Author ORCID Identifier

Date of Award

Spring 5-4-2021

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Ike Okosun

Second Advisor

Dr. Barbara Yankey



There is the need for consistent research on cardiovascular diseases and the associated risks to provide more information towards prevention, control, and management.


This study estimated linear trends of cardiovascular disease risks and their association with selected anthropometric measurements.


Five bi-annual data from 2007 to 2016 was obtained from the National Health and Nutrition Examination survey. Analysis was performed on all participants aged between 20 and 80 years (n = 29,201). The outcome variable was cardiovascular disease risk (CVDRisk), estimated as the ratio of total cholesterol (TCHOL) to high-density lipoprotein (HDL). Analyses of linear trends were performed for all lipid profiles and selected anthropometric variables. The multiple linear regression analysis procedure was used to estimate anthropometric variables that best predict CVDRisk.


The mean CVDRisk for the studied population was 4.0 (95% CI: 3.8-4.2). There was a decrease of 0.05 in mean CVDRisk bi-annually from 4.1 in 2007-2008 to 3.9 in 2015-2016 (t = -3.27, p = 0.0467). The percentage with desirable CVDRisk decreased by 0.07 bi-annually from 0.42% in 2007-2008 to 0.1% in 2015-2016 (p = 0.0689). Borderline risk increased by 0.8 bi-annually from 90.7% in 2007-2008 to 93.8% in 2015-2016 (p = 0.1176). High CVDRisk decreased by 0.7 from 8.9% in 2007-2008 to 6.2% in 2015-2016 (t = -1.95, p = 0.1464). CVDRisk was consistently higher in males than females for all the cohorts (p < 0.0001). The risk was high among the 30-69 years age group but declined after age 70. Overall, waist circumference (WC), weight (WT), and the WC*WT interaction term, adjusted for age, gender, and race/ethnicity significantly helped to predict CVDRisk (p < 0.0001).


The majority of the studied population had either borderline or high risk for cardiovascular diseases based on the TCHOL/HDL ratio. Thus suggesting the need to intensify existing primary prevention efforts to minimize risk and avert cardiovascular disease progression.


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