Cardiovascular disease risk in middle-aged and older US adults with obesity according to lifestyle and socioeconomic patterns.

Background and aim: Cardiovascular disease (CVD) risk factors frequently co-occur within specific identifiable patterns. To address this critical need, the present study examined CVD risk associations in clusters of lifestyle and socioeconomic factors in middle-aged and older US adults with obesity. Methods and result: The present study was conducted using four biennial cycles of National Health and Nutrition Examination Survey data (n = 3074). Eleven lifestyle and socioeconomic indicators were considered in this analysis including dietary quality, lifestyle activity status (physical activity, sedentary time), substance usage (smoking, drinking), mental well-being (sleep disorders, depression), and socioeconomic status (marital status, education, household income, employment and food security). A standard stepwise latent analysis was utilized and adjusted for classification errors using Bolck, Croon, Hagenaars method. Four and three classes were identified for males and females respectively. Higher CVD risk was observed in other classes relative to the health reference class, associated with a range of unhealthy lifestyle factors such as smoking, sleep disorders, and depression, and different levels of socioeconomic status. Comparing to male class 1 (reference group), higher CVD risk observed in male classes 2 (OR=5.30, 95%CI [1.97, 14.31]), 3 (OR=11.50, 95%CI [3.50, 27.78]) and 4 (OR=7.32, 95%CI [2.54, 21.06]). A similar pattern was also observed in females. Conclusions: These results highlight the interplay between lifestyle choices and socioeconomic conditions, revealing how socioeconomic status critically conditions the healthy lifestyle patterns for cardiovascular risk management among middle-aged and older adults with obesity.