Skip to main content
Top
Published in: Journal of General Internal Medicine 2/2013

Open Access 01-07-2013 | Original Research

Cardiovascular Disease Risk Factors Among Women Veterans at VA Medical Facilities

Authors: Varsha G. Vimalananda, MD, MPH, Donald R. Miller, ScD, Cindy L. Christiansen, PhD, Wenyu Wang, MS, Patricia Tremblay, MMS, B. Graeme Fincke, MD

Published in: Journal of General Internal Medicine | Special Issue 2/2013

Login to get access

ABSTRACT

BACKGROUND

Hypertension, hyperlipidemia, diabetes, and obesity in middle adulthood each elevate the long-term risk of cardiovascular disease (CVD). The prevalence of these conditions among women veterans is incompletely described.

OBJECTIVE

To describe the prevalence of CVD risk factors among women veterans in middle adulthood.

DESIGN

Serial cross-sectional studies of data from the Diabetes Epidemiologic Cohorts (DEpiC), a national, longitudinal data set including information on all patients in the Veterans Health Administration (VA).

PARTICIPANTS

Women veterans (n = 255,891) and men veterans (n = 2,271,605) aged 35–64 receiving VA care in fiscal year (FY) 2010.

MAIN MEASURES

Prevalence of CVD risk factors in FY2010 by age and, for those aged 45–54 years, by race, region, period of military service, priority status, and mental illness or substance abuse; prevalence by year from 2000 to 2010 in women veterans receiving VA care in both 2000 and 2010 who were free of the factor in 2000.

KEY RESULTS

Hypertension, hyperlipidemia, and diabetes were common among women and men, although more so among men. Hypertension was present in 13 % of women aged 35–44 years, 28 % of women aged 45–54, and 42 % of women aged 55–64. Hyperlipidemia prevalence was similar. Diabetes affected 4 % of women aged 35–44, and increased more than four-fold in prevalence to 18 % by age 55–64. The prevalence of obesity increased from 14 % to 18 % with age among women and was similarly prevalent in men. The relative rate of having two or more CVD risk factors in women compared to men increased progressively with age, from 0.55 (35–44 years) to 0.71 (45–54) to 0.73 (55–64). Most of the women with a factor present in 2010 were first diagnosed with the condition in the 10 years between 2000 and 2010.

