Trends in Cardiovascular Risk Factors, Disease Management, and Predicted Cardiovascular Risk Among US Adults, 1999-2023

Obesity rose among US nonpregnant adults aged 20+ from 47.4% to 57.2% across NHANES 1999-2000 to 2021-2023, with class III obesity more than doubling from 4.7% to 9.7%.

• Why it matters: Despite gains in some cardiovascular risk factors, the post-pandemic period has been incompletely described, especially how changing prevalence and management translate into predicted cardiovascular risk.
• What they did: Using 11 NHANES periods (1999-2000 through 2021-2023; n=60,199), survey-weighted regression tested age-standardized trends and subgroup differences, while PREVENT equations estimated 10- and 30-year risks in adults without self-reported CVD.
• The result: Predicted 10-year total CVD risk declined from 5.66% to 5.28%, while ASCVD risk declined by 0.16 percentage points per decade and heart failure risk increased by 0.10, with 2021-2023 estimates nearly identical (3.20% vs 3.19%).

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