title: Trends in self-reported multiple cardiovascular disease risk factors among adults in the United States, 1991-1999.
abstract: BACKGROUND
  There are few national- and state-level data on multiple cardiovascular disease (CVD) risk factor status and trends over time. We examined the prevalence of self-reported multiple CVD risk factors from 1991 through 1999.
  
  
  METHODS
  The Behavioral Risk Factor Surveillance System is a state-based telephone survey of adults 18 years or older. Surveys in 1991, 1993, 1995, 1997, and 1999 ascertained reported high blood pressure, high blood cholesterol level, diabetes, obesity, and current smoking status. Trends in the prevalence of persons with each risk factor and of having 2 or more risk factors were calculated. Data were age standardized to the 2000 US population.
  
  
  RESULTS
  From 1991 to 1999, the prevalence of reported high blood pressure increased from 23.8% to 25.4%, high cholesterol levels increased from 24.9% to 27.7%, diabetes increased from 5.5% to 7.1%, obesity increased from 13.5% to 20.3%, and smoking remained at approximately 21%. The prevalence of adults with 2 or more risk factors increased from 23.6% in 1991 to 27.9% in 1999 and significantly increased for both men and women and for all race or ethnic, age, and education groups. Among states, the prevalence of multiple risk factors ranged from 15.0% to 29.9% in 1991 and from 18.7% to 37.1% in 1999. From 1991 to 1999, the prevalence of multiple risk factors increased by 10% or more in 36 states.
  
  
  CONCLUSIONS
  The substantial proportion of persons with known multiple risk factors (25% of the population) suggests that increased CVD prevention and risk factor reduction efforts should focus on comprehensive risk reduction strategies.
authors.affiliation: Cardiovascular Health Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. keg9@cdc.gov
authors.forename: Kurt J
authors.initials: KJ
authors.lastname: Greenlund
authors.forename: Zhi Jie
authors.initials: ZJ
authors.lastname: Zheng
authors.forename: Nora L
authors.initials: NL
authors.lastname: Keenan
authors.forename: Wayne H
authors.initials: WH
authors.lastname: Giles
authors.forename: Michele L
authors.initials: ML
authors.lastname: Casper
authors.forename: George A
authors.initials: GA
authors.lastname: Mensah
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012647:Self-Assessment; D012737:Sex Factors; D014481:United States / Q000453:epidemiology