Preventing Chronic Diseases: 

Investing Wisely in Health 

Preventing Heart Disease 

and Stroke U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

The Reality 

• Heart disease and stroke—the principal components of cardiovascular disease—are the first and third leading causes of death 

in the United States, accounting for nearly 40% of all deaths. 

• Nearly 930,000 Americans die of cardiovascular diseases each


year, which amounts to one death every 33 seconds.


• About 70 million Americans (almost one-fourth of the 

population) have some form of cardiovascular disease, which 

is responsible for more than 6 million hospitalizations each year. 

• Much of the burden of heart disease and stroke could be eliminated by reducing their major risk factors: high blood pressure, 

high blood cholesterol, tobacco use, diabetes, physical inactivity, 

and poor nutrition. 

• About 90% of middle-aged Americans will develop high blood 

pressure in their lifetime, and nearly 70% of those who have 

Reducing Risk Factors for Heart Disease 

Saves Lives and Money 

• An average reduction of just 12–13 mm Hg in systolic blood 

pressure over 4 years of follow-up is associated with a 21% 

reduction in coronary heart disease, a 37% reduction in stroke, 

a 25% reduction in total cardiovascular disease deaths, and a 

13% reduction in overall death rates. 

• A 10% reduction in serum cholesterol levels can result in a


30% reduction in the incidence of heart attacks and strokes.


• U.S. adults substantially lowered their blood pressure, high 

cholesterol levels, and other heart disease risk factors during 

the 1980s. As a result, U.S. costs associated with coronary 

heart disease declined by an estimated 9%—from about $240 

billion in 1981 to about $220 billion in 1990. 

it now do not have it under control. 

• In 2002, more than 106 million people were 

told that they had total blood cholesterol 

levels that were above normal or high 

(200 mg/dL or higher). 

The Cost of Heart Disease 

and Stroke 

• In 2005, the cost of heart disease and 

stroke in the United States is projected 

to exceed $394 billion: $242 billion 

for health care expenditures and $152 

billion for lost productivity from death 

and disability. 

• In 2001, the cost of hospitalization for 

cardiovascular problems among Medicare 

beneficiaries topped $29 billion. 

• In 2005, $60 billion in health care 

spending was attributed to high 

blood pressure. 

Rates of Death Due to Diseases of the Heart,* 2001

DE 

MD 

NJ 

RI 

CT 

NH 

VT 

MA 

DC 

171–210 211–233 234–274 275–329

* Deaths per 100,000, age adjusted to 2000 total U.S. population. 

Revised July 2005 
been diagnosed by a health 

In Wisconsin, 1 in 4 adults has 

high blood pressure that has 

professional. Many more people 

have high blood pressure but 

are not aware of it. Keeping 

blood pressure under control is 

essential to preventing heart 

attacks and strokes, averting disability, and cutting 

hospitalization charges. 

To increase the percentage of patients who have their blood 

pressure under control, the state’s Cardiovascular Health 

Program collaborated with many public and private health 

organizations. In just 1 year, these partners demonstrated a 

21% relative increase in the number of health maintenance 

organization (HMO) patients with their high blood pressure 

under control. The Wisconsin Collaborative Diabetes 

Quality Improvement Project asked 20 of its participating 

HMOs to collect data on cardiovascular disease among 

their patients. Only 48% of patients were found to have 

their high blood pressure controlled in 2000. The health 

plans used this information to put into place strategies to 

improve their patients’ blood pressure control. As a result, 

58% of patients had their high blood pressure controlled by 

2001. The Cardiovascular Health Program is currently 

coordinating efforts to help these partners address both 

high blood pressure and high cholesterol. 

Wisconsin’s experiences demonstrate how a state program 

can provide a population-based perspective to health plans 

and can bring these plans together to share information 

on how to improve the quality of services they offer. This 

exemplary state program is promoting changes that will 

lead to better cardiovascular health for state residents. 

State Program in Action: 

Wisconsin Partners with Health Plans To Help 

People Control Their Blood Pressure 

Effective Strategies 

• Community health centers and other health care settings need 

to have systems in place that will improve the quality of care 

that high-risk patients receive. For example, community health 

centers and private clinics and doctor’s offices can use electronic 

reminder messages to alert doctors to patients’ follow-up needs. 

In Utah, community health centers have used such a system to 

substantially increase the proportion of patients who have their 

blood pressure under control. Before the system was in place, 

33% of patients had their blood pressure under control, compared with 58% of patients just 6 months after the centers 

began using the system. 

• Work sites are an ideal place to promote the cardiovascular 

health of millions of people. For example, employers can offer 

health screenings and follow-up services to help employees 

control their blood pressure and cholesterol levels. These 

services are proven effective in the workplace. In addition, 

employees can be trained to recognize the signs of a heart 

attack and stroke and how to respond. Another strategy is 

for work sites to offer adequate insurance coverage for health 

services that aim to prevent heart disease and stroke. 

• Educating the public about signs of a heart attack and stroke 

and the importance of calling 911 quickly is an important step 

to improving the chances for survival and minimizing the damage that can occur following a heart attack or stroke. Research 

indicates that 47% of deaths from heart attack occur before a 

person can be admitted to a hospital, and about 48% of stroke 

victims die before emergency medical personnel arrive. Only 

11% of adults in this country know both the signs of a heart 

attack and the urgency of calling 911. 

• Other important strategies to reduce people’s risk for heart 

disease and stroke are to avoid tobacco use, eat healthier foods, 

control diabetes, and be more physically active. 

Hope for the Future 

The prevention and control of the major risk factors for heart 

disease and stroke are critical to achieving a heart-healthy and 

stroke-free America. Health agencies at the federal, state, and 

local levels are working to reduce these risk factors and to eliminate disparities in health as well as those in the delivery of health 

care services. 

Whether you are a citizen, health care provider, employer, school 

administrator, or elected official, there are things you can do to 

improve the health of your heart. For suggestions, check out 

CDC’s Moving Into Action, available at http://www.cdc.gov/cvh. 

For more information and references supporting these 

facts, visit www.cdc.gov/nccdphp. For additional copies 

of this document, E-mail ccdinfo@cdc.gov.