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

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

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  • 1Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 NE 13 Street, Oklahoma City, OK 73104, USA. christina-shay@ouhsc.edu



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.


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.


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.

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