Examining Risk Factor Goal Attainment and Adherence to Treatment Among US Heart Failure Patients: The National Health and Nutrition Examination Survey 2007–2010

To examine the associations of heart failure (HF) with five domains of disability while controlling for covariates. Subjects with HF and aged ≥ 50 years were selected from the 1999 to 2018 National Health and Nutrition Examination Survey data. Five domains of disability were measured with 19 physical tasks. Logistic regression with adjustment for covariates was conducted. The prevalence of HF in 27,185 adults aged ≥ 50 years was 6.37%. After controlling for demographics and smoking, logistic regression showed that HF was associated with 2.8 to 3.4 times increased odds of all domains of disability compared to adults without HF, but with additional adjustments of covariates, the association was attenuated indicating the mediating effects of covariates. The future study may examine the mediating effects of covariates when intervening difficulties with lower extremity mobility and activities of daily living while considering in community-dwelling older adults with HF.

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Abstract 15214: Food Insecurity and Cardiovascular Disease in NHANES (National Health and Nutrition Examination Survey) 2011-2016

Circulation ◽

10.1161/circ.142.suppl_3.15214 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

MONICA M DELSON ◽

Janice F Bell ◽

Tequila S Porter ◽

Julie T Bidwell

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Food Insecurity ◽

National Health ◽

The United States ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Artery Disease

Background: Adherence to a heart-healthy diet is foundational for the prevention, management, and treatment of cardiovascular disease (CVD). Despite the fact that adhering to dietary guidelines may be challenging in the context of food insecurity, little is known about the likelihood of food insecurity in persons with CVD. Hypothesis: We hypothesized that persons with CVD (hypertension, coronary artery disease, heart failure, or stroke) would have significantly higher odds of food insecurity. Methods: This was an analysis of data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional study of health in the United States. All adults aged 19 years or older with food insecurity data were included across 3 cycles of NHANES (2011-2016). Food insecurity was measured using the 10-item Food Security Scale. CVD diagnosis was measured by self-report. Risk for food insecurity by CVD diagnosis was examined using multivariable logistic regression models, incorporating NHANES sample and person weights, and controlling for common sociodemographic confounders (age, gender, race/ethnicity, education, marital status). Results: The sample consisted of 17,175 persons (weighted study N =229,247,659). Slightly more than half were male (51.9%), and most were non-Hispanic white (65.1%). Just under half (45.6%) were in early adulthood (19-44 years), 35.3% were in middle adulthood (45-64 years), and 18.6% were in late adulthood (≥65 years). One quarter (25.9%) were food insecure. Consistent with our hypothesis, diagnosis of any CVD (stroke, heart failure, coronary artery disease, or hypertension) was significantly associated with higher likelihood for food insecurity (stroke: OR=2.18; 95% CI 1.83-2.60; p<0.001; heart failure OR=1.94, 95% CI 1.46-2.57, p<0.001; coronary artery disease: OR=1.90, 95% CI 1.49-2.43, p<0.001; and hypertension: OR=1.25, 95% CI 1.10-1.42, p=0.001). Conclusions: Diagnoses of hypertension, stroke, coronary artery disease, and heart failure were all significantly associated with higher risk for food insecurity. Given the necessity of dietary modification in CVD, further efforts to study food insecurity in CVD alongside other social determinants of health are urgently needed.

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Abstract TMP50: Antihypertensive Medication Trends Among Individuals With History of Stroke and Hypertension: The National Health and Nutrition Examination Survey (NHANES) 2005 - 2016

Stroke ◽

10.1161/str.51.suppl_1.tmp50 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Daniel Santos ◽

Mandip S Dhamoon

Keyword(s):

Risk Factor ◽

National Health ◽

Stroke Risk ◽

Beta Blockers ◽

Stroke Survivors ◽

Nutrition Examination Survey ◽

Stroke Risk Factor ◽

Health And Nutrition ◽

History Of ◽

Over Time

Background: Hypertension (HTN) is a well-established, modifiable stroke risk factor. National HTN management trends among stroke survivors may provide important insight into secondary preventive treatment gaps. We investigated the adequacy of blood pressure (BP) control among stroke survivors and national antihypertensive (ATH) treatment trends. Methods: The National Health and Nutrition Examination Survey (NHANES) is a large, nationally representative cross-sectional survey conducted in 2-year cycles in the U.S. Evaluations include interviews, medication lists, physical examinations, and blood samples. We included participants aged >=20 years with HTN and history of stroke from 2005 to 2016. HTN was defined by self-report, ATH use, or uncontrolled HTN (BP >140/90) on physical examination. ATH medications were classified into calcium channel blockers, beta blockers, diuretics, and ACE inhibitors/angiotensin receptor blockers (ACE/ARBs). We report weighted frequencies and means using NHANES methodology, estimating the proportion of those with stroke with HTN. For all other analyses we examined those with stroke and HTN, summarizing number and classes of ATH, frequency of uncontrolled HTN, and associations between ATH classes and BP control. We examined trends in ATH use over time. Results: Among an estimated 6.4 million adults with history of stroke from 2005-2016, 78.2% had HTN but only 69.6% reported having been prescribed ATH medication. Among those with history of stroke and HTN (n=4971136), 37.1% (33.5-40.8%) had uncontrolled HTN on examination with 80.4% taking ATH. Most commonly used ATH medications were beta blockers (43.8%, 40.3-47.3%) and diuretics (41.5%, 37.2-45.8%). ATH classes associated with uncontrolled HTN included ACE/ARB (56.0%) and beta blockers (42.6%). Examining trends over time, diuretics have become less commonly used (49.4% in 2005-2006 vs. 35.7% in 2015-2016) whereas other classes remain more constant. Conclusion: Using a national survey, we found significant under-treatment of HTN in those with history of stroke, and >1/3 had uncontrolled HTN. Since HTN is a major stroke risk factor, this data demonstrates a significant missed opportunity nationally for secondary stroke prevention.

