title: Changes in Cardiovascular Health in the United States, 2003-2011.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of death in the United States, making improving cardiovascular health a key population health goal. As part of efforts to achieve this, the American Heart Association has developed the first comprehensive cardiovascular health index (CVHI). Our objective was to investigate the changes in CVHI in US states from 2003 to 2011.
  
  
  RESULTS
  CVHI was examined using Behavioral Risk Factor Surveillance System data between 2003 and 2011 (odd-numbered years). Total CVHI decreased from 3.73±0.01 in 2003 to 3.65±0.01 in 2009. The majority of states (88%) experienced a decline in CVHI and an increase in the prevalence of "poor" CVHI between 2003 and 2009. Among CVHI components, the highest prevalence of "ideal" was observed for blood glucose followed by smoking, whereas the lowest prevalence of "ideal" was observed for physical activity and diet. Between 2003 and 2009, prevalence of "ideal" smoking and diet status increased, while "ideal" prevalence of blood pressure, cholesterol, blood glucose, body mass index, and physical activity status decreased. We observed statistically significant differences between 2009 and 2011, outside the scope of the 2003-2009 trend, which we hypothesize are partially attributable to differences in sample demographic characteristics related to changes in Behavioral Risk Factor Surveillance System methodology.
  
  
  CONCLUSIONS
  Overall, CVHI decreased, most likely due to decreases in "ideal" blood pressure, body mass index, and cholesterol status, which may stem from low prevalence of "ideal" physical activity and diet status. These findings can be used to inform state-specific strategies and targets to improve cardiovascular health.
authors.affiliation: School of Medicine, West Virginia University, Morgantown, WV (C.S.P., S.S.S.) School of Public Health, West Virginia University, Morgantown, WV (C.S.P., S.S.S., T.K.B., S.J.F.) Center for Cardiovascular and Respiratory Sciences, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, WV (C.S.P., S.S.S., T.K.B.).
authors.forename: Courtney S
authors.initials: CS
authors.lastname: Pilkerton
authors.affiliation: School of Medicine, West Virginia University, Morgantown, WV (C.S.P., S.S.S.) School of Public Health, West Virginia University, Morgantown, WV (C.S.P., S.S.S., T.K.B., S.J.F.) Center for Cardiovascular and Respiratory Sciences, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, WV (C.S.P., S.S.S., T.K.B.).
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Singh
authors.affiliation: School of Public Health, West Virginia University, Morgantown, WV (C.S.P., S.S.S., T.K.B., S.J.F.) Center for Cardiovascular and Respiratory Sciences, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, WV (C.S.P., S.S.S., T.K.B.) Health Research Center, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, WV (T.K.B.).
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Bias
authors.affiliation: School of Public Health, West Virginia University, Morgantown, WV (C.S.P., S.S.S., T.K.B., S.J.F.) Center for Basic and Translational Stroke Research, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, WV (S.J.F.).
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Frisbee
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D002784:Cholesterol
keywords: 2020 Strategic Impact Goals; cardiovascular health; epidemiology; states; trends