Heart Disease and Stroke Statistics 2010 Update. 2009, American Heart Association. All rights reserved.

Transcription

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2 Heart Disease and Stroke Statistics 21 Update

3 Questions on statistics? Audio-visual questions? Please keep the red wave and logo attached to these slides.

4 Deaths in Thousands Years Males Females CVD disease mortality trends for males and females (United States: ). Source: NCHS and NHLBI.

5 Per 1, Population Coronary Heart Disease Stroke Lung Cancer Breast Cancer White Females Black Females Age-adjusted death rates for CHD,, stroke, lung and breast for white and black females (United States: 26). Source: NCHS.

6 1, Deaths in Thousands Years Deaths from diseases of the heart (United States: 19 26) Note: See Glossary for an explanation of Diseases of the Heart. Source: NCHS.

7 12 Deaths in Thousands Years Deaths from cardiovascular disease (United States: 19 26). Source: Source: NCHS and NHLBI.

8 Discharges in Millions Years Hospital discharges for cardiovascular diseases. (United States: ). 26). Note: Hospital discharges include people discharged alive, dead and status unknown. Source: NCHS and NHLBI.

9 Coronary Heart Disease Stroke HF* High Blood Pressure Diseases of the Arteries Other Percentage breakdown of deaths from cardiovascular diseases (United States: 26) * - Not a true underlying cause. Source: NCHS.

10 Percent of Population Men Women Prevalence of CVD in adults age 2 and older by age and sex (NHANES 23-26). Source: NCHS and NHLBI. These data include coronary heart disease, heart failure, stroke and hypertension.

11 Per 1, Person Years Age Men Women Incidence of CVD* by age and sex. (FHS,, ). Source: NHLBI. * Includes CHD, HF,, stroke or intermittent claudication.. Does not include hypertension alone.

12 Deaths in Thousands 1, < Total Ages CVD Cancer CVD deaths vs. cancer deaths by age. (United States: 26). Source: NCHS.

13 Deaths 9, 8, 7, 6, 5, 4, 3, 2, 1, Alzheimer CLRD Cancer All Other CVD Stroke Heart Disease All Ages < CVD and other major causes of death: both sexes. (United States: 26). Source: NCHS and NHLBI.

14 Deaths 45, 4, 35, 3, 25, 2, 15, 1, 5, CLRD Accidents Cancer All Other CVD Stroke Heart Disease All Ages < CVD and other major causes of death: males (United States: 26). Source: NCHS and NHLBI.

15 5, Deaths 4, 3, 2, 1, Alzheimer CLRD Cancer All Other CVD Stroke Heart Disease All Ages < CVD and other major causes of death: females (United States: 26). Source: NCHS and NHLBI.

16 5, 4, 398, ,79 Deaths 3, 2, 29,69 269,819 1, 78,941 59,26 36,6 65,323 51,281 42,658 A B C D E A B D F C Males Females A CVD (I-I99; I99; Q2-Q28) Q28) B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Alzheimer s s Disease CVD and other major causes of death for all males and females (United States: 26). Source: NCHS and NHLBI.

17 Percent of Total Deaths A B C D E A B D F C Males Females A CVD (I-I99; I99; Q2-28) 28) B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Alzheimer s s Disease CVD and other major causes of death for white males and females (United States: 26). Source: NCHS and NHLBI.

18 Percent of Total Deaths A B C D E A B E F C Males Females A CVD (I-I99; I99; Q2-Q28) Q28) B Cancer C Accidents D Assault (Homicide) E Diabetes Mellitus F Nephritis, Nephrotic Syndrome and Nephrosis CVD and other major causes of death for black males and females. (United States: 26). Source: NCHS and NHLBI.

19 Percent of Total Deaths A B C D E A B D C F Males Females A CVD (I-I99) I99) B Cancer C Accidents D Diabetes Mellitus E Assault (Homicide) F CLRD CVD and other major causes of death for Hispanic or Latino males and females (United States: 26). Source: NCHS and NHLBI.

