Status of cardiovascular health in US adults: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2003-2008

Circulation. 2012 Jan 3;125(1):45-56. doi: 10.1161/CIRCULATIONAHA.111.035733. Epub 2011 Nov 17.


Background: The American Heart Association's 2020 Strategic Impact Goals define a new concept, cardiovascular (CV) health; however, current prevalence estimates of the status of CV health in US adults according to age, sex, and race/ethnicity have not been published.

Methods and results: We included 14 515 adults (≥20 years of age) from the 2003 to 2008 National Health and Nutrition Examination Surveys. Participants were stratified by young (20-39 years), middle (40-64 years), and older (≥65 years) ages. CV health behaviors (diet, physical activity, body mass index, smoking) and CV health factors (blood pressure, total cholesterol, fasting blood glucose, smoking) were defined as poor, intermediate, or ideal. Fewer than 1% of adults exhibited ideal CV health for all 7 metrics. For CV health behaviors, nonsmoking was most prevalent (range, 60.2%-90.4%), whereas ideal Healthy Diet Score was least prevalent (range, 0.2%-2.6%) across groups. Prevalences of ideal body mass index (range, 36.5%-45.3%) and ideal physical activity levels (range, 50.2%-58.8%) were higher in young adults compared with middle or older ages. Ideal total cholesterol (range, 23.7%-36.2%), blood pressure (range, 11.9%-16.3%), and fasting blood glucose (range, 31.2%-42.9%) were lower in older adults compared with young and middle-aged adults. Prevalence of poor CV health factors was lowest in young age but higher at middle and older ages. Prevalence estimates by age and sex were consistent across race/ethnic groups.

Conclusions: These prevalence estimates of CV health represent a starting point from which effectiveness of efforts to promote CV health and prevent CV disease can be monitored and compared in US adult populations.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Health Behavior*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys / methods
  • Nutrition Surveys / trends*
  • Prevalence
  • United States / epidemiology
  • Young Adult