Cardiovascular Risk Profile Among Reproductive-Aged Women in the U.S.: The Behavioral Risk Factor Surveillance System, 2015–2020
Ellen Boakye, MD, MPH,
Chigolum P. Oyeka, MD, MPH,
Yaa A. Kwapong, MD, MPH,
Faith E. Metlock, BSN,
Sadiya S. Khan, MD, MSc,
Mamas A. Mamas, MBBCh,
Amanda M. Perak, MD, MS,
Pamela S. Douglas, MD,
Michael C. Honigberg, MD, MPP,
Khurram Nasir, MD, MPH, MSc,
Michael J. Blaha, MD, MPH,
Garima Sharma, MD
Affiliations
Ellen Boakye, MD, MPH
Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins Medicine, Baltimore, Maryland
Chigolum P. Oyeka, MD, MPH
Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins Medicine, Baltimore, Maryland
Yaa A. Kwapong, MD, MPH
Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins Medicine, Baltimore, Maryland
Faith E. Metlock, BSN
Johns Hopkins School of Nursing, Baltimore, Maryland
Sadiya S. Khan, MD, MSc
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Mamas A. Mamas, MBBCh
Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Staffordshire, United Kingdom
Amanda M. Perak, MD, MS
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Pamela S. Douglas, MD
Division of Cardiology, Duke Clinical Research Institute, Duke University, Durham, North Carolina
Michael C. Honigberg, MD, MPP
Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts; Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Khurram Nasir, MD, MPH, MSc
Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas; Center for Outcomes Research, Houston Methodist, Houston, Texas
Michael J. Blaha, MD, MPH
Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins Medicine, Baltimore, Maryland
Garima Sharma, MD
Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins Medicine, Baltimore, Maryland; Inova Schar Heart and Vascular, Inova Fairfax Medical Campus, Falls Church, Virginia; Address correspondence to: Garima Sharma, MD, Inova Schar Heart and Vascular Institute, Inova Fairfax Medical Campus, 3300 Gallows Road, Falls Church VA.
Introduction: Suboptimal cardiovascular health is associated with adverse pregnancy outcomes and long-term cardiovascular risk. The authors examined trends in cardiovascular risk factors and correlates of suboptimal cardiovascular risk profiles among reproductive-aged U.S. women. Methods: With data from 335,959 women in the Behavioral Risk Factor Surveillance System (2015–2020), the authors conducted serial cross-sectional analysis among nonpregnant reproductive-aged women (18–44 years) without cardiovascular disease who self-reported information on 8 cardiovascular risk factors selected on the basis of Life's Essential 8 metrics. The authors estimated the prevalence of each risk factor and suboptimal cardiovascular risk profile (≥2 risk factors) and examined trends overall and by age and race/ethnicity. Using multivariable Poisson regression, the authors assessed the sociodemographic correlates of suboptimal cardiovascular risk profile. Results: The weighted prevalence of women aged <35 years was approximately 64% in each survey year. The prevalence of suboptimal cardiovascular risk profile increased modestly from 72.4% (71.6%–73.3%) in 2015 to 75.9% (75.0%–76.7%) in 2019 (p<0.001). This increase was mainly driven by increases in overweight/obesity (53.1%–58.4%; p<0.001). Between 2015 and 2019, significant increases in suboptimal cardiovascular risk profile were observed among non-Hispanic White (69.8%–72.6%; p<0.001) and Hispanic (75.1%–80.3%; p<0.001) women but not among non-Hispanic Black (82.7%–83.7%; p=0.48) or Asian (68.1%–73.2%; p=0.09) women. Older age, rural residence, and non-Hispanic Black and Hispanic race and ethnicity were associated with a higher prevalence of suboptimal cardiovascular risk profile. Conclusions: There has been a modest but significant increase in suboptimal cardiovascular risk profile among U.S. women of reproductive age. Urgent preventive efforts are needed to reverse this trend and improve cardiovascular health, particularly among subgroups at increased risk, to mitigate its implications.
