Cardiovascular Health Among Rural and Urban US Adults—Healthcare, Lifestyle, and Social Factors
Key result
Rural residence was associated with higher rates of hypertension (37.1% vs 30.9%; RR 1.20; 95% CI 1.13-1.27) and other cardiometabolic risks, which were completely attenuated by social risk factors.
Why the study?
Little was known about the current state of rural cardiovascular health and the underlying drivers of rural-urban disparities in the US.
Does rural residence increase the prevalence of cardiometabolic risk factors and cardiovascular diseases in US adults compared to urban residence?
Population
27 172 US adults aged 20 years or older
Comparison
Rural vs urban residence based on county-level rurality
Design
Nationally representative cross-sectional study
Authors
Discussion
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Member takes
Implication
Rural CV disparities merit policy focus; cross-sectional data leaves causal drivers and interventions open.
Study Design
Type
Cross-Sectional (n=27,172)
Multicenter
Yes
Structured PICO
Does rural residence increase the prevalence of cardiometabolic risk factors and cardiovascular diseases in US adults compared to urban residence?
P
Population
27,172 US adults aged 20 years or older from the 2022 National Health Interview Survey, analyzed to compare cardiovascular health between rural and urban areas.
E
Exposure
Rural residence (county-level rurality)
C
Comparator
Urban residence
O
Outcome
Age-standardized rates of cardiometabolic risk factors (hypertension, hyperlipidemia, obesity, and diabetes) and cardiovascular diseases (coronary heart disease [CHD] and stroke)
Main Result
Relative Risk: 1.2 (95% CI 1.13–1.27)
Absolute Event Rate: 37.1% vs 30.9%
Substantial rural-urban disparities in cardiovascular health exist in the US, particularly among young adults, and are primarily driven by social risk factors rather than healthcare access or lifestyle.
Cite This Study
Liu et al. (2025) conducted a cross-sectional in Cardiometabolic risk factors and cardiovascular diseases (n=27,172). County-level rurality vs. Urban residence was evaluated on Age-standardized rates of cardiometabolic risk factors (hypertension, hyperlipidemia, obesity, and diabetes) and cardiovascular diseases (coronary heart disease and stroke) (RR 1.20, 95% CI 1.13-1.27). Rural residence was associated with higher rates of hypertension (37.1% vs 30.9%; RR 1.20; 95% CI 1.13-1.27) and other cardiometabolic risks, which were completely attenuated by social risk factors.