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 therapy in older persons, Congress is evaluating the coverage of nutritional services for Medicare beneficiaries. OBJECTIVE: To estimate the number of older persons in the US who have one or more cardiovascular risk factors (hypertension, increased low density lipoprotein (LDL) cholesterol, and diabetes mellitus), for which nutritional therapy is recommended. DESIGN: Cross-sectional analysis of adults, aged greater than or equal to 65, participating in the Third National Health and Nutrition Examination Survey (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, gender, race, and/or socioeconomic factors were associated with the prevalence of any or all three conditions. RESULTS: Approximately 86% (20 million persons) in the WS, aged greater than or equal to 65, have at least one of the index conditions. Wheseas a higher body mass index (BMI) increased the likelihood of having any or all three conditions, 81% of persons of average body weight (BMI <25 kg/m(2)) had at least one condition. After adjusting for age, gender, BMT, marital status, and poverty index, blacks were more likely than whites to have any one condition (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 nutritional interventions may be valuable especially for blacks, who have a higher prevalence of conditions requiring nutritional therapy.