20 Percent of Total Deaths A B C D E A B C E F Males Females A CVD (I-I99) I99) B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Influenza and Pneumonia CVD and other major causes of death for Asian or Pacific Islander males and females (United States: 26). Source: NCHS and NHLBI.

21 Percent of Total Deaths A B C D E A B C D F Males Females A CVD (I-I99) I99) B Cancer C Accidents D Diabetes Mellitus E Chronic Liver Disease and Cirrhosis F Chronic Lower Respiratory Diseases CVD and other major causes of death for American Indian or Alaska Native males and females (United States: 26). Source: NCHS and NHLBI.

22 Cardiovascular Obstetrical V Digestive System Respiratory System External: Injuries, etc Mental Genitourinary System Musculoskeletal System Endocrine System Neoplasms Hospital Discharges (in millions) for the 1 Leading diagnostic Groups (United States: 26). Source: NHDS/NCHS and NHLBI.

23 Estimated 1-Year Rate% A B C D Men Women Estimated 1-Year CVD risk in 5 to 54-year year-old adults according to levels of various risk factors (Framingham Heart Study). Source: D Agostino D et al., Circulation. 28;117: A B C D Age HDL Cholesterol, mg/dl Total Cholesterol (mg/dl dl) ) Systolic BP mm/hg, no treat Smoker No No No Yes Diabetes No No Yes Yes mm Hg = millimeters of mercury. mg/dl = milligrams per deciliter of blood

24 Proportion (%) With Detectable Calcium Men Women White Black Prevalence (%) of Coronary Calcium: US Adults Ages Years (CARDIA Study). Source: Loria et al., JACC.. 27;49(2):

25 Proportion (%) With Detectable Calcium White Black Hispanic Chinese Men Women Prevalence (%) of Coronary Calcium: US Adults Ages Years (The MESA Study). Source: Bild et al., Circulation. 25;111:

26 Hazard Ratio (HR) Compared to CAC= >3 Major CHD Events Any CHD Events Hazard Ratios for CHD Events Associated With Coronary Calcium Scores: US Adults Ages Years (Reference Group CAC=) Source: Detrano et al., NEJM.. 28;358(13):

27 Hazard Ratio (HR) Compared to CAC= FRS <1% FRS 1-15% FRS 16-2% CAC >2% CAC CAC 1-1 CAC 11-3 CAC >3 Hazard Ratios for CHD Events Associated With Coronary Calcium Scores: US Adults (Reference Group CAC= and Framingham Risk Scores <1%) Source: Greenland et al., JAMA.. 24;291(2):

28 Mean Carotid IMT (mm) Common Carotid Carotid Bulb Internal Carotid White Women Black Women White Men Black Men Mean Values of Carotid IMT for Different Carotid Artery Segments in Younger Adults by Race and Sex (Bogalusa Heart Study) Source: Urbina et al., Am J Card. 22;9(9):

29 Mean Carotid IMT (mm) Common Carotid Internal Carotid White Black Hispanic Chinese Mean Values of Carotid IMT for Different Carotid Artery Segments in Older Adults by Race (MESA Heart Study) Source: Manolio et al., Atherosclerosis 28;197(1):

30 Estimated Estimated 1-Year 1-Year Rate Rate (%) (%) A B C D Blood Pressure (mm Hg) 12/8 14/9 14/9 14/9 Total Cholesterol (mg/dl) HDL Cholesterol (mg/dl) Diabetes 5 Cigarettes 5 Men Women No No No No Yes No mm Hg = millimeters of mercury. mg/dl = milligrams per deciliter of blood Estimated 1-Year CHD risk in 55-year year-old adults according to levels of various risk factors (Framingham Heart Study). Source: Wilson et al., Circulation. 1998;97: A B C D Yes Yes 27 27

31 New and Recurrent MI or Fatal CHD Ages Men Women Annual number of U.S. Adults having diagnosed heart attack by age and sex (ARIC:: and CHS: ). Source: NHLBI. Includes MI and fatal CHD but not silent MI s.

