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Cardiovascular Disease Risk Factors Among Male Veterans, U.S., 2009-2012.

ABSTRACT: INTRODUCTION:Cardiovascular disease remains an important cause of death in the U.S. where veterans of the U.S. Armed Forces represent a significant segment of the population. Limited national estimates of cardiovascular disease risk factors using physical measurements and reported veteran status in the U.S. civilian population have been reported. The purpose of this study was to compare the prevalence of cardiovascular disease risk factors among veteran and non-veteran men in the U.S. civilian population. METHODS:Using data from the 2009-2012 National Health and Nutrition Examination Surveys, 1,107 veteran and 3,972 non-veteran men were identified for this study (analyzed in 2014-2015). Differences in hypertension, dsylipidemia, diabetes, obesity, and smoking between veterans and non-veterans were compared using chi-square and t-tests. Predicted prevalence from multivariable logistic regression models adjusted for age, race/Hispanic origin, and poverty level were used to assess whether previous military service was associated with having a cardiovascular disease risk factor. RESULTS:Veteran men were older than non-veteran men (59.9 years vs 43.4 years) and were more likely to be non-Hispanic white (79.9% vs 65.7%). Adjusted predicted prevalence estimates show that veterans were more likely than non-veterans to be obese (42.6% vs 33.7%, p<0.01). After adjustment for obesity, there was no difference in hypertension, dyslipidemia, diagnosed diabetes, or smoking between veteran and non-veteran men. CONCLUSIONS:This study identified a segment of the U.S. civilian population-veteran men-who have a higher prevalence for obesity, a risk factor associated with increased risk for other cardiovascular disease risk factors.

SUBMITTER: Fryar CD

PROVIDER: S-EPMC7339966 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Cardiovascular Disease Risk Factors Among Male Veterans, U.S., 2009-2012.

Fryar Cheryl D CD Herrick Kirsten K Afful Joseph J Ogden Cynthia L CL

American journal of preventive medicine 20150729 1

<h4>Introduction</h4>Cardiovascular disease remains an important cause of death in the U.S. where veterans of the U.S. Armed Forces represent a significant segment of the population. Limited national estimates of cardiovascular disease risk factors using physical measurements and reported veteran status in the U.S. civilian population have been reported. The purpose of this study was to compare the prevalence of cardiovascular disease risk factors among veteran and non-veteran men in the U.S. ci ...[more]

PMID: 26232905

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Project description:ImportanceCardiovascular disease is a leading cause of mortality in patients with prostate cancer, and androgen deprivation therapy (ADT) may worsen cardiovascular risk. Adherence to guideline-recommended assessment and management of cardiovascular risk factors (CVRFs) in patients initiating ADT is unknown.ObjectiveTo describe CVRF assessment and management in men with prostate cancer initiating ADT and overall.Design, setting, and participantsA cross-sectional analysis of 90 494 men treated within the US Veterans Health Administration diagnosed with prostate cancer between January 1, 2010, and December 31, 2017, was conducted. Participants included men with a history of atherosclerotic cardiovascular disease (ASCVD), and treatment with ADT within 1 year of diagnosis. Data analysis was conducted from September 10, 2019, to July 1, 2020.Main outcomes and measuresRates of comprehensive CVRF assessment, uncontrolled CVRFs, and untreated CVRFs. Comprehensive CVRF assessment was defined as recorded measures for blood pressure, cholesterol, and glucose levels; CVRF control as blood pressure lower than 140/90 mm Hg, low-density lipoprotein cholesterol 130 mg/dL, and hemoglobin A1c less than 7%; and CVRF treatment as receipt of cardiac risk-reducing medications. Multivariable risk difference regression assessed the association between ASCVD and initiation of ADT and these outcomes.ResultsOf 90 494 veterans, median age was 66 years (interquartile range, 62-70 years); and 22 700 men (25.1%) received ADT. Overall, 68.1% (95% CI, 67.8%-68.3%) of the men received comprehensive CVRF assessment; 54.1% (95% CI. 53.7%-54.4%) of those assessed had uncontrolled CVRFs, and 29.6% (95% CI, 29.2%-30.0%) of those with uncontrolled CVRFs were not receiving corresponding cardiac risk-reducing medication. Compared with the reference group of patients without ASCVD not receiving ADT, patients with ASCVD not receiving ADT had a 10.4% (95% CI, 9.5%-11.3%) higher probability of comprehensive CVRF assessment, 4.0% (95% CI, 2.9%-5.1%) lower risk of uncontrolled CVRFs, and 22.2% (95% CI, 21.1%-23.3%) lower risk of untreated CVRFs. Similar differences were observed in patients with ASCVD receiving ADT. In contrast, patients without ASCVD receiving ADT had only a 3.0% (95% CI, 2.1%-3.9%) higher probability of comprehensive CVRF assessment, 2.6% (95% CI, 1.6%-3.5%) higher risk of uncontrolled CVRFs, and 5.4% (95% CI, 4.2%-6.6%) lower risk of untreated CVRFs.Conclusions and relevanceThese findings suggest that veterans with prostate cancer had a high rate of underassessed and undertreated CVRFs, and ADT initiation was not associated with substantial improvements in CVRF assessment or management. These findings highlight gaps in care and the need for interventions to improve CVRF mitigation in this population.

Dataset Information

Cardiovascular Disease Risk Factors Among Male Veterans, U.S., 2009-2012.

Publications

Cardiovascular Disease Risk Factors Among Male Veterans, U.S., 2009-2012.

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