4 Interrelationships,Prevalence,Impact Risk Factors_SW_2.ppt

4 Interrelationships,Prevalence,Impact Risk...

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Unformatted text preview: Prevalence of CV Prevalence of CV Disease Risk Factors Prevalence Estimates of Prevalence Estimates of High Total Cholesterol POPULATION TOTAL CHOLESTEROL TOTAL CHOLESTEROL 48.4% 16.8% Total Adults ≥ 200mg/dL ≥ 240mg/dL Males 47.8% 16.2% Females 48.6% 17.1% Asians/Pacific Islanders ­­­­­ 27.3% American Indians/Alaskans ­­­­­ 26.0­28.6% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Low HDL Cholesterol POPULATION PREVALENCE Total Adults Males 16.7% 25.1% 9.1% Females POPULATION PREVALENCE White Males 26.2% White Females African American Males 8.8% 15.5% African American Females Mexican American Males 6.9% 27.7% Mexican American Females 13.0% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Hypertension POPULATION PREVALENCE Total Adults Males 33.6% 33.2% Females 33.6% Stage 1 (140­159/90­99) = 67% of all hypertensives Stage 2 (160­179/100­109) = 22% of all hypertensives Stage 3 or 4 (>180/>110) = 11% of all hypertensives Prehypertension (120­139/80­89) = 37.4% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Hypertension POPULATION PREVALENCE White Males 32.5% White Females African American Males 31.9% 42.6% African American Females Mexican American Males 46.6% 28.7% Mexican American Females Asians/Pacific Islanders 31.4% 16.1% American Indians/Alaskans 23.9% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Cigarette Smoking POPULATION PREVALENCE Total Adults 20.9% Males 23.4% Females 18.5% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Physical Activity Prevalence Estimates of Physical Activity Prevalence Estimates of Physical Activity 9­15% in this sample! Prevalence Estimates of Physical Activity 29­51% in this sample! Prevalence Estimates of Physical Inactivity 15­43% in this sample! Prevalence Estimates of Prevalence Estimates of Physical Inactivity POPULATION PREVALENCE Total Adults 23.7% Males 21.4% Females 25.9% ~25% of Americans are Physically Inactive! Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Regular Physical Activity POPULATION PREVALENCE Total Adults 30.1% ***Regular physical activity is defined as light-moderate activity for ≥ 30 minutes, ≥ 5 days per week OR vigorous activity for ≥ 20 minutes, ≥ 3 days per week Source: 2007 AHA Heart Disease and Stroke Statistics Update. Obesity Trends* Among U.S. Adults Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% * BMI ≥ 30 kg/m2 Obesity Trends Among U.S. Adults Obesity Trends Among U.S. Adults BRFSS, 1990 No Data <10% 10%–14% Obesity Trends Among U.S. Adults Obesity Trends Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% Obesity Trends Among U.S. Adults Obesity Trends Among U.S. Adults BRFSS, 2000 No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends Among U.S. Adults Obesity Trends Among U.S. Adults BRFSS, 2005 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Prevalence Estimates of Prevalence Estimates of Overweight & Obesity POPULATION OVERWEIGHT & OR OBESITY OBESITY Total Adults 66.0% 31.4% Males 70.5% 29.5% Females 61.6% 33.2% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Overweight & Obesity POPULATION OVERWEIGHT & OR OBESITY OBESITY 71.0% 30.2% White Females African American Males 57.6% 67.0% 30.7% 30.8% African American Females Mexican American Males 79.6% 74.6% 51.1% 29.1% Mexican American Females Asians/Pacific Islanders 73.0% 25.1% 39.4% 6.0% American Indians/Alaskans 33.5% 32.9% White Males Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Overweight in Children POPULATION OVERWEIGHT 2­5 Year Olds ~14% 6­11 Year Olds 17.5% 12­19 Year Olds 17% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Diabetes POPULATION DIAGNOSED DIABETES PREDIABETES Total Adults 7.1% 27.6% Males 7.4% 33.8% Females 6.9% 21.7% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Prevalence Estimates of Prevalence Estimates of Diabetes POPULATION DIAGNOSED DIABETES PREDIABETES 6.7% 34.3% White Females African American Males 5.6% 10.7% 21.6% 23.1% African American Females Mexican American Males 13.2% 11.0% 20.5% 37.5% Mexican American Females Asians/Pacific Islanders 10.9% 7.5% 22.6% ­­­­­ American Indians/Alaskans 15.8% ­­­­­ White Males Source: 2007 AHA Heart Disease and Stroke Statistics Update. Comparison