Cardiovascular Diseases Clinical Trial
To describe secular trends in cardiovascular risk factors in the adolescent and adult United States population and to identify and quantify the changes in variables related to these risk factors. Also, to modify and implement the statistical methodology available for the analysis of complex sample survey data in order to model and test these secular trends across separate nationally representative databases. The differences in risk factors in these samples were contrasted with those from a special population group, Hispanic Americans.
BACKGROUND:
In 1985 when the study was initiated, there were surprisingly little data on the
distribution of risk factors among subgroups of the population and the changes occurring
over time. These issues assumed greater importance as the decline in coronary heart disease
mortality focused interest on the role of primary prevention through alteration of risk
factors. In review of the potential contributions to this decline, it was noted that
cessation of cigarette smoking, better blood pressure control and decrease in total serum
cholesterol may have accounted partially for the decline in coronary heart disease
mortality. However, these observations overlooked the possibility that observations in the
total population or confined to specific socioeconomic groups may fail to disclose
differential changes in particular population segments. For example, Americans in the higher
educational and income groups experienced rapid and marked changes in risk behaviors while
less educated, lower income Americans or specific racial/ethnic groups experienced no
beneficial changes. The majority of cohort studies followed rather select groups and most
cross-sectional surveys also had little sociodemographic variability. However, focusing
public health, educational and medical intervention efforts required that particular groups
at greater risk or experiencing less beneficial secular change be identified and targeted
for greater efforts.
DESIGN NARRATIVE:
Trends in blood pressure, serum lipids, and cigarette smoking were described in nationally
representative samples of adolescents ages 12 to 17 and in young adults ages 18 to 24 using
data from surveys conducted from 1960 to 1984 by the National Center for Health Statistics
(NCHS). Trends in blood pressure, serum lipids, cigarette smoking, and obesity were
described in nationally representative samples of older adults ages 35 to 75 using NCHS
survey data. The national surveys used included National Health Examination Surveys (NHES-I
and III), the National Health and Nutrition Examination Surveys (NHANES I and II) and
Hispanic NHANES. The secular trends in these risk factors were contrasted by subgroupings of
age, race, sex, family income, and education. The correlates of these risk factors were
determined and secular changes over time were identified and quantified. Risk factor values
and their correlates in the national population sample were contrasted with the three
Hispanic populations surveyed in the Hispanic Health and Nutrition Examination Survey
(HHANES). Statistical methodologies were refined including statistical software for the
analysis of complete sample survey data, model fitting strategies to characterize the
secular trends across four national surveys, and guidelines for the choice of analytical
strategies.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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