32 Percent of Population Men Women Prevalence of CHD by age and sex (NHANES :23-26) 26). Source: Source: NCHS and NHLBI.

33 Prevalence (%) All Women Men Prevalence of low CHD risk, overall and by sex, ages (NHANES : ) 26). Source:Personal communication with communication with NHLBI 6/28/7. Low risk is defined as SBP <12 mm Hg and DBP<8 mm Hg; cholesterol < 2 mg/dl and BMI <25 kg/m2 and currently not smoking cigarettes and no prior MI or DM.

34 Per 1, Persons White Men Black Men White Women Black Women Annual rate of first heart attack by age, sex and race. (ARIC Surveillance: ) 24). Source: NHLBI.

35 Per 1, Person Years Incidence of Myocardial Infarction* by Age, Race and Sex. (ARIC Surveillance: ). Source: NHLBI NHLBI. * MI diagnosed by expert committee based on review of hospital records. White Men Black Men White Women Black Women

36 Per 1, Person Years Age Men Women Incidence of Angina Pectoris* by Age and Sex. (FHS:: /23). Source: NHLBI NHLBI. * AP uncomplicated based on physicians interview of patient. Note: Rate for women age considered unreliable.

37 Discharges in Thousands Years Males Females Hospital discharges for coronary heart disease by sex (United States: ). Source: NHDS/NCHS. Note: Hospital discharges include people discharged alive, dead, and status unknown.

38 14 Procedures in Thousands Years Trends in Carotid Endarterectomy Procedures (United States: ). Source: NHDS/NCHS NHDS/NCHS and NHLBI.

39 Percent of Population Men Women Prevalence of stroke by age and sex (NHANES:: 23-26). 26). Source: NCHS and NHLBI.

40 Incidence per per 1, 1, Ischemic Intracerebral hemorrhage Subarachnoid hemorrhage Annual age-adjusted adjusted incidence of first-ever stroke, by race. Inpatient plus out-of of-hospital ascertainment. (GCNKSS:: and 1999). Source: Stroke 25;36;72 White White '93-94 '93-94 White White '99 '99 Black Black '93-94 '93-94 Black Black '99 '99 Source: Stroke 25;36;

41 Per 1, Persons Age s Annual rate of first cerebral infarction by age, sex and race (GCNKSS:: 1999). Source: Unpublished data GCNKSS. Note rates for ages for black males and females and for black males ages 75 and over, are considered unreliable. An estimated 15, people have first cerebral infarctions before age 45. WM WF BM BF

42 Per 1, Persons Ages Annual rate of all first-ever strokes by age, sex and race (GCNKSS:: 1999). Source: GCNKSS unpublished data. Note: rates for ages for black men and women and for black men 75 and over, are considered unreliable. WM WF BM BF

43 Estimated Estimated 1-Year 1-Year Rate Rate (%) (%) Men Men Women Women A B C D E F A B C D E F Systolic BP* Diabetes No No Yes Yes Yes Yes Cigarettes No No No Yes Yes Yes Prior Atrial Fib. No No No No Yes Yes Prior CVD No No No No No Yes *Closest ranges for women are: and Estimated 1-year stroke risk in 55-year year-old adults according to levels of various risk factors (FHS). Source: Wolf et al., Stroke.1991;22:

44 Percent of Population Men Women Prevalence of high blood pressure in Adults age 2 and older, by age and sex (NHANES:: 23-26) 26). Source: NCHS and NHLBI.

45 Percent of Population With Hypertension Awareness Treatment Controlled Total Population NH Whites NH Blacks Mexican Americans Extent of awareness, treatment and control of high blood pressure by race/ethnicity (NHANES : 23-26). 26). Source: NCHS and NHLBI.

46 5 Percent of Population NH White Men NH White Women NH Black Men NH Black Women Mexican American Men Mexican American Women Age-adjusted prevalence trends for high blood pressure in Adults age 2 and older by race/ethnicity, sex and survey (NHANES:: , 94, and 23-6). 6). Source: NCHS and NHLBI.. NH- non-hispanic

47 Percent of Population With Hypertension Awareness Treatment Controlled Extent of Awareness, Treatment and Control of High Blood Pressure by Age (NHANES:: 23-26). 26). Source: NCHS and and NHLBI.

