Rural and urban characteristics impact cardiovascular risk reduction.

Purpose: Our aim was to provide a descriptive analysis of specific differences between rural and urban residents and the interaction between these differences and those who reduced cardiovascular disease (CVD) risk in response to intervention versus those who did not.

Methods: This study is a descriptive analysis comparing rural groups with urban groups and those who decreased CVD risk with those who did not. Two hundred five rural (median age = 64.0 years [interquartile = 57.0, 71.0], 56% men) and 183 urban (median age = 58.0 years [interquartile = 50.0, 65.0], 53% men) residents were included.

Results: Rural and urban groups differed (P < .05) for demographic, anthropometric, physiological, and health-related variables. Those who decreased CVD risk, regardless of rural or urban, had greater blood pressure, greater low-density lipoprotein cholesterol, lower walking distance, greater CVD risk score, greater metabolic syndrome score, and greater internal health locus of control (all P < .05). Interestingly, there were differences between those who decreased risk and those who did not within the rural and urban groups. Triglycerides, C-reactive protein, diabetes knowledge, risk perception, and outcome expectations were greater for the rural group who decreased their CVD risk versus those who did not (all P < .05). For the urban group, there was a greater powerful others locus of control for those who decreased CVD risk (P < .05).

Conclusions: To maximize the likelihood of success, risk reduction intervention and educational strategies for urban and rural groups must be tailored to address unique demographic, physiological, and health-related characteristics.