Heart age differentials and general cardiovascular risk profiles for persons with varying disabilities: NHANES 2001-2010

Background: Persons with disabilities are at risk for secondary conditions, including allostatic load contributing to cardiovascular disease. The General Cardiovascular Risk Profile (GCRP) estimates cardiovascular disease risk for individuals. The GCRP variables are present in the National Health and Nutrition Examination Survey (NHANES) for the Healthy People 2010 decade.

Objective/hypothesis: The objective of this study was to compare persons with varying disabilities versus persons without disabilities on GCRP cardiovascular disease risk estimates across the Healthy People 2010 decade.

Methods: Weighted cross-sectional one-way Analyses of Variance (ANOVA) and non-parametric Kruskal-Wallis analyses compared persons with each of eight disability types versus persons without disabilities for point estimate GCRP heart vascular age differential and Cox regression model ten-year risk estimate in each NHANES survey year for 2001-2010.

Results: Persons with mobility or vision disabilities had significantly (p < .025) greater ten-year percent risks for cardiovascular disease and negative heart vascular age differentials (with respect to actual age, therefore "older" hearts) than persons without disabilities. The GCRP dual models conflict for certain disabilities (e.g., hearing, physical/mental/emotional) but are consistently reliable measures of GCRP for persons with mobility limitations and vision disabilities.

Conclusions: With higher CVD risk among persons with disabilities, there is a clear need for increased interventions to benefit the health of persons with disabilities. The GCRP represents a valuable, simple measurement that uses routinely collected examination data. Physicians and nurses can use the GCRP to make immediate CVD assessments and to provide point-of-contact counseling to patients with and without disabilities.