of CV Disease Comparison of CV Disease Risk Factor Prevalences Risk Factor Obesity Overweight +/or Obese Hypertension Prehypertension Cholesterol Levels TC ≥ 200 mg/dL TC ≥ 240 mg/dL TC HDL ≤ 40 mg/dL HDL Cigarette Smoking Physical Inactivity Physical Diabetes Diabetes Prediabetes Prevalence Prevalence 31.4% 31.4% 66.0% 33.6% 33.6% 37.4% 48.4% 16.8% 16.7% 20.9% 20.9% 23.7% 7.1% 7.1% 27.6% Source: 2007 AHA Heart Disease and Stroke Statistics Update. Bottom line ­ all of the modifiable Bottom line ­ all of the modifiable CV disease risk factors are very prevalent in the population of the United States!!!!!! Interrelationships Interrelationships Among CV Disease Risk Factors Interrelationships: Blood Pressure & Age Interrelationships: Diabetes & Age Interrelationships: Total Cholesterol & Age Interrelationships: LDL­C & Age Interrelationships: HDL­C & Age Total Cholesterol/HDL­C Ratios Total Cholesterol/HDL­C Ratios Age 5 – 9 10 – 14 15 – 19 20 – 24 25 – 29 30 – 34 35 – 39 40 – 44 45 – 49 50 – 54 55 – 59 60 – 64 65 – 69 70+ White Men 2.9 2.9 3.3 3.7 4.1 4.2 4.6 4.7 4.7 4.6 4.5 4.2 4.2 4.1 White Women 3.1 3.1 3.0 3.2 3.2 3.2 3.4 3.4 3.5 3.5 3.6 3.6 3.6 3.7 Interrelationships: Body Fat & Age Genetics and CVD Genetics and CVD Heritable Factors Non­heritable DNA Sequence Variation Non­sequence­driven Variation Total Cholesterol Insulin Sensitivity/Diabetes LDL Cholesterol HDL Cholesterol Blood Pressure Obesity... Beware of Genetic Determinism! Interrelationships Continued... Syndrome X Syndrome X Diabetes and Hypertension Diabetes and Hypertension Diabetes and Overweight Diabetes and Overweight Diabetes and Obesity Diabetes and Obesity PHYSICAL INACTIVITY PHYSICAL INACTIVITY AND CVD RISK FACTORS INCREASED LIKELIHOOD OF SMOKING (CORRELATION) INCREASED CHANCE OF POOR DIET (CORRELATION) PHYSICAL INACTIVITY INCREASED RISK OF ABNORMAL LIPIDS INCREASED RISK OF OBESITY INCREASED RISK OF DIABETES INCREASED RISK OF HYPERTENSION Bottom line – Numerous CV disease risk Bottom line – Numerous CV disease risk factors are very closely associated with each other. Thus, knowing information about one risk factor provides a substantial amount of information about additional risk factors that individual may have!!!!!! Overall Impact of Overall Impact of CV Disease Risk Factors Population Attributable Risk takes into account Both the Risks associated with a risk factor and the Prevalence of the risk factor. The higher it is, the more important it is for the health of that population Population Attributable Risk takes into account Both the Risks associated with a risk factor and the Prevalence of the risk factor. The higher it is, the more important it is for the health of that population Anderson et al. (1991) Anderson et al. (1991) • Based on Framingham data • • • • • – Almost entirely Caucasian participants 12­yr follow­up Age of subjects: 30­74 yrs (at 1st measure) 5573 people (2983 women, 2590 men) Overall, 385 cases of CHD Equation estimates risk of developing CHD Anderson et al. (1991) Anderson et al. (1991) • Equation uses blood pressure, cholesterol levels, HDL­cholesterol levels, age, gender, smoking status, diabetes status, and LV hypertrophy status – WE USE A VERSION OF THIS EQUATION IN THE WRITING ASSIGNMENTS (w/o LV hypertrophy) • Complex equation • Broken into a points version in the article Odell et al. (1994) Odell et al. (1994) • Based on Framingham data – Almost entirely Caucasian participants 20­yr follow­up 4404 people (2460 women, 1944 men) Overall, 1300 cases of CHD, 700 heart attacks, 300 strokes, 225 sudden deaths • Equations estimate risk of developing CHD, risk of heart attack, risk of stroke, or risk of sudden death • • • Odell et al. (1994) Odell et al. (1994) • Equations use systolic blood pressure, cholesterol levels, age, gender, weight, and smoking status • Complex equations w/ different variables used for each CV event Anderson Prediction Equations in Practice 1 in 5 men with this profile will develop heart disease Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Anderson Prediction Equations in Practice Relative Risk Relative Risk Relative Risk ...
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This note was uploaded on 10/18/2011 for the course KNES 260 taught by Professor Hagberg during the Spring '08 term at Maryland.

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