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HSR&D 2004 National Meeting Abstracts

1015. Heart Healthy Behaviors in the US Population
Rosalie R Miller, MD, MPH, VA Puget Sound Healthcare System, AE Sales, VA Puget Sound Healthcare System, B Kopjar, VA Puget Sound Healthcare System, S Finn, VA Puget Sound Healthcare System, C Bryson, VA Puget Sound Healthcare System

Objectives: National recommendations for physical activity, diet and nonsmoking can reduce both incident and prevalent coronary heart disease (CHD), yet adherence to recommendations is below goals. Aggregate prevalence data for heart healthy behaviors are lacking. The impact for veterans has not previously been assessed.

Methods: We analyzed survey data from the 2000 Behavioral Risk Factor Surveillance System to: 1) determine the distribution of self-reported practice of physical activity, diet and nonsmoking among patients with and without CHD; and 2) determine predictors of adherence. We excluded individuals who reported poor physical health or activity limitation.

Results: Five percent of individuals were fully adherent in all three behaviors among both the CHD-positive (N=25,486) and CHD-negative (N=2,395) groups. Among the CHD-negative group, female (OR, 1.42), non-white race (OR, 1.64) and higher education (OR, 1.76) predicted adherence. The odds of adherence were 40% less for veterans than nonveterans. In those with CHD, among the general and veteran populations, the odds of adherence were close to 10-fold greater for those reporting good mental health. The odds of being adherent were 60% less for VA-users with CHD, but this was not statistically significant.

Conclusions: These data demonstrate the lack of a heart healthy lifestyle among a nationally representative group of U.S. adults. Adherence to combined behaviors is below adherence to any of the reported individual behaviors. Among veterans with CHD, good mental health predicted adherence.

Impact: Efforts to increase adherence to heart healthy behaviors must be accelerated to reduce the burden of CHD in the U.S.