Cardiovascular Disease Risk Varies By Demographics and Geography Interview with:
Dr. Quanhe Yang PhD
CDC’s Division for Heart Disease and Stroke Prevention

What is the background for this study? What are the main findings?

Dr. Yang: Our study reveals that an individual’s predicted risk of developing cardiovascular disease (CVD), coronary heart disease (CHD) and stroke over the next decade varies significantly from state-to-state, as well as by demographic factors including age, gender, race-ethnicity and household income.

Among the key findings: the 10-year risk is higher in the Southeast and lower in northwestern states – and higher among men than women. For men, the 10-year risk of developing CVD was 14.6 percent for the nation as a whole, ranging from a low of 13.2 percent in Utah to a high of 16.2 percent in Louisiana. CHD risk among men ranged from 9.5 percent in Utah to 11.7 percent in Louisiana, while stroke risk was 2.1 percent in Utah and 2.6 percent in Louisiana. Among women, CVD risk was 7.5 percent, ranging from 6.3 percent in Minnesota to as high as 8.7 percent in Mississippi. CHD risk for women ranged from 3.8 percent in Minnesota to 5.3 percent in Mississippi, while stroke risk was as low as 1.5 percent in Minnesota and as high as 2.1 percent in Mississippi. Nationally, we found the risk increased significantly with age and was highest among non-Hispanic blacks, those with less than a high school education and those with household incomes below $35,000 .

As part of this study, CDC researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010, as well as the 2009 Behavioral Risk Factor Surveillance System, the world’s largest ongoing telephone health surveillance system. The state-based, random-digit-dialed phone survey included information from almost 300,000 U.S. residents between the ages of 30 and 74.

What should clinicians and patients take away from your report?

Dr. Yang: CVD including heart disease and stroke kill more than 800,000 Americans each year and cost an estimated 315 billion dollars a year in health care and lost productivity. This study is meaningful because it helps to identify geographic disparities in the prevalence of cardiovascular disease risk factors, such as hypertension, smoking, diabetes and overweight/obesity. Knowing how people’s risks break down – and which states pose higher risks – will help clinicians, patients and public health representatives focus efforts as needed.

For example, our research showed that high blood pressure and anti-hypertension medication use played a major role in state-based disparities, highlighting the importance of hypertension control in efforts to reduce cardiovascular disease. As a result, doctors and patients can work together on customized strategies aimed at lowering risk and improving cardiovascular health, such as those stressed by Million Hearts®, a national initiative aimed at preventing one million heart attacks and strokes by 2017.

What recommendations do you have for future research as a result of this study?

Dr. Yang: Our study is the first to analyze 10-year risk of developing CVD, CHD and stroke at the state-level. Further research is needed to monitor the changes in the key cardiovascular risk factors at the state level, such as the prevalence and control of hypertension, prevalence of smoking and diabetes, and total and low-density lipoprotein [LDL] cholesterol levels. Effective prevention strategies, such as increasing physical activity, having a healthy diet, weight and blood pressure control, are needed to reduce the risk of developing CVD, CHD and stroke and the disparities in the risk of developing these diseases at the state level.


Predicted 10-Year Risk of Developing Cardiovascular Disease at the State Level in the U.S.

American Journal of Preventive Medicine November 09, 2014









Last Updated on November 19, 2014 by Marie Benz MD FAAD