Social and Behavioral Risk Marker Clustering Associated with Biological Risk Factors for Coronary Heart Disease: NHANES 2001–2004

Table 4

Predictive ability of the Sociobehavioral Risk Marker Index (SRI) for biological coronary heart disease risk factors, stratified by sex. Three different receiver operating characteristic (ROC) curve analyses, resulting in three different C-statistics, were performed that included age and race/ethnicity as well as (1) individual SRI components only (i.e., education, smoking, fruit/vegetable consumption, and physical activity), (2) SRI only, or (3) both SRI and individual SRI components, NHANES 2001–2004.

	Coronary heart disease risk factors
	Systolic hypertension (yes/no)*		Elevated total cholesterol (yes/no)^†		Low HDL cholesterol; (yes/no)^‡		Large waist circumference (yes/no)§		Obese; (yes/no)**		Diabetes; (yes/no)
	C^††	95% CI^‡‡	C	95% CI	C	95% CI	C	95% CI	C	95% CI	C	95% CI
Females
Only includes SRI§§ individual components	0.85	0.84, 0.87	0.59	0.57, 0.62	0.62	0.60, 0.65	0.68	0.65, 0.70	0.57	0.55, 0.59	0.75	0.73, 0.77
SRI = 0 or 4§§ versus SRI = 1–3
Includes SRI only	0.85	0.84, 0.86	0.59	0.56, 0.61	0.60	0.58, 0.62	0.66	0.64, 0.68	0.56	0.54, 0.58	0.75	0.73, 0.77
Includes SRI and SRI individual components	0.85	0.84, 0.87	0.59	0.57, 0.62	0.62	0.60, 0.65	0.68	0.65, 0.70	0.57	0.56, 0.59	0.75	0.73, 0.77
Males
Only includes SRI individual components	0.78	0.76, 0.80	0.57	0.54, 0.60	0.58	0.55, 0.60	0.68	0.66, 0.70	0.55	0.53, 0.57	0.75	0.73, 0.77
SRI = 0 or 4 versus SRI = 1–3
Includes SRI only	0.78	0.76, 0.80	0.56	0.53, 0.59	0.57	0.54, 0.59	0.68	0.66, 0.69	0.51	0.49, 0.53	0.75	0.73, 0.76
Includes SRI and SRI individual components	0.78	0.76, 0.80	0.57	0.55, 0.60	0.58	0.56, 0.61	0.68	0.66, 0.70	0.55	0.53, 0.57	0.75	0.73, 0.77

∗Systolic hypertension is defined as having systolic blood pressure ≥140 mmHg. Model includes antihypertensive medication use.
^†Elevated total cholesterol is defined as having total cholesterol ≥240 mg/dL. Model includes cholesterol-lowering medication use.
^‡Low HDL cholesterol is defined as having HDL <50 mg/dL for women and <40 mg/dL for men. Adjusted for cholesterol medication use.
§Large waist circumference is defined as having a waist circumference >88 cm for women and >102 cm for men.
**Obesity defined as ≥30 kg/m² versus <30 kg/m².
^††C-Statistic determined from Mann-Whitney test for ROC curves.
^‡‡95% confidence interval.
§§Sociobehavioral Risk Marker Index (SRI) components include variables for the following: less than high school or high school diploma/GED versus more than high school; met versus did not meet physical activity guidelines; met versus did not meet fruit and vegetable guidelines; current versus never or former smokers. Each participant received either a 1 if they had the particular sociobehavioral risk marker or a 0 if they did not have the risk marker. The sum of these values produced an index with a range of 0–4, with SRI = 4 indicating having all risk markers (i.e., all unhealthy risk markers) and SRI = 0 indicating that the participant had no risk markers (i.e., all healthy risk markers).