The crude U.S. adult prevalence of CVD during 2015-2016 was highest in the oldest age group (26% in those aged ≥70 years vs. 1% in those aged 20-39 years); in males (10% vs. 6% in females); in non-Hispanic whites (8%) and non-Hispanic blacks (8% vs. 4% in Mexican-Americans); and in adults with obesity (9% vs. 7% in those without obesity).
Chart Explanation: In 2015-2016, the crude prevalence of CVD was greatest among older adults (25.7% in 70+ years and 15.2% in 60-69 years) compared to younger individuals (1.0% in 20-39 years). Based on gender, males had a higher crude prevalence of CVD compared to women (9.8% vs. 6.3%). Non-Hispanic whites and non-Hispanic blacks had very similar crude prevalences (8.4% and 8.2%), whereas Mexican-Americans had a much lower recorded prevalence (3.7%). Furthermore, crude prevalence was greater among adults with obesity than in those without obesity (9.2% vs. 6.7%).
The NHANES (National Health and Nutrition Examination Survey) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the Centers for Disease Control and Prevention's National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.
CVD and CKD are both diseases of the vessels and the two diseases are inextricably linked. Much has been written about CVD and associated morbidity and mortality as a consequence of CKD (e.g., Go et al., 2004); however, there is increasing evidence that the association is bidirectional and that CVD may also be a risk factor for the development of CKD (Menon et al., 2005; Elsayed et al., 2007). The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from the 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016 NHANES. All forms of CVD (coronary heart disease, myocardial infarction/heart attack, cerebrovascular accident/stroke, angina, and congestive heart failure) were self-reported by questionnaire with the question, “Have you ever been told by a doctor or health care provider that you have/had [condition/event]?,” using both technical and lay terms. Note that coronary heart disease was asked separately from myocardial infarction, cerebrovascular accident, and angina; those reporting the latter conditions did not necessarily report having coronary heart disease.
| Field | Data |
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| Description of Measure | Prevalence of CVD in the general population |
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| Data Source | NCHS |
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| Type of Data Source | Public |
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| Data Set | NHANES |
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| Health Care System Data | No |
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| Regional or National? | National |
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| Demographic Group | Non-institutionalized U.S. residents aged 20+ years |
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| Numerator | Participants 20+ with self-reported CVD from medical conditions questionnaire |
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| Denominator | Participants 20+ with responses to medical conditions questionnaire |
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| Primary Data Source Indicator | Mcq160b-f: “Have you ever been told by a provider that you have CHD, angina, MI, stroke, CHF” |
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| Primary Indicator Method of Measurement | Medical conditions questionnaire (20+ only) |
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| Secondary Data Source Indicator | Composite variable |
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| Secondary Indicator Method of Measurement | Composite of questionnaire variables (excluding CHF) |
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| Frequency of Measurement (Primary) | Once (cross-sectional) |
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| U.S. Region Covered by Primary Variable | All |
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| Period Currently Available | 1999–2016 |
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| Pending Data | 2017-2018 |
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| Additional Data Items of Interest | stratification variables of interest (age, gender, race/ethnicity, BMI) |
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| Limitations of Indicator | Self-reported conditions without validation; information on symptoms, fitness, and PVD (ABI) only collected in subsets |
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| Analytic Considerations | Appropriate NHANES survey weights must be used for all analyses |
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References and Sources:
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Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-305.
http://www.ncbi.nlm.nih.gov/pubmed/15385656
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Menon V, Gul A, Sarnak MJ. Cardiovascular risk factors in chronic kidney disease. Kidney Int. 2005;68(4):1413-1418
http://www.ncbi.nlm.nih.gov/pubmed/16164615
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Elsayed EF, Tighiouart H, Griffith J, et al. Cardiovascular disease and subsequent kidney disease. Arch Intern Med. 2007;167(11):1130-6.
http://www.ncbi.nlm.nih.gov/pubmed/17563020