Status of Cardiovascular Health Among Adult Americans in the 50 States and the District of Columbia, 2009

BACKGROUND: With ideal cardiovascular health metrics, the American Heart Association established a goal of improving cardiovascular health for all Americans by 20% by 2020. Determining how the metrics vary by state is important to the individual states as well as to researchers and policy makers nationwide. METHODS AND RESULTS: Using 2009 data from Behavioral Risk Factor Surveillance System, a state-based telephone survey with 356 441 eligible participants, we examined the 7 metrics defined by the American Heart Association: hypertension, high cholesterol, smoking, body mass index, diabetes, physical activity, and consumption of fruits and vegetables. The 3 primary outcomes of this study were (1) the percentage of the population achieving ideal health status on all 7 factors, (2) the percentage of the population with only 0 to 2 of the 7 metrics (poor cardiovascular health); and (3) the mean overall score (number of ideal metrics). Overall, 3.3% of population was in ideal cardiovascular health, and 9.9% was in poor cardiovascular health. The mean overall score was 4.42. The percentage with ideal cardiovascular health varied from 1.2% (Oklahoma) to 6.9% (District of Columbia ). The adjusted prevalence ratio of ideal cardiovascular health ranged from 0.38, 95% confidence interval 0.29 to 0.52 (Oklahoma), to 1.91, 95% confidence interval 1.51 to 2.42 (District of Columbia), with Illinois as the referent. CONCLUSIONS: In the United States, the cardiovascular health status of the population varies substantially by state. The estimates here could help state programs charged with preventing heart disease and stroke to set their goals for reducing risk and improving cardiovascular health in their jurisdictions.