# Presentation: 249780

## Healthy People 2010 Focus Area 12:Heart Disease and StrokeProgress ReviewMay 21, 2007

## Leading Causes of Death, 2004

**Leading Causes of Death, 2004**

**All Other Causes**

**3.Stroke**

**1.Heart Disease**

**2. Cancer**

- Note: Heart Disease is defined by ICD-10 codes I00-I09, I11, I13, I20-I51, cancer by ICD-10 codes C00-C97, and stroke by ICD-10 codes I60-I69.
- Source:  Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**(27%)**

**(6%)**

**(23%)**

**(43%)**

## About 16 million Americans have had a heart attack, angina pectoris or both (2004)
about 8.5 million males and 7.2 million females. 
In 2007, about 1.2 million Americans will have a new or recurrent coronary attack. 
Over 650,000 people in the US died from heart disease in 2004, making it the leading cause of death.
About 75% were coronary heart disease deaths.

**about 8.5 million males and 7.2 million females. **
**In 2007, about 1.2 million Americans will have a new or recurrent coronary attack. **
**Over 650,000 people in the US died from heart disease in 2004, making it the leading cause of death.**
**About 75% were coronary heart disease deaths.**

**Heart Disease**

## Heart Disease Deaths, 2004

**Heart Disease Deaths, 2004**

- Note: Heart disease deaths are defined by ICD-10 codes I00-I09, I11, I13, I20-I51.
- Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**45-54 **

**55-64**

**85+**

**64-74**

**75-84**

- 1

- 2

- 3

- 4

- 5

- 6

- 0

**Age in years**

**Female (death rates)**

**Male (death rates)**

**Rate per**
**100 population**

## Heart Disease Deaths, 2004

**45-54 **

**55-64**

**85+**

**64-74**

**75-84**

**Number**
**in thousands**

**Rate per**
**100 population**

**Heart Disease Deaths, 2004**

- Note: Heart disease deaths are defined by ICD-10 codes I00-I09, I11, I13, I20-I51.
- Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Female (number of deaths)**

**Male (number of deaths)**

**Age in years**

**Female (death rates)**

**Male (death rates)**

- 1

- 2

- 3

- 4

- 5

- 6

- 0

## About 700,000 Americans have a new or recurrent stroke each year. 
Stroke kills more than 150,000 people a year.
about 1 of every 16 deaths. 
3rd leading underlying cause of death.
Of every 5 deaths from stroke, 2 occur in men and 3 in women.
Americans will pay about $62.7 billion in 2007 for stroke-related medical costs and disability.

**Stroke kills more than 150,000 people a year.**
**about 1 of every 16 deaths. **
**3****rd**** leading underlying cause of death.**
**Of every 5 deaths from stroke, 2 occur in men and 3 in women.**
**Americans will pay about $62.7 billion in 2007 for stroke-related medical costs and disability.**

**Stroke**

## Highlighted Objectives

**12-1.   Coronary heart disease (CHD) deaths**
**12-7.   Stroke deaths**

**Target met or exceeded**

**Improving**

**12-6.   Heart failure hospitalizations**
**12-10. High blood pressure control**
**	**

**Getting worse**

**12-9.   High blood pressure**

## Coronary Heart Disease Deaths

**Decrease desired**

**Coronary Heart Disease Deaths**

**Obj. 12-1**

- Note: Coronary heart disease deaths are defined by ICD-10 codes I11, I20-I25.  Data are age adjusted to the 2000 standard population. Source:  Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Total**

**Male**

**Age-adjusted rate**
**per 100,000 population**

**2010 Target: 162 **

**Female**

## Coronary Heart Disease Deaths

**Decrease desired**

**Coronary Heart Disease Deaths**

**Obj. 12-1**

- Note: Coronary heart disease deaths are defined by ICD-10 codes I11, I20-I25.  Data are age adjusted to the 2000 standard population. Asian includes Pacific Islander.  The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be of any race.
- Source:  Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**2010 Target: 162 **

