Introduction:
Young women are thought to have low cardiovascular disease (CVD) risk; however, mortality due to ischemic heart disease has actually risen among women aged 35-44 years. We hypothesized that young women with increased CVD risk burden are more likely to misperceive body image and less likely to practice healthful behaviors.
Methods:
To determine CVD risk burden among young women (aged 18-49 years) of a primarily urban population, 569 women visiting outpatient medical clinics were assessed. Anthropometric measures [height, weight, waist, body mass index (BMI)], attitudes towards weight, and lifestyle behavior were determined. Body image self-perception was assessed using validated silhouette scales. Increased CVD risk burden was defined as presence of hypertension, diabetes mellitus, tobacco use, hyperlipidemia, and/or obesity.
Results:
Participants were Hispanic (62.7%; 357/569); non-Hispanic White (20.7%; 118/569); non-Hispanic Black (8.9%; 51/569) and Asian/other ethnicity (7.5%; 43/569); mean age was 35.9 years ± 8.1 and income $39,828 ± $20,229. BMI categories were: obese (BMI ≥ 30 kg/m
2
, 27.4%; 155/569); overweight (BMI 25.0 - 29.9 kg/m
2
, 29.0%; 164/569); normal (BMI 18.5 - 24.9, 41.2%; 233/569); and underweight (BMI ≤ 18.4; 2.3%; 13/569). Women without CVD risk burden were the reference standard.
Nearly half (47.7%; 271/569) had increased CVD risk burden; and 33.5% (190/569) had ≥ 1 CVD risk factor, exclusive of obesity, including hypertension (18.0%), hyperlipidemia (11.5%), current tobacco use (10.2%), and diabetes mellitus (5.8%).
Women with increased CVD risk were less likely to correctly identify body size (48.3% vs. 69.4%, p<0.0001). They were more likely to be concerned about weight (82.0% vs. 65.8%, p =0.01) and actively trying to lose weight (77.3% vs. 65.4%, p=0.03). But, they were less likely to read nutrition labels when making food choices (29.4% vs. 17.9%, p=0.03) and more likely to cite cost (18.7% vs. 12.1%, p=0.03) and difficulty implementing a weight loss regimen (22.2% vs. 15.6%, p=0.05) as barriers to losing weight. Most, regardless of CVD risk burden, knew blood pressure, cholesterol, and blood sugar status. However, women with increased CVD risk burden were less likely to know cholesterol level (81.4% vs. 88.8%, p=0.02). Fewer obese women knew that tobacco contributes to CVD risk compared to non-obese women (92.3% vs. 96.6%, p=0.04).
Conclusion:
Paradoxically, though aware of their CVD risk factors and with heightened weight concerns, young women with increased CVD risk burden misperceive their body size and lack healthy behavior knowledge. A disconnect exists between this group’s recognition of their underlying risk and ability to modify their lifestyle to decrease CVD risk burden.
Cardiovascular disease risk perceptions and tobacco use among Appalachian youth
