Transcript Slide 1

Types of Cardiovascular
Disease and Associated
Risks
Jill Birnbaum, State Advocacy Consultant,
National Center, American Heart Association
About the American Heart
Association
• The American Heart Association is a not-for-profit,
voluntary health organization funded by private
contributions. Our mission is to reduce disability
and death from cardiovascular diseases and stroke.
• Preventing heart disease and stroke is — and
always has been — our first priority. We’ve funded
about $2 billion in heart and blood vessel research
since 1949. Nearly 30 percent of our yearly
expenses supports research.
A complete version of this update
is available on our Web site,
www.americanheart.org/statistics
Click on “Heart Disease and
Stroke Statistics — 2006 Update”
Prevalence of
Cardiovascular Diseases (CVD)
• 71.3 million Americans have some type
of CVD (~1 in 3 adult men & women)
–
–
–
–
–
–
–
High Blood Pressure………...65,000,000
Coronary Heart Disease…….13,200,000
Heart Attack…7,200,000
Chest Pain…...6,500,000
Heart Failure…….5,000,000
Stroke…………………………...5,500,000
Congenital Heart Disease……1,000,000+
Leading Causes of Death for
All Males and Females
United States: 2003*
Deaths in Thousands
500
484
427
400
287
300
268
Males
Females
200
100
68
60
66
35
45 39
0
A
B
A Total CVD
B Cancer
C Accidents
C
D
E
A
B
D
F
E
D Chronic Lower Respiratory Diseases
E Diabetes Mellitus
F Alzheimer’s Disease
Source: CDC/NCHS and NHLBI. *Preliminary
Deaths From Diseases of the Heart*
United States: 1900–2003*
Deaths in Thousands
900
800
700
600
500
400
300
200
100
Years
Source: CDC/NCHS. *Preliminary.
00
90
80
70
60
50
40
30
20
10
19
00
0
Cardiovascular Disease is an
Equal Opportunity Employer
• 426,772 male deaths per year
• 483,842 female deaths per year
Cardiovascular Disease Mortality
Trends for Males and Females
Deaths in Thousands
United States: 1979-2003*
520
500
480
460
440
420
4000
79 80
85
90
95
Years
Males
Source: CDC/NCHS.
* Preliminary
Females
00
03
Cardiovascular Diseases
•
•
•
•
•
Coronary heart disease
Stroke
High blood pressure
Heart failure
Congenital cardiovascular defects
Percentage Breakdown of Deaths From
Cardiovascular Diseases
United States:2003*
53%
13%
0.4%
0%
1% 4%
0.5%
17%
6%
6%
Coronary Heart Disease
Heart Failure
HF
Diseases of the Arteries
Coronary
Heart
Disease Heart Disease
Rheumatic
Fever/Rheumatic
Stroke
High Blood Pressure
Congenital Cardiovascular Defects
Stroke
Other
Heart Failure
High Blood Pressure
Diseases of the Arteries
Congenital Cardiovascular Defects
Rheumatic Fever/Rheumatic Heart Disease
Other
Source: CDC/NCHS and NHLBI. *Preliminary
Coronary Heart Disease
• Acute myocardial infarction
• Other acute ischemic (coronary)
heart disease
• Angina pectoris
• Atherosclerotic cardiovascular
disease
• All other forms of chronic ischemic
heart disease
Coronary Artery Disease
• Results
from
blocked
arteries
that feed
the heart
muscle.
Complete
blockage
will lead to
a heart
attack.
Heart Attack
Death of, or damage to, part of the
heart muscle due to an insufficient
blood supply.
Medical term is
myocardial infarction (MI)
Incidence
• This year an estimated 1,200,000 Americans will
have a new or recurrent coronary attack.
– 700,000 will have a new coronary attack.
– 500,000 will have a recurrent attack.
• It is estimated that an additional 175,000 silent
first heart attacks occur each year.
• About every 26 seconds an American will suffer
a coronary event, and about every minute
someone will die from one.
• About 40 percent of the people who experience
a coronary attack in a given year will die from it.
Annual Number of Americans Having
Diagnosed Heart Attack by Age and Sex
New and Recurrent Attacks
ARIC: 1987-2000
500,000
410,000
400,000
300,000
372,000
250,000
Men
Women
200,000
100,000
88,000
34,000
10,000
0
29-44
45-64
65+
Ages
Source: Extrapolated from rates in the NHLBI’s ARIC surveillance study,
1987-2000. These data don’t include silent MIs.
