title: Clustering of cardiovascular disease risk factors and health-related quality of life among US adults.
abstract: OBJECTIVE
  To assess the association of clusters of multiple cardiovascular disease (CVD) risk factors with health-related quality of life (HRQOL) among US adults aged 18 years or older in 2003.
  
  
  METHODS
  Data from the 2003 Behavioral Risk Factor Surveillance System were analyzed. The four HRQOL questions developed by the Centers for Disease Control and Prevention were used. The CVD risk factors included diabetes, hypertension, high cholesterol, obesity, and current smoking.
  
  
  RESULTS
  The adjusted odds ratios of having four or more CVD risk factors were 14.0 (95% confidence interval [CI] 12.4-16.0) for poor or fair health, 6.4 (95% CI 5.6-7.3) for 14 or more physically unhealthy days, 4.8 (95% CI 4.2-5.6) for 14 or more mentally unhealthy days, and 8.0 (95% CI6.8-9.3) for 14 or more impaired activity days compared to having none of the five risk factors. A greater number of CVD risk factors was significantly associated with an increasing likelihood of having poor or fair health (P(1) < 0.0001 for linear trend, P(2) < 0.0001 for quadratic trend), 14 or more physically unhealthy days (P(1) < 0.0001, P(2) < 0.0001), 14 or more mentally unhealthy days (P(1) < 0.0001, P(2) = 0.02), and 14 or more impaired activity days (P(1) < 0.0001, P(2) < 0.0001).
  
  
  CONCLUSIONS
  A greater number of multiple CVD risk factors may be associated with more detrimental impairment of HRQOL. Preventing or reducing the clustering of multiple CVD risk factors to improve HRQOL is needed among adults.
authors.affiliation: 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. cli@cdc.gov
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Earl S
authors.initials: ES
authors.lastname: Ford
authors.forename: Ali H
authors.initials: AH
authors.lastname: Mokdad
authors.forename: Lina S
authors.initials: LS
authors.lastname: Balluz
authors.forename: David W
authors.initials: DW
authors.lastname: Brown
authors.forename: Wayne H
authors.initials: WH
authors.lastname: Giles
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016009:Chi-Square Distribution; D003710:Demography; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011788:Quality of Life; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology