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Predicted 10-year CV risk improved in US adults
From 1999 to 2012, predicted 10-year CV risk improved in the United States, but the gains were greater in women than men and in white adults than nonwhite adults, according to a new report.
Earl S. Ford, MD, MPH, and colleagues applied the Pooled Cohort Risk Equations from the 2013 American College of Cardiology/American Heart Association Guideline on the Assessment of Cardiovascular Risk to participants from seven 2-year cycles of the National Health and Nutrition Examination Survey, from 1999-2000 to 2011-2012. All participants were aged 40 to 79 years and free of self-reported congestive HF, CHD, angina, MI or stroke.
Earl S. Ford
Of the five modifiable risk factors analyzed, the researchers reported improvements in smoking status (P=.045), total cholesterol (P<.001), HDL (P=.04) and systolic BP (P<.001), but a greater prevalence of diabetes (P=.001) from 1999-2000 and 2011-2012.
The percentage of people with a 10-year CV risk calculated at ≥20% declined from 13% in 1999-2000 to 9.4% in 2011-2012 (P=.008). The greatest declines were in women (9.4% to 4.7%; P<.001), non-Hispanic white participants (13.2% to 9.1%; P=.02), non-Hispanic white women (9.3% to 3.8%; P=.001) and non-Hispanic black women (16.2% to 8.9%; P=.03), according to the results.
However, in each 2-year cycle, the rate of predicted 10-year CV risk of ≥20% was higher in men than in women, and higher in non-Hispanic black women than in non-Hispanic white women.
Ford and colleagues also examined the potential impact of aligning the levels of modifiable risk factors with optimal values on predicted 10-year CV risk in participants from the 2011-2012 survey. They found that the largest drop in mean predicted risk occurred with the achievement of systolic BP <120 mm Hg (absolute change, –1.32%; 95% CI, –1.54 to –1.1) followed by elimination of diabetes (absolute change, –1.04%; 95% CI, –1.17 to –0.92) and smoking (absolute change, –0.9%; 95% CI, –1.03 to –0.77).
“Improvement in risk factors levels, led by systolic [BP], can produce substantial reductions in future [CVD],” Ford, from the division of population health at the National Center for Chronic Disease Prevention and Health Promotion at the CDC, and colleagues wrote. “Interventions aimed at improving the modifiable risk factors other than total cholesterol level could help narrow the gender gap in predicted risk, and improving systolic [BP] and concentrations of HbA1c could help to narrow the racial disparity.”
Disclosure: The researchers report no relevant financial disclosures.