CONCLUSIONS

CVD risk factors are common among women veterans aged 35–64. Future research should investigate which interventions would most effectively reduce risk in this population.
Appendix
Available only for authorised users
Literature
2.
go back to reference Lloyd-Jones DM, Leip EP, Larson MG, D’Agostino RB, Beiser A, Wilson PW, et al. Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age. Circulation. 2006;113(6):791–8.PubMedCrossRef Lloyd-Jones DM, Leip EP, Larson MG, D’Agostino RB, Beiser A, Wilson PW, et al. Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age. Circulation. 2006;113(6):791–8.PubMedCrossRef
3.
go back to reference Kazis LE, Ren XS, Lee A, Skinner K, Rogers W, Clark J, et al. Health status in VA patients: Results from the Veterans Health Study. Am J Med Qual. 1999;14(1):28–3.PubMedCrossRef Kazis LE, Ren XS, Lee A, Skinner K, Rogers W, Clark J, et al. Health status in VA patients: Results from the Veterans Health Study. Am J Med Qual. 1999;14(1):28–3.PubMedCrossRef
4.
go back to reference Agha Z, Lofgren RP, VanRuiswyk JV, Layde PM. Are patients at Veterans Affairs medical centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med. 2000;160(21):3252–7.PubMedCrossRef Agha Z, Lofgren RP, VanRuiswyk JV, Layde PM. Are patients at Veterans Affairs medical centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med. 2000;160(21):3252–7.PubMedCrossRef
5.
go back to reference Ahmadi N, Hajsadeghi F, Mirshkarlo HB, Budoff M, Yehuda R, Ebrahimi R. Post-traumatic stress disorder, coronary atherosclerosis, and mortality. Am J Cardiol. 2011;108(1):29–33.PubMedCrossRef Ahmadi N, Hajsadeghi F, Mirshkarlo HB, Budoff M, Yehuda R, Ebrahimi R. Post-traumatic stress disorder, coronary atherosclerosis, and mortality. Am J Cardiol. 2011;108(1):29–33.PubMedCrossRef
6.
go back to reference Jiang W, Glassman A, Krishnan R, O’Connor CM, Califf RM. Depression and ischemic heart disease: What have we learned so far and what must we do in the future? Am Heart J. 2005;150(1):54–78.PubMedCrossRef Jiang W, Glassman A, Krishnan R, O’Connor CM, Califf RM. Depression and ischemic heart disease: What have we learned so far and what must we do in the future? Am Heart J. 2005;150(1):54–78.PubMedCrossRef
7.
go back to reference Yoon J, Scott JY, Phibbs CS, Frayne SM. Trends in rates and attributable costs of conditions among female VA patients, 2000 and 2008. Womens Health Issues. 2012;22(3):e337–44.PubMedCrossRef Yoon J, Scott JY, Phibbs CS, Frayne SM. Trends in rates and attributable costs of conditions among female VA patients, 2000 and 2008. Womens Health Issues. 2012;22(3):e337–44.PubMedCrossRef
8.
go back to reference Bean-Mayberry B, Yano EM, Washington DL, Goldzweig C, Batuman F, Huang C, Miake-Lye I, Shekelle PG. Systematic review of women veterans’ health: update on successes and gaps. Womens Health Issues. 2011;21(4 Suppl):S84–97. Review.PubMedCrossRef Bean-Mayberry B, Yano EM, Washington DL, Goldzweig C, Batuman F, Huang C, Miake-Lye I, Shekelle PG. Systematic review of women veterans’ health: update on successes and gaps. Womens Health Issues. 2011;21(4 Suppl):S84–97. Review.PubMedCrossRef
9.
go back to reference Frayne SM, Parker VA, Christiansen CL, Loveland S, Seaver MR, Kazis LE, et al. Health status among 28,000 women veterans. the VA Women’s Health Program Evaluation Project. J Gen Intern Med. 2006;21(Suppl 3):S40–6.PubMedCrossRef Frayne SM, Parker VA, Christiansen CL, Loveland S, Seaver MR, Kazis LE, et al. Health status among 28,000 women veterans. the VA Women’s Health Program Evaluation Project. J Gen Intern Med. 2006;21(Suppl 3):S40–6.PubMedCrossRef
10.
go back to reference Egan BM, Zhao Y, Axon R. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010;303(20):2043–2050.PubMedCrossRef Egan BM, Zhao Y, Axon R. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010;303(20):2043–2050.PubMedCrossRef
11.
go back to reference Wong ND, Lopez V, Tang S, Williams GR. Prevalence, treatment, and control of combined hypertension and hypercholesterolemia in the United States. Am J Cardiol. 2006;98(2):204–8.PubMedCrossRef Wong ND, Lopez V, Tang S, Williams GR. Prevalence, treatment, and control of combined hypertension and hypercholesterolemia in the United States. Am J Cardiol. 2006;98(2):204–8.PubMedCrossRef
