Prevalence of obesity in the United States has increased dramatically in recent decades, but the magnitude of change in cardiovascular disease(CVD) risk factors among the growing proportion of overweight and obese Ame...Prevalence of obesity in the United States has increased dramatically in recent decades, but the magnitude of change in cardiovascular disease(CVD) risk factors among the growing proportion of overweight and obese Americans remains unknown. Abstract: To examine 40- year trends in CVD risk factors by body mass index(BMI) groups among US adults aged 20 to 74 years. Design, Setting, and Participants: Analysis of 5 cross-sectional, nationally representative surveys: National Health Examination Survey(1960- 1962); National Health and Nutrition Examination Survey(NHANES) I(1971- 1975), II(1976- 1980), and III(1988- 1994); and NHANES 1999- 2000. Main Outcome Measures: Prevalence of high cholesterol level(≥ 240 mg/dL[≥ 6.2 mmol/L] regardless of treatment), high blood pressure(≥ 140/90 mm Hg regardless of treatment), current smoking, and total diabetes(diagnosed and undiagnosed combined) according to BMI group(lean,< 25; overweight, 25- 29; and obese, ≥ 30). Results: The prevalence of all risk factors except diabetes decreased over time across all BMI groups, with the greatest reductions observed among overweight and obese groups. Compared with obese persons in 1960- 1962, obese persons in 1999- 2000 had a 21- percentage- point lower prevalence of high cholesterol level(39% in 1960- 1962 vs 18% in 1999- 2000), an 18- percentage- point lower prevalence of high blood pressure(from 42% to 24% ), and a 12-percentage-point lower smoking prevalence(from 32% to 20% ). Survey x BMI group interaction terms indicated that compared with the first survey, the prevalence of high cholesterol in the fifth survey had fallen more in obese and overweight persons than in lean persons(P< .05). Survey x BMI changes in blood pressure and smoking were not statistically significant Changes in risk factors were accompanied by increases in lipid-lowering and antihypertensive medication use, particularly among obese persons. Total diabetes prevalence was stable within BMI groups over time, as nonsignificant 1- to 2- percentage-point increas展开更多
文摘Prevalence of obesity in the United States has increased dramatically in recent decades, but the magnitude of change in cardiovascular disease(CVD) risk factors among the growing proportion of overweight and obese Americans remains unknown. Abstract: To examine 40- year trends in CVD risk factors by body mass index(BMI) groups among US adults aged 20 to 74 years. Design, Setting, and Participants: Analysis of 5 cross-sectional, nationally representative surveys: National Health Examination Survey(1960- 1962); National Health and Nutrition Examination Survey(NHANES) I(1971- 1975), II(1976- 1980), and III(1988- 1994); and NHANES 1999- 2000. Main Outcome Measures: Prevalence of high cholesterol level(≥ 240 mg/dL[≥ 6.2 mmol/L] regardless of treatment), high blood pressure(≥ 140/90 mm Hg regardless of treatment), current smoking, and total diabetes(diagnosed and undiagnosed combined) according to BMI group(lean,< 25; overweight, 25- 29; and obese, ≥ 30). Results: The prevalence of all risk factors except diabetes decreased over time across all BMI groups, with the greatest reductions observed among overweight and obese groups. Compared with obese persons in 1960- 1962, obese persons in 1999- 2000 had a 21- percentage- point lower prevalence of high cholesterol level(39% in 1960- 1962 vs 18% in 1999- 2000), an 18- percentage- point lower prevalence of high blood pressure(from 42% to 24% ), and a 12-percentage-point lower smoking prevalence(from 32% to 20% ). Survey x BMI group interaction terms indicated that compared with the first survey, the prevalence of high cholesterol in the fifth survey had fallen more in obese and overweight persons than in lean persons(P< .05). Survey x BMI changes in blood pressure and smoking were not statistically significant Changes in risk factors were accompanied by increases in lipid-lowering and antihypertensive medication use, particularly among obese persons. Total diabetes prevalence was stable within BMI groups over time, as nonsignificant 1- to 2- percentage-point increas
