The coronary heart disease risk factor profile of Americans has been improving, with decreasing blood pressure and cholesterol levels. However, it is not apparent whether this improvement is due to primary prevention of risk factors through lifestyle choices or to secondary prevention (management) of established risk factors. Since secondary prevention only targets people with high blood pressure or cholesterol levels, the effect should be demonstrated by temporal declines in the upper percentiles (75th, 90th) of the blood pressure and cholesterol GENDER AND MINORITIES This study will use existing NHANES and NHES tapes that were collected in 1960 to the present. These federal data sets contain about 50% women and 10-15% individuals of non-white race. BUDGET Given the complexity of the data analyses proposed, the overall budget appears justified. However, the salary support for an administrative secretary at 10% time is not clearly justified. Given the nature of this project, the effort should be eliminated or redistributed in statistical or programming efforts.
| Goff Jr, David C; Labarthe, Darwin R; Howard, George et al. (2002) Primary prevention of high blood cholesterol concentrations in the United States. Arch Intern Med 162:913-9 |
| Goff, D C; Howard, G; Russell, G B et al. (2001) Birth cohort evidence of population influences on blood pressure in the United States, 1887-1994. Ann Epidemiol 11:271-9 |