12.
go back to reference Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, Williams DE, Gregg EW, Bainbridge KE, Saydah SH, Geiss LS. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005–2006. Diabetes Care. 2009;32(2):287–94.PubMedCrossRef Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, Williams DE, Gregg EW, Bainbridge KE, Saydah SH, Geiss LS. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005–2006. Diabetes Care. 2009;32(2):287–94.PubMedCrossRef
13.
go back to reference Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity Among US adults, 1999–2008. JAMA. 2010;303(3):235–241.PubMedCrossRef Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity Among US adults, 1999–2008. JAMA. 2010;303(3):235–241.PubMedCrossRef
14.
go back to reference Miller DR, Safford MM, Pogach LM. Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data. Diabetes Care. 2004;27(Suppl 2):B10–21.PubMedCrossRef Miller DR, Safford MM, Pogach LM. Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data. Diabetes Care. 2004;27(Suppl 2):B10–21.PubMedCrossRef
15.
go back to reference Perlin J, Kazis L, Miller DR, Skinner K, Ren XS, et al. Health status and outcomes of veterans: physical and mental component summary scores: veterans SF-36; 1999 large health survey of veteran enrollees, executive report, veterans health administration, May, 2000. Perlin J, Kazis L, Miller DR, Skinner K, Ren XS, et al. Health status and outcomes of veterans: physical and mental component summary scores: veterans SF-36; 1999 large health survey of veteran enrollees, executive report, veterans health administration, May, 2000.
16.
go back to reference Borghi C. Interactions between hypercholesterolemia and hypertension: Implications for therapy. Curr Opin Nephrol Hypertens. 2002;11(5):489–96.PubMedCrossRef Borghi C. Interactions between hypercholesterolemia and hypertension: Implications for therapy. Curr Opin Nephrol Hypertens. 2002;11(5):489–96.PubMedCrossRef
17.
go back to reference Yu W, Ravelo A, Wagner TH, Phibbs CS, Bhandari A, Chen S, et al. Prevalence and costs of chronic conditions in the VA health care system. Med Care Res Rev. 2003;60(3 Suppl):146S–67.PubMedCrossRef Yu W, Ravelo A, Wagner TH, Phibbs CS, Bhandari A, Chen S, et al. Prevalence and costs of chronic conditions in the VA health care system. Med Care Res Rev. 2003;60(3 Suppl):146S–67.PubMedCrossRef
18.
go back to reference Johnson ML, Pietz K, Battleman DS, Beyth RJ. Prevalence of comorbid hypertension and dyslipidemia and associated cardiovascular disease. Am J Manag Care. 2004;10(12):926–32.PubMed Johnson ML, Pietz K, Battleman DS, Beyth RJ. Prevalence of comorbid hypertension and dyslipidemia and associated cardiovascular disease. Am J Manag Care. 2004;10(12):926–32.PubMed
19.
go back to reference Das SR, Kinsinger LS, Yancy WS Jr, Wang A, Ciesco E, Burdick M, et al. Obesity prevalence among veterans at Veterans Affairs medical facilities. Am J Prev Med. 2005;28(3):291–4.PubMedCrossRef Das SR, Kinsinger LS, Yancy WS Jr, Wang A, Ciesco E, Burdick M, et al. Obesity prevalence among veterans at Veterans Affairs medical facilities. Am J Prev Med. 2005;28(3):291–4.PubMedCrossRef
20.
go back to reference Crandall JP, Knowler WC, Kahn SE, Marrero D, Florez JC, Bray GA, et al. The prevention of type 2 diabetes. Nat Clin Pract Endocrinol Metab. 2008;4(7):382–93.PubMedCrossRef Crandall JP, Knowler WC, Kahn SE, Marrero D, Florez JC, Bray GA, et al. The prevention of type 2 diabetes. Nat Clin Pract Endocrinol Metab. 2008;4(7):382–93.PubMedCrossRef
21.
go back to reference Kahwati LC, Lewis MA, Kane H, Williams PA, Nerz P, Jones KR, et al. Best practices in the Veterans Health Administration’s MOVE! weight management program. Am J Prev Med. 2011;41(5):457–64.PubMedCrossRef Kahwati LC, Lewis MA, Kane H, Williams PA, Nerz P, Jones KR, et al. Best practices in the Veterans Health Administration’s MOVE! weight management program. Am J Prev Med. 2011;41(5):457–64.PubMedCrossRef
22.
go back to reference Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;16(2):CD000011. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;16(2):CD000011.
23.
