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. 2024 Feb 6;24(1):91.
doi: 10.1186/s12872-023-03672-3.

Association of cardiovascular risk profile with premature all-cause and cardiovascular mortality in US adults: findings from a national study

Ryan T Nguyen  1 , Vardhmaan Jain  2 , Isaac Acquah  3 , Safi U Khan  3   4 , Tarang Parekh  5   6 , Mohamad Taha  3   4 , Salim S Virani  7   8 , Michael J Blaha  9 , Khurram Nasir  3   4   5 , Zulqarnain Javed  10   11
Affiliations

Association of cardiovascular risk profile with premature all-cause and cardiovascular mortality in US adults: findings from a national study

Ryan T Nguyen et al. BMC Cardiovasc Disord. .

Abstract

Objective: To assess the association between cardiovascular risk factor (CRF) profile and premature all-cause and cardiovascular disease (CVD) mortality among US adults (age < 65).

Methods: This study used data from the National Health Interview Survey from 2006 to 2014, linked to the National Death Index for non-elderly adults aged < 65 years. A composite CRF score (range = 0-6) was calculated, based on the presence or absence of six established cardiovascular risk factors: hypertension, diabetes, hypercholesterolemia, smoking, obesity, and insufficient physical activity. CRF profile was defined as "Poor" (≥ 3 risk factors), "Average" (1-2), or "Optimal" (0 risk factors). Age-adjusted mortality rates (AAMR) were reported across CRF profile categories, separately for all-cause and CVD mortality. Cox proportional hazard models were used to evaluate the association between CRF profile and all-cause and CVD mortality.

Results: Among 195,901 non-elderly individuals (mean age: 40.4 ± 13.0, 50% females and 70% Non-Hispanic (NH) White adults), 24.8% had optimal, 58.9% average, and 16.2% poor CRF profiles, respectively. Participants with poor CRF profile were more likely to be NH Black, have lower educational attainment and lower income compared to those with optimal CRF profile. All-cause and CVD mortality rates were three to four fold higher in individuals with poor CRF profile, compared to their optimal profile counterparts. Adults with poor CRF profile experienced 3.5-fold (aHR: 3.48 [95% CI: 2.96, 4.10]) and 5-fold (aHR: 4.76 [3.44, 6.60]) higher risk of all-cause and CVD mortality, respectively, compared to those with optimal profile. These results were consistent across age, sex, and race/ethnicity subgroups.

Conclusions: In this population-based study, non-elderly adults with poor CRF profile had a three to five-fold higher risk of all-cause and CVD mortality, compared to those with optimal CRF profile. Targeted prevention efforts to achieve optimal cardiovascular risk profile are imperative to reduce the persistent burden of premature all-cause and CVD mortality in the US.

Keywords: Cardiovascular mortality; Cardiovascular risk profile; Coronary Heart Disease.

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Conflict of interest statement

None to declare.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
KM Curve for All-cause Mortality by Risk Factor Profile Note: Adjusted for sociodemographic factors including sex, race/ethnicity, education, SES, insurance status
Fig. 2
Fig. 2
KM Curve for CVD mortality by Risk Factor Profile Note: Adjusted for sociodemographic factors including sex, race/ethnicity, education, SES, insurance status
Fig. 3
Fig. 3
All-Cause Mortality Hazard Ratios by Sociodemographic subgroups, from National Interview Health Survey 2006–2014
Fig. 4
Fig. 4
Cardiovascular Mortality Hazard Ratios by Sociodemographic Subgroups, from National Interview Health Survey, 2006–2014
See this image and copyright information in PMC

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