Nutrition-related cardiovascular risk factors in older people: Results from the Third National Health and Nutrition Examination Survey

SETTING: In view of the recognized potential benefits of nutritional therap y in older persons, Congress is evaluating the coverage of nutritional serv ices for Medicare beneficiaries. OBJECTIVE: To estimate the number of older persons in the US who have one o r more cardiovascular risk factors (hypertension, increased low density lip oprotein (LDL) cholesterol, and diabetes mellitus), for which nutritional t herapy is recommended. DESIGN: Cross-sectional analysis of adults, aged greater than or equal to 6 5, participating in the Third National Health and Nutrition Examination Sur vey (NHANES III). MAIN OUTCOMES: The authors estimated the proportion of adults, aged greater than or equal to 65, with diabetes mellitus, increased LDL cholesterol and /or hypertension. Efforts were made to assess whether obesity status, gende r, race, and/or socioeconomic factors were associated with the prevalence o f any or all three conditions. RESULTS: Approximately 86% (20 million persons) in the WS, aged greater tha n or equal to 65, have at least one of the index conditions. Wheseas a high er body mass index (BMI) increased the likelihood of having any or all thre e conditions, 81% of persons of average body weight (BMI <25 kg/m(2)) had a t least one condition. After adjusting for age, gender, BMT, marital status , and poverty index, blacks were more likely than whites to have any one co ndition (odds ratio (OR) = 3.0, P < .01) or all three conditions (OR = 2.3, P = .05). CONCLUSIONS: Almost 90% of Americans aged greater than or equal to 65 have one or more nutrition-related cardiovascular risk factors. Improved nutriti onal interventions may be valuable especially for blacks, who have a higher prevalence of conditions requiring nutritional therapy.