How Common Are Risk Factors for Developing Heart Disease? Very Common

Heart disease is the leading cause of mortality in the United States. The American Heart Association’s “Life’s Essential 8” (LE8) is a metric with four behavioral factors and four health factors used to assess cardiovascular health. Blood pressure, blood lipids, blood glucose, and body mass index (BMI), the four health factors of LE8, are cardiovascular disease (CVD) risk factors. Having a greater number of these CVD risk factors is associated with increased risk of CVD and all-cause mortality.

At the KAHN CENTER, we take extensive and detailed histories followed by advanced lab testing to get a full spectrum of all CVD risk factors that can be tested. However, even the "simple" assessment of risk factors has importance.

A new report presents prevalence estimates for none, one, or two or more of these CVD risk factors (uncontrolled high blood pressure, uncontrolled high blood lipids, uncontrolled high mean blood glucose as measured with hemoglobin A1c, and high BMI) in U.S. adults during August 2021–August 2023.

RESULTS

The percentage of adults with no CVD risk factors was 36.4%; one risk factor, 34.9%; and two or more risk factors, 28.7%, during August 2021–August 2023 .

● The percentage of adults with no or one CVD risk factors did not differ between men and women.

● More men (31.7%) than women (25.8%) had two or more CVD risk factors. The percentage of adults with no CVD risk factors decreased with age, while having one or two or more risk factors was higher among older adults.

The percentage of adults with no CVD risk factors decreased with age, from 53.7% among adults ages 20–39 to 29.6% among adults ages 40–59 to 24.7% among those age 60 and older (Figure 2, Table 2).

● The percentage of adults with one CVD risk factor increased with age, from 27.0% among adults ages 20–39 to 35.9% among adults ages 40–59 to 42.6% among those age 60 and older.

● The percentage of adults with two or more CVD risk factors was lower in adults ages 20–39 (19.3%) compared with adults ages 40–59 (34.5%) and those age 60 and older (32.7%).

The percentage of adults with no CVD risk factors was highest among those with family income 350% or more of the federal poverty level.

● The percentage of adults with no CVD risk factors was higher in adults with family income of 350% or more of the federal poverty level (FPL) (38.9%) compared with adults with family income less than 130% FPL (32.9%) and 130% to 349% FPL (33.3%).

● The percentage of adults with one CVD risk factor did not differ between income groups.

● The percentage of adults with two or more CVD risk factors was lower in adults with family income of 350% FPL or more (24.7%) compared with adults with family income less than 130% FPL (31.3%) and 130% to 349% FPL (32.6%).

The age-adjusted percentage of adults with two or more CVD risk factors increased between 2013–2014 and August 2021–August 2023.

● From 2013–2014 to August 2021–August 2023, the age-adjusted percentage of adults with two or more CVD risk factors increased from 23.7% to 28.1% (Figure 4, Table 4).

● Between the two most recent survey cycles, 2017–March 2020 and August 2021–August 2023, a significant decrease was seen in the percentage of adults with one CVD risk factor (from 37.2% to 33.9%), but no change was seen in the percentage of adults with no or two or more CVD risk factors

CONCLUSIONS

During August 2021–August 2023, nearly two-thirds of adults in the United States had at least one CVD risk factor (uncontrolled high blood pressure, uncontrolled high blood lipids, uncontrolled high mean blood glucose, or high BMI), and differences were observed by sex, age group, and family income.

Men were more likely to have two or more CVD risk factors compared with women. The percentage of adults with two or more CVD risk factors was higher among older age groups. The percentage of adults with no CVD risk factors was highest and the percentage of adults with two or more CVD risk factors was lowest among those in the highest income category.

From 2013–2014 to August 2021–August 2023, the percentage of adults with two or more CVD risk factors increased.

Continued monitoring of the prevalence of CVD risk factors will provide information on the cardiovascular health of adults in the United States. 

At the KAHN CENTER, we measure all of these risk factors and many more (sleep quality, Lipoprotein(a), inflammation markers, genetic markers, insulin levels, etc) and work to improve and normalize them. Starting as young as possible is the key.