Cardiovascular disease risk reduction in the behavioral risk factor surveillance system

Background: Cardiovascular disease (CVD) risk-reduction practices are Suboptimal in populations at high risk for CVD, and this problem may be worse in women than in men. Methods: In 2003, CVD risk-reduction practices were compared between men and women after stratification by CVD risk status (high, intermediate, low) in a cross-sectional analysis of the 1999 Behavioral Risk Factor Surveillance System (BRFSS), a random-digit telephone survey of state population-based samples of the civilian non-institutionalized population of adults. This analysis included persons aged >40 years who answered questions regarding lipid and blood pressure screening, recommendations for lifestyle modification, that is, exercise and reduced fat intake, and aspirin use. Risk status was defined according to Adult Treatment Panel III definitions. Results: In the 97,387 adults included in this analysis, high CVD risk was associated with lipid and blood pressure screening, lifestyle modification, and aspirin use in both men and women compared to intermediate-risk and low-risk (p < 0.001). Among high-risk adults, men and women reported similar frequency of blood pressure and cholesterol measurement and physician advice on lifestyle modification; among intermediate-risk and low-risk adults, women reported slightly more frequent screening and lifestyle modification than men (p < 0.001). In all CVD risk categories, women reported significantly less aspirin use than in men (P < 0.001). Conclusions: Among people at high risk for CVD, women report lifestyle modification more often than men, while men report use of aspirin more often than women. These findings may assist with targeting interventions to reduce CVD risk to the unique needs of men and women. (C) 2004 American Journal of Preventive Medicine.