Prevalence of traditional and non-traditional cardiovascular risk factors in adults with congenital heart disease.

Background: Adults with congenital heart disease (CHD) may be at increased risk of acquired cardiovascular disease (CVD). Understanding the prevalence of CV risk factors (CVRF) in this population is an important step in developing strategies to mitigate long-term risk.

Methods: The Oregon All Payer All Claims database for the years 2010-2017 was queried for adults with CHD International Classification of Diseases (ICD) codes. The prevalence of CVRF was measured, and we then evaluated the association with patient characteristics.

Results: There were 13,896 individuals with CHD. 72.8% (99% CI: 71.8-73.7) had at least one RF and 52.3% (99% CI: 51.2-53.4) had ≥2 RF. The prevalence of ≥1 RF increased with age (18-24: 39.6% (99% CI: 37.0-42.1) vs. 93.6% (99% CI: 92.6-94.6) in those 55-65). Hypertension (aOR 1.49 (99% CI: 1.36-1.63)), diabetes (aOR 1.24 (99% CI: 1.13-1.36)), sleep apnea (aOR 1.40 (99% CI 1.26-1.55)) and kidney disease (aOR 1.33 (99% CI:1.14-1.54)) were more prevalent in moderate-complex as opposed to simple CHD. When compared with a matched non-CHD population, there was higher prevalence of CVRF in ACHD (≥1 RF: 76.1 vs. 64.1%, OR 1.79 (99% CI: 1.69-1.89); ≥2 RF: 52.6 vs. 36.5%, OR 1.92 (99% CI: 1.83-2.03).

Conclusions: To our knowledge, this is the first comprehensive attempt to measure both traditional and non-traditional CVRF in US adults with CHD. We show that CVRF are common even in young adults. Given the additive effect of acquired CVD on CHD, addressing RF should be an important priority for in ACHD.