Disparity seen in decline in heart risk factors

NEW YORK (Reuters Health) - There has been an overall decline in the prevalence of cardiovascular disease (CVD) risk factors in the US population over the last three decades, according to federal health officials from the Centers for Disease Control and Prevention (CDC).

However, disparities in risk reduction still remain between individuals of high and low socioeconomic status and in some cases the gap worsened.

"The lack of progress in reducing disparities... underscores the need for public health efforts to find ways to reach people with lower and intermediate levels of annual income and education," Dr. Edward W. Gregg and colleagues offer in the latest issue of the Archives of Internal Medicine.

Gregg's team reviewed data from four consecutive National Health and Nutrition Examination Surveys (NHANES), encompassing the period between 1971 and 2002. They determined the prevalence of high serum cholesterol levels of 240 mg/dL or greater, high blood pressure (140/90 or higher), smoking, and diabetes.

The prevalence of high blood pressure declined by about half and the prevalence of high cholesterol declined by about one third in all of the groups. Cholesterol levels fell the most among the rich and highly educated, while blood pressure improved the most among the poor and less educated.

The gap between groups in the prevalence of smoking and diabetes widened over time, the authors report. The prevalence of smoking decreased by about 19.6 percent in the highest quartile of income versus 6.6 percent in the lowest income quartile.

Diabetes prevalence increased across the board, but the disparity between high and low income groups nearly tripled between the NHANES I and NHANES IV, from 2.3 percent to 6.2 percent.

"Despite the general success in reducing CVD risk factors in the US population, not all segments of society are benefiting equally and improvements may have slowed," Gregg and his associates conclude.

SOURCE: Archives of Internal Medicine, November 27, 2006.