recent trends in cardiovascular mortality in the United States and public health goals.
Sidney, S., Quesenberry, C. P., Jaffe, M. G., Sorel, M., Nguyen-Huynh, M. N., Kushi, L. H., Go, A. S., & Rana, J. S. (2016) · JAMA Cardiology · doi:10.1001/jamacardio.2016.1326 · Cited by 569 · see citing works
Epidemiology of Obesity in Adults: Latest Trends
Inoue, Y., Qin, B., Poti, J., Sokol, R., & Gordon-Larsen, P. (2018) · Current Obesity Reports · doi:10.1007/s13679-018-0317-8 · Cited by 308 · see citing works
Martin, S. S., Feldman, D. I., Blumenthal, R. S., Jones, S. R., Post, W. S., McKibben, R. A., Michos, E. D., Ndumele, C. E., Ratchford, E. V., Coresh, J., et al. (2015) · Journal of the American Heart Association · doi:10.1161/jaha.115.002239 · Cited by 267 · see citing works
The Gut Microbiome, Energy Homeostasis, and Implications for Hypertension
Riedl, R. A., Atkinson, S. N., Burnett, C. M. L., Grobe, J. L., & Kirby, J. R. (2017) · Current Hypertension Reports · doi:10.1007/s11906-017-0721-6 · Cited by 58 · see citing works
Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Di Biase, N., Bollanti, L., Conti, F., Zanuso, S., et al. (2017) · PLOS ONE · doi:10.1371/journal.pone.0173337 · Cited by 46 · see citing works
The complex relationship between physical activity and diabetes: an overview
Palermi, S., Iacono, O., Sirico, F., Modestino, M., Ruosi, C., Spera, R., & De Luca, M. (2022) · Journal of Basic and Clinical Physiology and Pharmacology · doi:10.1515/jbcpp-2021-0279 · Cited by 35 · see citing works
Wide educational disparities in young adult cardiovascular health
Lawrence, E. M., Hummer, R. A., Domingue, B. W., & Harris, K. M. (2018) · SSM - Population Health · doi:10.1016/j.ssmph.2018.07.006 · Cited by 27 · see citing works
- Authors
- Huffman, M. D., Capewell, S., Ning, H., Shay, C. M., Ford, E. S., & Lloyd-Jones, D. M.
- Affiliations
- Northwestern University (US)
- From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.D.H., H.N., C.M.S., D.M.L.-J.); Division of Public Health, University of Liverpool, Liverpool, United Kingdom (S.C.); and Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA (E.S.F.).
- Venue
- Circulation
- Published
- 2012-05-29
- Volume
- 125
- Issue
- 21
- Pages
- 2595-2602
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3914399
- OpenAlex
- W1992593810
- Cited by
- 299
- References
- 26
- Citations by year
- 2025: 15 · 2024: 18 · 2023: 18 · 2022: 23 · 2021: 23 · 2020: 17 · 2019: 16 · 2018: 23 · 2017: 22 · 2016: 19 · 2015: 42 · 2014: 22 · 2013: 31 · 2012: 8
- FWCI
- 21.20
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL069771)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- cardiovascular health, cardiovascular health score, smoking, physical activity, diet quality, obesity, hypercholesterolemia, hypertension, impaired fasting glucose, diabetes mellitus, cardiovascular disease prevention, sex differences
- MeSH terms
- Adult, Aged, Aged, 80 and over, American Heart Association, Cardiovascular Diseases, Diet, Female, Humans, Hypercholesterolemia, Hyperglycemia, Hypertension, Male, Middle Aged, Motor Activity, Nutrition Surveys, Retrospective Studies, Risk Factors, Smoking, United States, Health Behavior, Body Mass Index, Prevalence
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