Relationships between Comorbidity and Health Behaviors Related to Hypertension in NHANES III

Background. Health behaviors such as diet, exercise, and smoking are frequently studied among persons with one particular diagnosis; however, comorbidities that complicate our understanding of behavior patterns are often present. In addition, behaviors and conditions may vary by demographic factors. This study describes the prevalence of behaviors related to hypertension among persons with one to three diagnoses and investigates the relative contribution of demographic factors and increased morbidity on these measures. Methods. Data are from a nationally representative sample of adults over age 30 from the NHANES III. Behaviors are compared among three groups: those with hypertension alone (N = 2,944), hypertension plus type 2 diabetes (N = 557), and hypertension, type 2 diabetes, and history of a heart attack (N = 116). Results. Demographic factors explained more of the variance in behavioral measures than morbidity level. Trends in behavior prevalence across morbidity levels were apparent for measures of alcohol and smoking. No group differences were found for exercise, fat intake, or sodium intake after controlling for demographic factors. Conclusions. Some behaviors were more strongly associated with increased levels of morbidity than others. Longitudinal studies are needed to better describe the reasons for behavior change in the face of various health conditions.