Comparison of examination-based and self-reported risk factors for cardiovascular disease, Washington State, 2006-2007.
BACKGROUND
Obesity, hypertension, and high cholesterol are risk factors for cardiovascular disease, which accounts for approximately 20% of deaths in Washington State. For most states, self-reports from the Behavioral Risk Factor Surveillance System (BRFSS) provide the primary source of information on these risk factors. The objective of this study was to compare prevalence estimates of self-reported obesity, hypertension, and high cholesterol with examination-based measures of obesity, hypertension, and high-risk lipid profiles.


METHODS
During 2006-2007, the Washington Adult Health Survey (WAHS) included self-reported and examination-based measures of a random sample of 672 Washington State residents aged 25 years or older. We compared WAHS examination-based measures with self-reported measures from WAHS and the 2007 Washington BRFSS (WA-BRFSS).


RESULTS
The estimated prevalence of obesity from WA-BRFSS (27.1%; 95% confidence interval [CI], 26.3%-27.8%) was lower than estimates derived from WAHS physical measurements (39.2%; 95% CI, 33.6%-45.1%) (P < .001). Prevalence estimates of hypertension based on self-reports from WA-BRFSS (28.1%; 95% CI, 27.4%-28.8%) and WAHS (33.4%; 95% CI, 29.4%-37.7%) were similar to the examination-based estimate (29.4%; 95% CI, 25.8%-33.4%). Prevalence estimates of high cholesterol based on self-reports from WA-BRFSS (38.3%; 95% CI, 37.5%-39.2%) and WAHS (41.8%; 95% CI, 35.8%-48.1%) were similar; both were lower than the examination-based WAHS estimate of high-risk lipid profiles (59.2%; 95% CI, 54.2%-64.2%) (P < .001).


CONCLUSIONS
Self-reported heights and weights underestimate the prevalence of obesity. The prevalence of self-reported high cholesterol is significantly lower than the prevalence of high-risk lipid profiles. Periodic examination-based measurement provides perspective on routinely collected self-reports.
Office of Epidemiology, Washington State Department of Health, PO Box 47812, Olympia, WA 98504-7812, USA. Juliet.VanEenwyk@doh.wa.gov
Juliet
J
Van Eenwyk
Lillian
L
Bensley
Eric M
EM
Ossiander
Karen
K
Krueger
D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D016000:Cluster Analysis; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008055:Lipids / Q000032:analysis / Q000097:blood; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D010808:Physical Examination; D012111:Residence Characteristics / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D012923:Social Class; D014861:Washington / Q000453:epidemiology
D008055:Lipids