**American Indian**

**Asian**

**Hispanic**

**Black**

**White**

**Age-adjusted rate**
**per 100,000 population**

## Coronary Heart Disease Deaths by Health Service Area, 2002-2004

**2010 Target: 162**

**Obj. 12-1**

**Coronary Heart Disease Deaths ****by Health Service Area, 2002-2004**

- Note: Coronary heart disease deaths are defined by ICD-10 codes  I11, I20-I25.  Data are age-adjusted to the 2000 standard population.  The 5 legend categories represent the following percentage of Health Service Areas (from lowest to highest): 10%, 20%, 40%, 20%, 10%.  Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Age-adjusted rate per 100,000**

## Stroke Deaths

**Decrease desired**

**Stroke Deaths**

**Age-adjusted rate**
**per 100,000 population**

**2010 Target: 50**

**Obj. 12-7**

- Note: Stroke deaths are defined by ICD-10 codes  I60-I69.  Data are age adjusted to the 2000 standard population.
- Source:  Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Male**

**Female**

## Stroke Deaths

**Decrease desired**

**Stroke Deaths**

**2010 Target: 50**

**American Indian**

**Asian**

**Hispanic**

**Black**

**White**

**Age-adjusted rate**
**per 100,000 population**

**Obj. 12-7**

- Note: Stroke deaths are defined by ICD-10 codes  I60-I69.  Data are age adjusted to the 2000 standard population. Asian includes Pacific Islander.  The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be of any race.
- Source:  Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

## Stroke Deathsby Health Service Area, 2002-2004

- Note: Stroke deaths are defined by ICD-10 codes  I60-I69.  Data are age-adjusted to the 2000 standard population. The 5 legend categories represent the following percentage of Health Service Areas (from lowest to highest): 10%, 20%, 40%, 20%, 10%.
- Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Obj. 12-7**

**2010 Target: 50**

**Stroke Deaths****by Health Service Area, 2002-2004**

**Age-adjusted rate per 100,000**

## Stroke Deaths in Select Areas, 2004

- * = Data are statistically unreliable.
- Note: Stroke deaths are defined by ICD-10 codes  I60-I69.  Data are age adjusted to the 2000 standard population. “Stroke Belt” States are Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina, and Tennessee.  Asian includes Pacific Islander.  The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be of any race. Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Age-adjusted rate per 100,000 population**

**Stroke Deaths in Select Areas, 2004**

**American**
**Indian**

**Asian**

**Male**

**Total**

**Female**

**Hispanic**

**Black**

**20**

**40**

**100**

**0**

**60**

**80**

**20**

**40**

**100**

**0**

**60**

**80**

**New York**

**“****Stroke Belt” States**

**Obj. 12-7**

**White**

*****

## Congestive Heart Failure Hospitalizations

- I = 95% confidence interval.
- Note: Congestive heart failure is defined by ICD-9-CM code 428.0
- Source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

**White**

**Black**

**1997**

**2005**

**1997**

**2005**

**Congestive Heart Failure Hospitalizations**

**Obj. 12-6**

**= 2010 Target**

**Rate per **
**100,000 population**

**65 to 74 years**

**2010 Target:6.5  **

## Congestive Heart Failure Hospitalizations

**White**

**Black**

**1997**

**2005**

**1997**

**2005**

**Congestive Heart Failure Hospitalizations**

**Obj. 12-6**

- I = 95% confidence interval.
- Note: Congestive heart failure is defined by ICD-9-CM code 428.0
- Source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

**= 2010 Target**

**Rate per **
**100,000 population**

**65 to 74 years**

**75 to 84 years**

**2010 Target:13.5  **

**2010 Target:6.5  **

## Congestive Heart Failure Hospitalizations

**100,000 population**

**White**

**Black**

**1997**

**2005**

**1997**

**2005**

**Congestive Heart Failure Hospitalizations**

**Obj. 12-6**

- I = 95% confidence interval.
- Note: Congestive heart failure is defined by ICD-9-CM code 428.0
- Source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

**= 2010 Target**

## Related Risk Factors

- Tobacco
- Obesity
- Nutrition
- Physical Activity
- Diabetes
- Cholesterol
- High Blood Pressure