48 Percent of Population With Hypertension Extent of Awareness, Treatment and Control of High Blood Pressure by Race/Ethnicity and Sex (NHANES:: ). Source: NCHS and NHLBI. Awareness Treatment Controlled NH White Men NH White Women NH Black Men NH Black Women Mexican-American Men Mexican-AmericanWomen

49 Percent of Population Men Women Prevalence of heart failure by age and sex (NHANES:: 23-26). 26). Source: NCHS and NHLBI.

50 7 Discharges in Thousands Years Male Female Hospital discharges for heart failure by sex. (United States: ). Source: NHDS/NCHS and NHLBI. Note: Hospital discharges include people discharged alive, dead and status unknown.

51 Per 1, Person Years Age Men Women Incidence of Heart Failure* by age and sex. (FHS:: ). Source: NHLBI. * HF based on physician review of medical records and strict diagnostic criteria.

52 Percent of Population NH Whites NH Blacks Hispanics Males Females Prevalence of students in grades reporting current cigarette smoking by race/ethnicity and sex. (YRBS:27). Source: MMWR. 28;57:SS4. NH non-hispanic.

53 Percent of Population Men NH White Hispanic NH American Indian/Alaska Native Prevalence of current smoking for Adults age 18 and older by race/ethnicity and sex (NHIS:27). Source: MMWR.. 28;57: NH non-hispanic. NH Black NH Asian Women

54 Mean Total Blood Cholesterol White Males Black Males White Females Black Females Mex. Am. Males Mex. Am. Females Trends in mean total serum cholesterol among adolescents ages by race, sex, and survey (NHANES:: , , 94, , 23-4, 4, and 25-6). 6). Source: NCHS and NHLBI

55 Mean Serum Total Cholesterol NH White NH Black Mexican American Trends in mean total serum cholesterol among adults age 2 and older, by race/ethnicity and survey (NHANES : , 94, , and 25-6). 6). Source: NCHS and NHLBI.. NH non-hispanic

56 Percent of Population NH White Males NH White Females NH Black Males NH Black Females MA Males MA Females Trends in the prevalence of total serum cholesterol (2+mg/dL) in adults age 2 and older, by sex, race/ethnicity and survey. (NHANES:: and 25-6) 6) Source: NCHS and NHLBI.. NH non-hispanic. MA Mexican Am

57 Percent of Population Male Female Prevalence of students in grades who met currently recommended levels of physical activity during the past 7 days by race/ ethnicity and a sex (YRBS:: 27). Source: MMWR.. 28;57:No. SS-4. NH non-hispanic. Note: Currently recommended levels is defined as activity that increased their heart rate and made them breathe hard some of the time for a total of at least 6 minutes/day on 5 or more of the 7 days preceding the survey. NH White NH Black Hispanic

58 Percent of Population NH White NH Black Hispanic Other race Prevalence of regular leisure-time physical activity among adults age 18 and older by race/ethnicity, and sex. (BRFSS:: 21 and 25). Source: MMWR,, 27;56:No. 46. NH non-hispanic. Men '1 Women '1 Men '5 Women '5

59 Percent of Population Male Female Prevalence of students in grades who did not meet currently recommended MVPA during the past 7 days by race/ethnicity, and sex. (YRBS:: 27). Source: MMWR (No.SS-4). NH non-hispanic. NH White NH Black Hispanic MMWR 28;57

60 Percent of Population Male Female Prevalence of children ages who attained sufficient MVPA to meet public health recommendations of >6 minutes/day on >5 of 7 days by sex and age. (NHANES:: 23-4). 4). Source: MSSE 28;4:

61 Percent of Population Males Females Prevalence of overweight among students in grades by race/ethnicity and sex (YRBS:: 27). Source: MMWR MMWR : No. SS-4. BMI 95th percentile or higher by age and sex of the CDC 2 growth chart. NH non-hispanic. NH Whites NH Blacks Hispanics

62 Percent of Population Men Women Age-adjusted prevalence of obesity in Adults ages 2-74 by sex and survey. (NHES,, ; 62; NHANES,, , 74, , and 23-26). 26). Source: Health, United States, 28. NCHS. Note: Obesity is defined as a BMI of 3. or higher.

