Prevalence of Cardiovascular Health Behaviors Among Adults: NHANES, 2011–2018

OBJECTIVES: To estimate the prevalence of four cardiovascular health (CVH) behaviors in a national sample of US adults and compare across age groups. METHODS: This analysis included 8,370 non-pregnant and non-lactating adults (≥20 y) who participated in the National Health and Nutrition Examination Survey (NHANES) 2011 to 2018. Participants included in the analysis were free of cardiovascular disease events and provided complete data for all outcomes. CVH behaviors were defined as poor, intermediate, and ideal in accordance with the criteria from the American Heart Association's (AMA's) Life's simple 7. We calculated the age-adjusted prevalence of CVH behaviors for three age groups: young (20–39 years), middle (40–59 years), and older (≥60 years). The 2010 US Census population estimates were used for age adjustment. We conducted a pairwise comparison of age-adjusted CVH behaviors. All analyses conducted accounted for the complex, multi-stage survey sampling design of the NHANES. RESULTS: Overall, the majority of adults were less likely to meet ideal body mass index (BMI) (28.5%) and ideal diet score (10.4%) of the four CVH health behaviors. Rather, the majority of adults were more likely to meet ideal physical activity (59.1%) and ideal smoking status (56.9%). Younger adults had higher rates of ideal BMI (36.1%), physical activity (PA) (69.2%), and smoking status (62.0%) but lower rates of ideal diet score (7.8%) compared to middle-aged and older adults. Middle-aged adults were more likely to have obesity(43.5%), have a poor diet (67.9%), and smoke (20.5%). Young adults (36.1%) were more likely to have ideal BMI compared to middle-aged (23.7%; p < 0.001) and older (24.5%; p < 0.001) adults. Older adults tended to have better ideal diet score (14.7%) compared to young (7.8%; p < 0.001) and middle-aged (10.2%; P = 0.002) adults. Older adults were also more likely to be less physically active (35.1%) compared to young (17.9%, p < 0.001) and middle-aged (25.9%, p < 0.001) adults. CONCLUSIONS: Older adults need continuous health promotion targeting to achieve ideal cardiovascular health and younger adults need dietary improvements. This approach aligns with the AMA's 2030 Impact Goal of helping people live healthier, longer lives. FUNDING SOURCES: None to declare.