## Tobacco 
Obesity
Nutrition
Physical Activity
Diabetes
Cholesterol
High Blood Pressure

- Obesity
- Nutrition
- Physical Activity
- Diabetes
- Cholesterol
- High Blood Pressure

**Related Risk Factors**

## High Blood Pressure Prevalence

**Age-adjusted percent**

**1988-1994**

**2001-2004**

**High Blood Pressure Prevalence**

- I = 95% confidence interval.  Note:  Data are for adults aged 20 years and over and are age adjusted to the 2000 standard population.  The black and white categories exclude persons of Hispanic origin.  Persons of Mexican American origin may be any race.  Prior to 1999, respondents were asked to select one race category; selection of more than one race was not an option.  For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

**= 2010 Target: 14%**

**Obj. 12-9**

**0**

**40**

**60**

**Race/ethnicity**

**Total**

**Gender**

**20**

**80**

**Black**

**White **

**Male **

**Female**

**Mexican American**

## Blood Pressure Distribution, 2001-2004

**0                20               40               60               80            100 **

**Percent**

**Uncontrolled  HBP**

**Controlled HBP**

**Normal BP**

**Black**

**White **

**Male **

**Female**

**Mexican American**

**Blood Pressure Distribution, 2001-2004**

- Note:  Data are for adults aged 18 years and over.  The black and white categories exclude persons of Hispanic origin.  Persons of Mexican American origin may be any race.  Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group.
- Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

## High Blood Pressure Control

**0**

**Black**

**40**

**60**

**Obj. 12-10**

**Race/ethnicity**

**White **

**Male **

**Female**

**1988-1994**

**Total**

**2001-2004**

**Gender**

**High Blood Pressure Control**

**Mexican American**

- I = 95% confidence interval. Note:  Data are for adults aged 18 years and over and are age adjusted to the 2000 standard population.  The black and white categories exclude persons of Hispanic origin.  Persons of Mexican American origin may be any race.  Prior to 1999, respondents were asked to select one race category; selection of more than one race was not an option.  For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

**20**

**2010 Target: 68**

**80**

**Age-adjusted percent**

## Heart Disease and Stroke Objectives

-            deaths
- 12-2.   Knowledge of symptoms of heart
-            attack and importance of calling 911
- 12-3a. Artery-opening therapy within an
-             hour of symptom onset
- 12-3b. Percutaneous intervention (PCI)
-             within 90 min of symptom onset
- 12-4.   Persons trained in cardiopulmonary
-             resuscitation (CPR) within 1 year
- 12-5.   Out-of-hospital cardiac arrest –
-             timely electrical shock therapy
- 12-6a. Heart failure hospitalizations,
-             65 -74 yrs
- 12-6b. Heart failure hospitalizations,
-             75-84 yrs
- 12-6c. Heart failure hospitalizations, 85+ yrs

- 12-7.   Stroke deaths
- 12-8.   Knowledge of early warning
-              symptoms of stroke
- 12-9.   High blood pressure
- 12-10. High blood pressure control
- 12-11. Taking action to help control
-              blood pressure
- 12-12. Blood pressure monitoring
- 12-13. Mean total blood cholesterol
-             levels
- 12-14. High blood cholesterol levels
- 12-15. Blood cholesterol screening
-             within 5 years
- 12-16. LDL-cholesterol level in CHD
-              patients

- *

- *

- Improving

- Getting worse

- Little or no change

- Baseline only

- Target met

**Heart Disease and Stroke Objectives**

## Met or exceeded targets: reducing coronary heart disease deaths, stroke deaths, and high blood cholesterol levels

High blood pressure remains a problem
Prevalence is getting worse
Control of high blood pressure is improving
control is still about 50% below target

Disparities in deaths and risk factors remain:  race/ethnicity, gender, geography 

- High blood pressure remains a problem
- Prevalence is getting worse
- Control of high blood pressure is improving
- control is still about 50% below target
- Disparities in deaths and risk factors remain:  race/ethnicity, gender, geography

**Summary**

## http://www.cdc.gov/nchs/hphome.htm

**Progress review data and slides**
**are available on the web at:**

**http://www.cdc.gov/nchs/hphome.htm**