Trends in Cardiovascular Disease Risk in the U.S., 1999-2014.

INTRODUCTION: Cardiovascular disease is the leading cause of death in the U.S. and national prevalence of the proportion of individuals at high risk is unknown. The objective of this study was to investigate the prevalence and trends in high cardiovascular disease risk among adults in the U.S.

METHODS: In 2017, the authors performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey, 1999-2014 for adults aged 40-79 years without a diagnosis of cardiovascular disease (unweighted n=18,269, weighted n=96,512,989). The American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease risk score was calculated for all participants with complete data. Change in prevalence of individuals at high risk of cardiovascular disease was assessed, defined as ≥7.5% 10-year risk and ≥20% 10-year risk.

RESULTS: The prevalence of high risk level did not significantly change over time for the entire sample using the 7.5% 10-year risk level, but did decline significantly at 20% 10-year risk level. Logistic regression results showed that prevalence among non-Hispanic black males increased significantly from 53.5% in 1999-2002 to 65.2% in 2011-2014 using the 7.5% 10-year risk cut off (p-trend=0.003).

CONCLUSIONS: A substantial proportion of the population is at high risk of cardiovascular disease. Prevalence of high-risk individuals is prominent for non-Hispanic black males; the reasons for which are unclear. Public health efforts to increase awareness should be considered for this vulnerable population.