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Elevated Serum Uric Acid and Self-Reported Heart Failure in US Adults: 2007–2016 National Health and Nutrition Examination Survey

Cardiorenal Medicine ◽

10.1159/000502438 ◽

2019 ◽

Vol 9 (6) ◽

pp. 344-353 ◽

Cited By ~ 1

Author(s):

Michelle L. Stone ◽

Michael R. Richardson ◽

Larry Guevara ◽

Bethany G. Rand ◽

James R. Churilla

Keyword(s):

Heart Failure ◽

Uric Acid ◽

Serum Uric Acid ◽

National Health ◽

Representative Sample ◽

Elevated Serum ◽

Activity Level ◽

Nutrition Examination Survey ◽

Men And Women ◽

Health And Nutrition

Introduction: There is limited evidence examining the relationship between elevated serum uric acid (sUA) concentration and heart failure (HF) in United States (US) adults. The aim of the present study was to examine the association(s) between elevated sUA and HF using a nationally representative sample of US adults. Methods: The final sample with complete data for this analysis (n = 17,349) included men and women aged ≥40 years who participated in the 2007–2016 National Health and Nutrition Examination Survey. Self-reported diagnosis of HF was assessed via interview. Elevated sUA was defined as values >6.0 mg/dL for women and >7.2 mg/dL for men. Multivariable gender-stratified logistic regression was utilized to examine the odds of self-reported HF. Results: The estimated prevalence of HF was 3.9 and 3.4% among men and women, respectively. Age-adjusted analysis revealed significantly increased odds of HF in men (OR 2.79; 95% CI 2.15–3.84, p < 0.01) and women (OR 3.24; 95% CI 2.37–4.44, p < 0.01) with elevated sUA. This relationship remained statistically significant following adjustment for age, race, education, income, alcohol consumption, smoking status, blood pressure, diabetes, physical activity level, cholesterol, creatinine level, and body mass index in men (OR 1.70; 95% CI 1.13–2.57 p < 0.05) and women (OR 1.74; 95% CI 1.18–2.58, p < 0.05). Conclusions: In a representative sample of US adults, having an elevated sUA concentration was associated with significantly increased odds of HF when compared to adults with normal sUA.

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Glomerular hyperfiltration may be a novel risk factor of restrictive spirometry pattern: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2015

PLoS ONE ◽

10.1371/journal.pone.0223050 ◽

2019 ◽

Vol 14 (9) ◽

pp. e0223050 ◽

Cited By ~ 1

Author(s):

Hong Il Lim ◽

Sang Jin Jun ◽

Sung Woo Lee

Keyword(s):

Risk Factor ◽

National Health ◽

Pattern Analysis ◽

Glomerular Hyperfiltration ◽

Nutrition Examination Survey ◽

Health And Nutrition

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Association of Blood Cadmium with Cardiovascular Disease in Korea: From the Korea National Health and Nutrition Examination Survey 2008–2013 and 2016

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176288 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6288

Author(s):

Jihyun Jeong ◽

Sang-moon Yun ◽

Minkyeong Kim ◽

Young Ho Koh

Keyword(s):

Cardiovascular Disease ◽

Young Adults ◽

Risk Factor ◽

National Health ◽

The Elderly ◽

Korean Population ◽

Nutrition Examination Survey ◽

Cvd Risk ◽

Health And Nutrition ◽

Blood Cadmium

Cardiovascular disease (CVD) is the leading cause of death globally, although the mortality rate has declined with improved technology and risk factor control. The incidence rate of stroke, one of the CVDs, is increasing in young adults, whereas it is decreasing in the elderly. The risk factors for CVD may differ between young adults and the elderly. Previous studies have suggested that cadmium was a potential CVD risk factor in the overall and middle-aged to elderly populations. We assessed the associations between cadmium and CVD events in the Korean population aged 20–59 years using the 2008–2013 and 2016 Korea National Health and Nutrition Examination Survey (KNHANES), a population-based cross-sectional study. Among 10,626 participants aged 20–59 years, those with high blood cadmium (BCd) level (>1.874 µg/L, 90th percentile) were higher associated with stroke and hypertension (stroke: odds ratio (OR), 2.39; 95% confidence interval (CI), 1.03–5.56; hypertension: OR, 1.46; 95% CI, 1.20–1.76). The strongest association between high blood cadmium concentrations and hypertension was among current smokers. Ischemic heart disease (IHD) was not associated with high blood cadmium level. These findings suggest that high blood cadmium levels may be associated with prevalent stroke and hypertension in the Korean population under 60 years of age.

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