Work

Are We Doing Anything Right?: Assessing the Temporal Impacts of Cardiac Risk Factor Modification in Nhanes

Year: 2025

Type: article

Abstract: ASCVD/CVD Risk Factors As treatment, nutrition, and lifestyles evolve in the United States, overall cardiovascular health changes as well. In this study, we aim to assess how cardiovascular health has changed over an 18-year period. The study population includes all adults over 18 years of age in the 1999-2000 and 2017-2018 NHANES datasets. Individuals missing data necessary to calculate atherosclerotic cardiovascular disease (ASCVD) risk from the Pooled Cohort Equations (PCE) were excluded. Baseline characteristics were analyzed, stratified by time period and ASCVD risk category, with ASCVD risk assessed using the PCE. To test for interaction between year and other covariates, a logistic regression model was run individually for each demographic variable, with high ASCVD (>7.5%) as the outcome and an interaction term for year and each variable as the predictor variables. A total of 4375 and 4817 individuals were surveyed in the 1999-2000 and 2017-2018 datasets, respectively. When comparing them directly, more of the 2017-2018 cohort was on antihypertensive (34.27% vs 21.30%, p=0.001) and cholesterol medications (29.27% vs 10.49%, p=0.001), was diagnosed with depression (24.42% vs 16.62%, p=0.001) and diabetes (15.67% vs 8.53%, p=0.001), weighed more (mean 82.82 kg vs 78.32 kg, p=0.001), had a higher average BMI (mean 29.80 kg/m2 vs 28.07 kg/m2, p=0.001) and waist circumference (mean 100.59 cm vs 95.50 cm, p=0.001), and overall had a higher calculated ASCVD risk (11.09% vs 9.69%, p=0.001) compared to the 1999-2000 cohort. In a separate logistic regression model, the effect of antihypertensive medications (OR=0.79, p=0.032) and eating fewer high fat foods (OR=0.63, p=0.017) on high ASCVD risk decreased from 1999 to 2017. Additionally, the effect of total cholesterol (OR=0.99, p=0.001), LDL cholesterol (OR=0.99, p=0.001), systolic blood pressure (OR=0.99, p=0.001), BMI (OR=0.98, p=0.005) and waist circumference (OR=0.99, p=0.001) on high ASCVD risk decreased from 1999 to 2017 (Table 1). Despite more patients receiving therapy in the more recent cohort, the ASCVD risk worsened when these two groups were compared. A better understanding of this may help target our therapy as well as focus on other aspects of patient health to reduce ASCVD risk.

Source: American Journal of Preventive Cardiology

DOI: 10.1016/j.ajpc.2025.101224

Authors: Sumair Ozair, Matthew Ambrosio, Bradley Boldizar, Barry Bertolet

Institutions: North Mississippi Medical Center, Virginia Commonwealth University

Language: English

Topic: Cardiovascular Health and Risk Factors

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,900