Project Title

Cardiovascular disease and its role on general health of the adult population in the United States.

Authors' Affiliations

Ogechukwu Laure Uchendu, Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN. Sheryl Strasser, Department of Health Policy & Behavior Sciences, School of Public Health, Georgia State University, Atlanta, GA Phani Veeranki, PRECISIONheor, Los Angeles, CA Shimin Zheng, Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN.

Faculty Sponsor’s Department

Biostatistics & Epidemiology

Type

Oral Competitive

Classification of First Author

Graduate Student-Master’s

Project's Category

Cardiovascular Disease

Abstract Text

Background: Despite the ongoing pandemic attributed to an infectious disease (SAR-CoV-2), non-infectious diseases-primarily cardiovascular diseases (CVD) remain the leading cause of death globally accounting for 655,000 annual deaths in the United States (U.S.). Additionally, CVD significantly impacts the quality of life attributing to total healthcare expenditure of $214 billion per year, of which $138 billion are attributed to the loss of productivity due to poor quality of life. The study's purpose is to assess the impact of CVD on the general health of adults in the U.S.

Question: What is the effect of CVD including angina, coronary heart disease, heart attack, and stroke on the general health of adults residing in the U.S.?

Methods: Study data included 418,268 adults who participated in the Behavioral Risk Factor Surveillance System (BRFSS) during 2019. The study outcome was general health status of U.S. adults categorized into excellent, very good, good, fair, and poor groups. Predictor variables included responses to the diagnosis of angina/coronary heart disease (CHD), heart attack (HD), and stroke during the respective years Other covariates included participants' demographics (age, education, and annual household income). Logistic regression models were conducted to estimate the association of CVD and other covariates with general health of U.S. adults adjusting for other confounders.

Results: After applying the study criteria, the final study sample included 355,391 participants. Poor general health status was reported among 83,882 study participants (19.6%).

The odds of reporting a poor general health status were 2.7 times (adjusted OR (aOR) 2.70, 95% CI 2.56-2.78), 2 times (aOR: 2.04, 95% CI 1.96-2.08), and 2.6 times (aOR 2.56, 95% CI 2.50-2.70) more likely among participants who had CHD, HD, and stroke respectively compared to participants who did not have such conditions.

The odds of reporting a poor general health status was 4% less likely among males compared to females (aOR 0.96, 95% CI 0.94-0.98). For every 5-year increase in age, the odds reporting poor general health status increased by 5% (aOR: 1.05, 95% CI 1.045-1.052). Participants earning $50,000 or more income were 68% less likely to report poor general health status compared with those earning less than $50,000 (aOR: 0.32, 95% CI 0.31- 0.33). Furthermore, participants with above high school education were 42% less likely to indicate poor general health status than those with high school or less education (aOR: 0.58, 95% CI 0.57-0.59).

Conclusion: The study findings provide subjective evidence about poor health status among U.S. adults diagnosed with CVD. Future studies are warranted to substantiate this evidence using objective measures and adjusting for other unmeasured cofounders.

Public Health Implications: While the nation continues to shift its strategies in addressing the COVID-19 pandemic and other emerging infectious diseases, there is a need for continued effort to address the prevention of CVD and other non-communicable diseases and reduce its impact among adults in the United States.

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Cardiovascular disease and its role on general health of the adult population in the United States.

Background: Despite the ongoing pandemic attributed to an infectious disease (SAR-CoV-2), non-infectious diseases-primarily cardiovascular diseases (CVD) remain the leading cause of death globally accounting for 655,000 annual deaths in the United States (U.S.). Additionally, CVD significantly impacts the quality of life attributing to total healthcare expenditure of $214 billion per year, of which $138 billion are attributed to the loss of productivity due to poor quality of life. The study's purpose is to assess the impact of CVD on the general health of adults in the U.S.

Question: What is the effect of CVD including angina, coronary heart disease, heart attack, and stroke on the general health of adults residing in the U.S.?

Methods: Study data included 418,268 adults who participated in the Behavioral Risk Factor Surveillance System (BRFSS) during 2019. The study outcome was general health status of U.S. adults categorized into excellent, very good, good, fair, and poor groups. Predictor variables included responses to the diagnosis of angina/coronary heart disease (CHD), heart attack (HD), and stroke during the respective years Other covariates included participants' demographics (age, education, and annual household income). Logistic regression models were conducted to estimate the association of CVD and other covariates with general health of U.S. adults adjusting for other confounders.

Results: After applying the study criteria, the final study sample included 355,391 participants. Poor general health status was reported among 83,882 study participants (19.6%).

The odds of reporting a poor general health status were 2.7 times (adjusted OR (aOR) 2.70, 95% CI 2.56-2.78), 2 times (aOR: 2.04, 95% CI 1.96-2.08), and 2.6 times (aOR 2.56, 95% CI 2.50-2.70) more likely among participants who had CHD, HD, and stroke respectively compared to participants who did not have such conditions.

The odds of reporting a poor general health status was 4% less likely among males compared to females (aOR 0.96, 95% CI 0.94-0.98). For every 5-year increase in age, the odds reporting poor general health status increased by 5% (aOR: 1.05, 95% CI 1.045-1.052). Participants earning $50,000 or more income were 68% less likely to report poor general health status compared with those earning less than $50,000 (aOR: 0.32, 95% CI 0.31- 0.33). Furthermore, participants with above high school education were 42% less likely to indicate poor general health status than those with high school or less education (aOR: 0.58, 95% CI 0.57-0.59).

Conclusion: The study findings provide subjective evidence about poor health status among U.S. adults diagnosed with CVD. Future studies are warranted to substantiate this evidence using objective measures and adjusting for other unmeasured cofounders.

Public Health Implications: While the nation continues to shift its strategies in addressing the COVID-19 pandemic and other emerging infectious diseases, there is a need for continued effort to address the prevention of CVD and other non-communicable diseases and reduce its impact among adults in the United States.

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