Population Attributable Risk of Cardiovascular Disease Associated with not Meeting Physical Activity Guidelines in Montana Adults

Abstract

Background : Coronary heart disease (CHD) is the number 1 cause of death in United States (U.S.) with stroke also a leading killer at number 5. Aside from decreased quality of life and increased years of potential life lost (YPLL), cardiovascular disease (CVD) has a major impact on health care costs. While many CVD events can be prevented by adopting a healthy lifestyle, data quantifying this are sparse. The aim of this study was to assess the proportion of CVD cases that can be attributed to not meeting physical activity (PA) guidelines in a specific adult population. Methods : The Montana Behavioral Risk Factor Surveillance System (BRFSS, 2019) was used for this study. A dichotomous PA variable was created indicating whether or not a participant met current PA guidelines. Seven other healthy lifestyle variables were created and included smoking, alcohol consumption, overweight status, vegetable consumption, fruit consumption, and, health coverage. Three different outcome variables were used and included CHD, stroke, and CVD (CHD or stroke). Logistic regression was used to examine the relationship between PA and each CVD outcome while controlling for healthy lifestyle factors and sociodemographic variables. Population attributable risk (PAR) percentages were computed substituting PA odds ratio (OR) values into Levin's formula. Results : Prevalence of reported CHD, stroke, and CVD were 6.7%, 3.1%, and 8.7%, respectively. Additionally, prevalence of each CVD outcome was significantly ( p s < .05) higher in adult groups not meeting PA guidelines, as compared to their more active counterparts. PA was significantly related to CHD (OR = 1.36, 95% CI: 1.04 – 1.79) and CVD (OR = 1.32, 95% CI: 1.02 – 1.71) in fully adjusted models and suggestively related to stroke (OR = 1.24, 95% CI: 0.81 – 1.91). PAR analyses indicated that approximately 12.1%, 8.4%, and 10.8% of CHD, stroke, and CVD cases (respectively) could be prevented in Montana with PA intervention. Conclusion : This study found that after controlling for several healthy lifestyle factors, not meeting PA guidelines independently contributes to a sizable number of CVD cases in Montana. Health promotion programming leaders should use such PAR statistics to drive the needs assessment process and plan for PA interventions.