•The age-adjusted prevalence of total diabetes was lower in China than in the U.S.•At the same BMI, there was little difference in total diabetes between both countries.•At the same BMI, diagnosed ...diabetes was lower in China than in the U.S.•Differences in BMI explain most differences in total diabetes between countries.
The risk of diabetes begins at a lower BMI among Asian adults. This study compares the prevalence of diabetes between the U.S. and China by BMI.
Data from the 2015–2017 China Nutrition and Health Surveillance (n=176,223) and the 2015–2018 U.S. National Health and Nutrition Examination Survey (n=4,464) were used. Diagnosed diabetes was self-reported. Undiagnosed diabetes was no report of diagnosed diabetes and fasting plasma glucose ≥126 mg/dL or HbA1c ≥6.5%. Predicted age-adjusted prevalence estimates by BMI were produced using sex- and country-specific logistic regression models.
In China, the age-adjusted prevalence of total diabetes was 7.8% (95% CI=7.4%, 8.3%), lower than the 14.6% (95% CI=13.1%, 16.3%) in the U.S. The prevalence of diagnosed diabetes was also lower in China than in the U.S. There were no statistically significant differences in the prevalence of undiagnosed diabetes between China and the U.S. The distribution of BMI in China was lower than in the U.S., and the predicted prevalence of total diabetes was similar between China and the U.S. when comparing adults with the same BMI. The predicted prevalence of undiagnosed diabetes was higher in China than in the U.S. for both men and women, and this disparity increased with BMI. When comparing adults at the same BMI, there was little difference in the prevalence of total diabetes, but diagnosed diabetes was lower in China than in the U.S., and undiagnosed was higher.
Although differences in BMI appear to explain nearly all of the differences in total diabetes prevalence in the 2 countries, not all factors that are associated with diabetes risk have been investigated.
▪
Objectives This study assesses (1) the prevalence of ever having a blood test for cholesterol, (2) current practices of following advice from a health care professional to manage high cholesterol, ...and (3) the association between total serum cholesterol level and following the advice. Methods A total of 17,260 adults aged 20 and older participated in the interview and medical examination in National Health and Nutrition Examination Survey (1999–2006). Cholesterol management was examined among adults previously diagnosed with high cholesterol who were advised to change their lifestyles through low-fat diets, weight loss, or exercise and/or to take medications. Five analytic groups were defined: (1) Those taking medications only, (2) those making one or more lifestyle changes, (3) those making one or two lifestyle changes and taking medications, (4) those making three lifestyle changes and taking medications, and (5) those not following any advice. Results Between 69% and 80% of adults advised to lower cholesterol reported following advice to control their cholesterol. Adults on medication only and adults with lifestyle changes and medication were more likely to have cholesterol level below 240 mg/dL compared with adults with lifestyle changes only (medication only: odds ratio OR, 2.7; 95% confidence interval CI, 1.3–5.8); one or two lifestyle changes and medication: OR, 4.1; 95% CI, 3.1–5.4; three lifestyle changes and medication: OR, 4.3; 95% CI, 3.0–6.2; referent: one or two or three lifestyle changes). Conclusion The combination of medication and lifestyle changes was more strongly associated with decreasing cholesterol compared with making one or more lifestyle changes without medication use.
OBJECTIVES: To describe hypertension trends in U.S. adults aged 60 and older using National Health and Nutrition Examination Survey (NHANES) data.
SETTING: NHANES III (1988–1994) and NHANES 1999 to ...2004.
DESIGN: Cross‐sectional nationally representative health examination survey.
PARTICIPANTS: Participants in NHANES III (n=5,093) and NHANES 1999 to 2004 (n=4,710).
MEASUREMENTS: Blood pressure (BP).
RESULTS: In 1999 to 2004, 67% of U.S. adults aged 60 and older years were hypertensive, an increase of 10% from NHANES III. Between 1988 to 1994 and 1999 to 2004, hypertension control increased for men from 39% to 51% (P<.05) but remained unchanged for women (35% to 37%; P>.05). Non‐Hispanic black men and women had higher prevalences of hypertension than non‐Hispanic whites (odds ratio (OR)=2.54, 95% confidence interval (CI)=1.90–3.40 and OR=2.07, 95% CI=1.31–3.26, respectively), but men were less likely to have controlled BP (OR=0.60, 95% CI=0.41–0.86). Mexican‐American men and women were less likely than non‐Hispanic whites to have controlled BP (OR=0.55, 95% CI=0.33–0.91 and OR=0.63, 95% CI=0.40–0.98, respectively). Women and men aged 70 and older were significantly less likely to control their hypertension than those aged 60 to 69. In addition, women aged 70 and older were significantly less aware and treated. Having BP measured within 6 months was significantly associated with greater awareness, greater treatment in men and women, and greater control in women. A history of diabetes mellitus or chronic kidney disease (CKD) was significantly associated with less hypertension control.
CONCLUSION: There was a significant increase in hypertension prevalence from 1988 to 2004. Hypertension control continues to be problematic for women, persons aged 70 and older, non‐Hispanic blacks and Mexican Americans, and individuals with diabetes mellitus and CKD.
Introduction This study evaluated recent trends in the prevalence of coronary heart disease in the U.S. population aged ≥40 years. Methods A total of 21,472 adults aged ≥40 years from the 2001–2012 ...National Health and Nutrition Examination Survey were included in the analysis. The analysis was conducted in 2015. Coronary heart disease included myocardial infarction, angina, and any other type of coronary heart disease, which were defined as a history of medical diagnosis of these specific conditions. Angina was also defined as currently taking anti-angina medication or having Rose Angina Questionnaire responses that scored with a Grade ≥1. Trends from 2001 to 2012 were analyzed overall, within demographic subgroups, and by major coronary heart disease risk factors. Results Between 2001 and 2012, the overall prevalence of coronary heart disease significantly decreased from 10.3% to 8.0% ( p -trend<0.05). The prevalence of angina significantly decreased from 7.8% to 5.5% and myocardial infarction prevalence decreased from 5.5% to 4.7% ( p -trend <0.05 for both groups). Overall coronary heart disease prevalence significantly decreased among women, adults aged >60 years, non-Hispanic whites, non-Hispanic blacks, adults who did not complete high school, adults with more than a high school education, and adults who had health insurance ( p -trend <0.05 for all groups). Conclusions The overall prevalence of coronary heart disease including angina and myocardial infarction decreased significantly over the 12-year survey period. However, this reduction was seen mainly among persons without established coronary heart disease risk factors. There was no change in coronary heart disease prevalence among those with specific coronary heart disease risk factors.
PDF