go back to reference Houston TK, Allison JJ, Sussman M, Horn W, Holt CL, Trobaugh J, et al. Culturally appropriate storytelling to improve blood pressure: A randomized trial. Ann Intern Med. 2011;154(2):77–84.PubMedCrossRef Houston TK, Allison JJ, Sussman M, Horn W, Holt CL, Trobaugh J, et al. Culturally appropriate storytelling to improve blood pressure: A randomized trial. Ann Intern Med. 2011;154(2):77–84.PubMedCrossRef
24.
go back to reference Biswas MS, Calhoun PS, Bosworth HB, Bastian LA. Are women worrying about heart disease? Womens Health Issues. 2002;12(4):204–11.PubMedCrossRef Biswas MS, Calhoun PS, Bosworth HB, Bastian LA. Are women worrying about heart disease? Womens Health Issues. 2002;12(4):204–11.PubMedCrossRef
25.
go back to reference Mosca L, Mochari H, Christian A, Berra K, Taubert K, Mills T, et al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113(4):525–34.PubMedCrossRef Mosca L, Mochari H, Christian A, Berra K, Taubert K, Mills T, et al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113(4):525–34.PubMedCrossRef
26.
go back to reference Weisman CS, Rich DE, Rogers J, Crawford KG, Grayson CE, Henderson JT. Gender and patient satisfaction with primary care: Tuning in to women in quality measurement. J Womens Health Gend Based Med. 2000;9(6):657–65.PubMedCrossRef Weisman CS, Rich DE, Rogers J, Crawford KG, Grayson CE, Henderson JT. Gender and patient satisfaction with primary care: Tuning in to women in quality measurement. J Womens Health Gend Based Med. 2000;9(6):657–65.PubMedCrossRef
27.
go back to reference Kressin NR, Skinner K, Sullivan L, Miller DR, Frayne S, Kazis L, et al. Patient satisfaction with department of Veterans Affairs health care: Do women differ from men? Mil Med. 1999;164(4):283–8.PubMed Kressin NR, Skinner K, Sullivan L, Miller DR, Frayne S, Kazis L, et al. Patient satisfaction with department of Veterans Affairs health care: Do women differ from men? Mil Med. 1999;164(4):283–8.PubMed
28.
go back to reference Washington DL, Bean-Mayberry B, Mitchell MN, Riopelle D, Yano EM. Tailoring VA primary care to women veterans: Association with patient-rated quality and satisfaction. Womens Health Issues. 2011;21(4 Suppl):S112–9.PubMedCrossRef Washington DL, Bean-Mayberry B, Mitchell MN, Riopelle D, Yano EM. Tailoring VA primary care to women veterans: Association with patient-rated quality and satisfaction. Womens Health Issues. 2011;21(4 Suppl):S112–9.PubMedCrossRef
29.
go back to reference Borzecki AM, Wong AT, Hickey EC, Ash AS, Berlowitz DR. Identifying hypertension-related comorbidities from administrative data: What’s the optimal approach? Am J Med Qual. 2004;19(5):201–6.PubMedCrossRef Borzecki AM, Wong AT, Hickey EC, Ash AS, Berlowitz DR. Identifying hypertension-related comorbidities from administrative data: What’s the optimal approach? Am J Med Qual. 2004;19(5):201–6.PubMedCrossRef
30.
go back to reference Saydah SH, Geiss LS, Tierney E, Benjamin SM, Engelgau M, Brancati F. Review of the performance of methods to identify diabetes cases among vital statistics, administrative, and survey data. Ann Epidemiol. 2004;14(7):507–16.PubMedCrossRef Saydah SH, Geiss LS, Tierney E, Benjamin SM, Engelgau M, Brancati F. Review of the performance of methods to identify diabetes cases among vital statistics, administrative, and survey data. Ann Epidemiol. 2004;14(7):507–16.PubMedCrossRef
31.
go back to reference Sohn MW, Zhang H, Arnold N, Stroupe K, Taylor BC, Wilt TJ, et al. Transition to the new race/ethnicity data collection standards in the Department of Veterans Affairs. Popul Health Metr. 2006;4:7.PubMedCrossRef Sohn MW, Zhang H, Arnold N, Stroupe K, Taylor BC, Wilt TJ, et al. Transition to the new race/ethnicity data collection standards in the Department of Veterans Affairs. Popul Health Metr. 2006;4:7.PubMedCrossRef
Metadata
Title
Cardiovascular Disease Risk Factors Among Women Veterans at VA Medical Facilities
Authors
Varsha G. Vimalananda, MD, MPH
Donald R. Miller, ScD
Cindy L. Christiansen, PhD
Wenyu Wang, MS
Patricia Tremblay, MMS
B. Graeme Fincke, MD
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue Special Issue 2/2013
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-013-2381-9

Other articles of this Special Issue 2/2013

Journal of General Internal Medicine 2/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.