Few studies have examined the risk factors of serious psychological distress (SPD) and behavioral factors for heart disease separately stratified as young (18–44 years), middle aged (45–64 years), and elderly (65 years or older). A total of 3,540 adults with heart disease and 37,703 controls were selected from the 2005 California Health Interview Survey. Data were weighted to be representative and adjusted for potential undercoverage and nonresponse biases. Multiple logistic regression models were used to estimate the associations of the factors with heart disease at different ages. The prevalence of SPD was 8% in cases and 4% in controls, respectively. For young adults, SPD and higher federal poverty level (FPL) were associated with an increased risk of heart disease while for middle-aged adults, SPD, past smoking, lack of physical activity, obesity, male, and unemployment were associated with an increased risk of heart disease. In addition, SPD, past smoking, lack of physical activity, obesity, male, unemployment, White, and lower FPL were associated with an increased risk of heart disease in elderly. Our findings indicate that risk factors for heart disease vary across all ages. Intervention strategies that target risk reduction of heart disease may be tailored accordingly. 1. Introduction Cardiovascular disease (CVD) is the leading cause of death for adults in the world [1, 2]. Although the death rate for CVD has declined by 30.6% from 1998 to 2008, coronary heart disease (CHD) as the main component of CVD remains the leading cause of death in the United States (USA) for men and women and particularly is the single leading killer in women [3, 4]. In 2010, the age-adjusted prevalence of heart disease for adults was 11.7% among Whites, 10.9% among Blacks or African Americans, 8.1% among Hispanics or Latinos, and 7.2% among American Asians [5]. Approximately half men and one-third women aged 40 years or older were at a higher risk of developing CHD [6]. CHD accounts for more than 50% of all cardiovascular events for both sexes younger than 75 years of age [7]. The estimated direct and indirect costs of heart disease in 2008 were $190.3 billion [4]. Furthermore, approximately four of every ten individuals in the USA are predicted to have some form of CVD by 2030 [8]. Several risk factors have been linked to predispose individuals to develop heart disease, including gender, heredity, age, physical inactivity, smoking, obese status, high blood pressure, high cholesterol, abnormal blood lipid levels, low daily fruit and vegetable consumption, alcohol
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