Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999‐2010

OBJECTIVE: To assess whether trends in cardiovascular disease (CVD) risk factors by among overweight and obese US adults have improved. METHODS: The study included 10,568 adults 18 years and older who participated in National Health and Nutrition Examination Survey 1999-2010. CVD risk factors included diabetes (self-reported diagnosis, glycated hemoglobin ≥6.5%, or fasting plasma glucose ≥126mg/dl), hypertension (treatment or blood pressure ≥140/90 mmHg), dyslipidemia (treatment or non-HDL cholesterol ≥160 mg/dl), and smoking (self-report or cotinine levels ≥10 ng/ml). The prevalence and temporal trends of CVD risk factors for each BMI group were estimated. RESULTS: In 2007-2010, the prevalence of diabetes, hypertension, and dyslipidemia was highest among obese (18.5%, 35.7%, 49.7%, respectively) followed by overweight (8.2%, 26.4%, 44.2%, respectively) and normal weight adults (5.4%, 19.8%, 28.6%, respectively). Smoking exposure was highest among normal weight (29.8%) followed by overweight (24.8%) and obese adults (24.6%). From 1999-2002 to 2007-2010, untreated hypertension decreased among obese and overweight adults and untreated dyslipidemia decreased for all weight groups. There were no significant temporal changes in smoking across BMI groups. CONCLUSIONS: Despite decreases in untreated risk factors, it is important to improve the CVD risk profile of overweight and obese US adults.