Prevalence of Risk Factors and Established Cardiovascular Disease Among All of Us Participants: Benchmarking Against...

Knowing how demographics, cardiovascular risk factors and established cardiovascular disease (CVD) of All of Us (AoU) Research Program participants differ from the U.S population is important for cardiovascular researchers using these data, and to inform the generalizability of findings.

We included AoU participants ≥18 years enrolled between May 2017-June 2022. 'AoU Survey' cohort included participants who completed the Personal and Family Health History survey. 'AoU EHR' included participants with linked EHR data. Cardiovascular risk factors and established CVD overall and by demographic sub-groups were compared to a weighted sample of adults ≥18 years from the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 cycle. Cardiovascular risk factors and established CVD were identified through survey questions in 'AoU Survey' and NHANES, and through SNOMED codes for 'AoU EHR'.

'AoU Survey' (N=185,232) was older than NHANES (N=9,683 representing 248 million) (56±17 vs 48±18 years), with more female (60.4% vs 51.8%) and Black (18.6% vs 11.5%, all P <0.001) participants. Prevalence of cardiovascular comorbidities in 'AoU Survey' was similar to NHANES overall, but lower when age stratified. However, this pattern was not observed among Black participants, who exhibited higher hypertension (42.2% vs 39%), diabetes (19.2% vs 12.5%), and congestive heart failure (3.8% vs 3.6%) rates than the U.S Black population. In contrast, female participants showed lower cardiovascular comorbidities. 'AoU EHR' with its code-based identification had higher prevalence of cardiovascular comorbidities.

AoU includes more historically underrepresented groups, as intended. However, researchers should account for differences in disease prevalence and subgroup characteristics with the U.S. population when interpreting survey estimates.