Trends in Cardiovascular Health Metrics in Obese Adults: National Health and Nutrition Examination Survey (NHANES), 1988–2014

Abstract

BackgroundNo study has quantified trends in the prevalence of cardiovascular disease risk factors and cardiovascular health metrics among obese people in the United States in recent years.Methods and ResultsWe examined the secular changes in cardiovascular health metrics and key cardiovascular disease risk factors among obese adults (aged ≥20 years) in the United States. We included 18 626 obese adults (body mass index ≥30) from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999–2014. Among those obese adults, there were decreases in mean systolic blood pressure, diastolic blood pressure, and total cholesterol levels and increases in mean high‐density lipoprotein cholesterol levels and mean hemoglobin A1c levels. Prevalence of blood pressure health and lipid health remained stable during the period 1988–2014, whereas prevalence of blood glucose health decreased significantly during this period. Prevalence of freedom from cardiovascular disease risk factors remained stable at ≈15% among the adult obese population during the period 1988–2014, whereas prevalence of presence of all 3 risk factors increased from 16.4% to 22.4% during this period, commensurate with a decline in those with 1 to 2 risk factors (from 69.6% to 62.4%).ConclusionsDuring the past 3 decades, blood pressure health and blood lipid health remained stable or improved, whereas blood glucose health deteriorated among adult obese population. This resulted in an overall decrease in cardiovascular health status among obese adults and greater risk of type 2 diabetes mellitus. The data argue for interventions targeted to those obese persons who are metabolically unhealthy to stem rising rates of diabetes mellitus.

Perceptions of Body Mass Index as a Valid Indicator of Weight Status among Adults in the United States

“…Van Minnen et al [19] reported that approximately half (53%) of Results from Bhanji et al [15] are similar to Van Minnen et al [19] with ap-ing weight status respectively. Despite lower agreement among those classified as obese or morbidly obese in the current study, these findings are generally consistent with those from several global settings [13] non, some argue that focus should be placed on physical activity, exercise, and cardiorespiratory fitness, instead of on weight status [47], while others contend the strong association between weight status and health outcomes maintains the value of such measures [49]. Another way fitness level may influence BMI is indirectly through increased muscle mass and decreased fatty tissue.…”

Anti-Obesity Therapy: from Rainbow Pills to Polyagonists

“…Of the numerous comorbidities linked to obesity, the most common are T2D; a variety of cardiovascular complications such as hypertension, coronary artery disease, and stroke; and certain types of cancer (Guo and Garvey, 2016). Notably, obesity and T2D represent top preventable causes of premature death and disability (Mathers and Loncar, 2006;Bauer et al, 2014), and the World Health Organization estimates that annually approximately 1.5 million deaths are directly attributable to diabetes (WHO, 2016).…”

Attributable burden and expenditure of cardiovascular diseases and associated risk factors in Mexico and other selected mega-countries

“…These four CVD risk factors are the most prevalent in Mexico and have been reported to be even greater than in some of the analyzed countries. In Mexico and India, adults with overweight are respectively 5.25 and 4.15 times more likely to have mixed dyslipidemia and hypertriglyceridemia [37,94], while up to 95.2% of American individuals with obesity have lipid abnormalities [95]. Considering that reductions starting at 1% of the Mexican population's average BMI would save up to $986 million USD in the next years [50], intensive strategies to improve dietary patterns, foster active lifestyles, and increase access to pharmacological treatments that normalize bodyweight and the lipid profile are vital to moderate costs generated by CVD.…”