Health care access and risk factor control in US adults with cardiovascular disease from 2015 to 2023
Authors' conclusion
In this high-risk population, health care access improved postpandemic, but changes in risk factor control were inconsistent. Despite declines in BP awareness and treatment among individuals with CVD or risk factors, overall BP control improved. In contrast, glycemic control worsened despite increased diabetes treatment.
Study context
- Population
- US civilian adults aged ≥20 years with cardiovascular disease (CVD) or CVD risk factors (hypertension (HTN), hyperlipidemia (HLD), DM), National Health and Nutrition Examination Survey (NHANES) 2015–Aug 2023unweighted
- Participants
- 14,354 adults
- Exposure
- Post-COVID-19 vs pre-COVID-19
- Outcome
- Health access, disease awareness, treatment and control of HTN, HLD and DM
Methodological detailsNHANES
- NHANES
Main finding
As reported in the abstract
Changes in health access, awareness, treatment and control, post- vs pre-COVID-19, high-risk adults
Awareness of high cholesterol
Awareness of prediabetes
Treatment for HTN
Treatment for HLD
mmHg
| Outcome | Pre-COVID-19 | Post-COVID-19 |
|---|---|---|
| Diastolic BP | 73 | 76 |
- Diastolic blood pressure (BP) higher post-COVID-19
- P < 0.001
- Awareness of high cholesterol greater post-COVID-19
- P = 0.03
- Awareness of prediabetes greater post-COVID-19
- P = 0.01
- Fewer reported HTN treatment post-COVID-19
- P < 0.001
- Fewer reported HLD treatment post-COVID-19
- P < 0.001
- DM treatment increased, all high-risk adults
- aOR 1.68 (95% CI 1.46-1.96, P < .001)
- Glycemic control worsened, all high-risk adults
- aOR 0.64 (95% CI 0.44-0.94, P = .023)
- Overall health access improved postpandemic
- aOR 1.54 (95% CI 1.10-2.14, P = .01)
Observational data: associations, not effects.
Further findings
HTN awareness, treatment and BP control (subgroup: CVD risk factors only)
aOR
- Decline in HTN awareness post-COVID-19
- 0.88 (95% CI 0.79-0.98, P = .02)
- Decline in HTN treatment post-COVID-19
- 0.32 (95% CI 0.25-0.42, P < .001)
- BP control unchanged
- Adjusted analyses
Original publication
Health care access and risk factor control in US adults with cardiovascular disease from 2015 to 2023. Am Heart J. Published 2 July 2025. doi:10.
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