General cardiovascular risk profiles for persons with varying disability: Nhanes cross-sectional years 2001-2010

Background: Persons with disabilities tend to be at risk for secondary conditions, including metabolic syndrome and allostatic load contributing to cardiovascular disease risk. D'Agostino et al. (2008) developed a predictive model for cardiovascular risk from Framingham Heart Study data, variables which are present in the five waves of NHANES for the Healthy People 2010 decade. Purpose: We evaluated the General Cardiovascular Risk Profile (GCRP) for persons reporting severe limitations in hearing, vision, memory, physical/mental/emotional, walking up ten steps, bending/kneeling, lifting/carrying, or using assistive devices versus persons without disabilities in NHANES. Significance: The GCRP uses routine clinical examination data, including age, total cholesterol, HDL cholesterol, systolic blood pressure, smoking and diabetic status, thereby representing a potential tool to evaluate cardiovascular risk for persons with and without disabilities. Methodology: Weighted cross-sectional independent samples t tests comparing persons with each disability type versus persons without disabilities were conducted on point and model GCRP heart vascular age and ten-year risk estimate in each of NHANES data collections for 2001-2002, 2003-2004, 2005-2006, 2007-2008, and 2009-2010. Disability Status crossed with the allostatic load variable “Fewer than Three Friends” were compared for the same dependent GCRP variables using ANOVA. Conclusions: Significantly (p < .025) higher GCRP was noted for persons with mobility and assistive device disabilities in years 2007-2008 and 2009-2010. The effects were significant for persons with these disabilities who reported fewer than three friends. There were discrepancies between the GCRP point and model values, thereby requiring careful interpretation of these results for applications in practice.