63 Percent of Population Trends in prevalence of overweight among U.S. children and adolescents by age and survey. (NHANES,, , and 23-26). 26). Source: Health, United States, 28. Source: Health, United States, 28. NCHS.

64 Percent of Population Men Women NH Whites NH Blacks Mexican Americans Prevalence of physician-diagnosed diabetes in Adults age 2 and older by race/ethnicity and sex (NHANES:: 23-26). 26). Source: NCHS and NHLBI.. NH non non-hispanic.

65 Percent of Population NH Whites NH Blacks Mexican Americans Less than high school High school More than high school Prevalence of Physician Diagnosed Type 2 diabetes in Adults age 2+ by Race/Ethnicity, and Years of Education (NHANES: 23-26). 26). Source: NCHS and NHLBI. NH non-hispanic.

66 Percent of Population Physician Diagnosed Undiagnosed Physician Diagnosed 23-6 Undiagnosed 23-6 Male Female Trends in diabetes prevalence in adults age 2+ by Sex (NHANES:: and 23-26). 26). Undiagnosed for females considered unreliable. Source: NCHS and NHLBI. NH non-hispanic.

67 Treated and Controled Treated and Uncontroled Not Treated, but Aware Not Treated and Undiagnosed Diabetes Awareness, Treatment and Control (NHANES:: 23-26). 26). Source: NHLBI.

68 23% 36% 62% 2% 3% 1% 4% 51% 5% % 2% 2% 2% 3% Eating and drinking places Retail stores, direct selling Schools and colleges Foods at Home Hotels and motels Recreational places All other foods away from home Figure Total U.S. Food Expenditures Away from Home and At Home, 1977 and 27. Source: United States Department of Agriculture Economic Research Service

69 per capita calories per day Soda/cola Sweetened fruit drinks Alcohol 1% Fruit juice Whole-fat milk Low-fat milk Coffee Tea Figure Per Capita Calories Consumed from Different Beverages by U.S. Adults (age 19 and older), Source: Nationwide Food Consumption Surveys (1965, ) 78) and NHANES ( , 94, ); Duffey & Popkin, Obesity (Silver Spring) 27

70 Fat Carbohydrate Protein Calories percent energy total kcal per day Men Women Figure Age-Adjusted Adjusted Trends in Macronutrients and Total Calories Consumed by U.S. Adults (2-74 years), Source: National Center for Health Statistics. Health, United States 28, With Special Focus on Young Adults. NCHS; ; 29

71 Number of Transplants 2,5 2, 1,5 1, ,363 2,17 2,199 2, Years Trends in Heart Transplants (UNOS: ). Source: United Network for Organ Sharing (UNOS), scientific registry data.

72 Procedures in Thousands Years Catheterizations PCI Pacemakers Bypass Carotid Endarterectomy Trends in Cardiovascular Operations and Procedures (United States: ) 26). Source: NCHS and NHLBI. Note: In-hospital procedures only.

73 Obstetrical Cardiovascular Digestive System Musculoskeletal Female Genital Organs Integumentary System Respiratory System 3-34 Nervous System Urinary System Hemic and Lymphatic Number of Surgical Procedures in the 1 Leading Diagnostic Groups (United States: 26). Source: NHDS/NCHS and NHLBI Millions

74 Cardiovascular Digestive System Mental Nervous System Injury and Poisoning Respiratory System Musculoskeletal system Neoplasms Genitourinary System Endocrine System Direct Costs of the 1 Leading Diagnostic Groups (Billions of dollars) (United States: 21). Source: Source: NHLBI.

75 Billions of Dollars Coronary Heart Disease Stroke Hypertensive Disease Heart Failure Estimated direct and indirect costs (in billions of dollars) of major cardiovascular diseases and stroke (United States: 21). Source: NHLBI.