Warning Signs of a
Heart Attack
• Chest discomfort – most attacks have discomfort in the center
of the chest that lasts more than a few minutes, or goes away and
comes back. Can feel like uncomfortable pressure, squeezing,
fullness or pain
• Discomfort in other areas of the upper body – can include
pain in one or both arms, back, neck, jaw or stomach
• Shortness of breath – may occur with or without chest
discomfort
• Other signs – may include breaking out in cold sweat, nausea or
lightheadedness
Heart attack is a medical emergency – call 9-1-1
Major Risk Factors for
Heart Attack
Those that can’t be changed:
 Heredity (including race)
 Male Sex
 Increasing Age
Major Risk Factors for
Heart Attack
Those that can be controlled, treated or modified:






Tobacco Smoke
High Blood Pressure
High Blood Cholesterol Levels
Physical Inactivity
Obesity and Overweight
Diabetes Mellitus
Arrhythmias and Sudden
Cardiac Death
• It’s the sudden, abrupt loss of heart function
(i.e., cardiac arrest) in a person who may or
may not have diagnosed heart disease. The
time and mode of death are unexpected.
• Arrhythmias are disorders of the regular
rhythmic beating of the heart.
• About 330,000 people a year in the USA die of
coronary heart disease (CHD) either without
reaching the hospital or in the emergency
room. Not all of these are sudden deaths, but
many are. In fact, some estimates show that
almost ½ of all deaths from CHD are sudden
cardiac deaths.
Heart Failure
• Chronic heart failure (CHF) is epidemic in the
United States
• It is estimated that 5 million Americans currently
have CHF (2003) with 550,000 new cases added
each year.
• Five-year survival of CHF patients is less than
50%.
• There are several suggested reasons for the
increasing burden of CHF in the U.S. population,
including improved survival after acute
myocardial infarction results in more patients
with damaged myocardium who are prone to
developing CHF.
Prevalence of Heart Failure by Age
and Sex
NHANES: 1999-2002
10.9
Percent of Population
11
9.8
9
7
6.2
5.8
5
4.1
3
1
-1
1.8
0.3
0.3
20-34
2.3
1.5
0.5 0.4
35-44
45-54
55-64
Ages
Men
Source: CDC/NCHS and NHLBI.
Women
65-74
75+
Hospital Discharges for Heart Failure
by Sex
Discharges in Thousands
United States: 1979-2003
700
600
500
400
300
200
100
0
79 80
85
90
95
00
Years
Male
Female
Note: Hospital discharges include people discharged alive and dead.
Source: National Hospital Discharge Survey, CDC/NCHS and NHLBI.
03
Stroke
• On average, someone in the United
States suffers a stroke every 45
seconds; every 3 minutes someone
dies of one.
• 700,000 new/recurrent strokes in
2003.
Stroke
• Happens when a blood vessel in
the brain bursts or is blocked by a
blood clot or some other particle
Sometimes a part of a
blood vessel can
“balloon out” (called
an aneurysm) and
burst. This causes a
hemorrhagic stroke.
If a blood vessel in the brain becomes
blocked, an ischemic stroke occurs
Aftermath
• Stroke is the leading cause of serious, longterm disability
• The length of time to recover from a stroke
depends on its severity.
– Between 50 and 70 percent of stroke survivors regain
functional independence, but 15 to 30 percent are
permanently disabled, and 20 percent require
institutional care at three months after onset.
• 14% of those who survive a stroke will have
another one within one year
Prevalence of Stroke by Age
and Sex
NHANES: 1999-2002
Percent of Population
14
12.0
12
11.5
10
8
6.6 6.3
6
4
2
0.4
0.3
1.1 0.8
1.2
3.1 3.0
2.1
0
20-34
35-44
45-54
55-64
Ages
Men
Source: CDC/NCHS and NHLBI.
Women
65-74
75+
Warning Signs of Stroke
• Sudden weakness or numbness of the face, arm or
•
•
•
•
leg, especially on one side of the body
Sudden confusion, trouble speaking or
understanding
Sudden trouble seeing in one or both eyes
Sudden, severe headaches with no known cause
Sudden trouble walking, dizziness, loss of balance
or coordination
STROKE IS A MEDICAL EMERGENCY –
CALL 9-1-1
Risk Factors for Stroke
Those that can’t be changed:
• Age
• Prior stroke or heart attack
• Family history and ethnicity
Risk Factors for Stroke
Those that can be controlled, treated
or modified:
•
•
•
•
•
•
•
•
•
•
High blood pressure
Cigarette smoking
Diabetes mellitus
Carotid or other artery disease
Heart disease
Transient ischemic attacks (TIAs)
High red blood cell count
Sickle cell anemia
Atrial fibrillation
High blood cholesterol
Blood Pressure
The force created by the heart
as it pumps blood into the
arteries and through the
circulatory system.
High Blood Pressure
Chronic increase in blood pressure
above its normal range (less than 140/90
mm Hg in adults).
Impact
• Nearly one in three adults has HBP.
• The prevalence of hypertension in
blacks in the United States is among the
highest in the world.
• Listed as a primary or contributing
cause of death in about 277,000 deaths
in 2003.
• The estimated direct and indirect cost
for HBP in 2006 is $63.5 billion.
Prevalence of High Blood Pressure
in Americans by Age and Sex
Percent of Population
NHANES: 1999-2002
90
80
70
60
50
40
30
20
10
0
74.0
55.5
83.4
69.2
60.9
46.6
34.1 34.0
21.3 18.1
11.1
5.8
20-34
35-44
45-54
55-64
Ages
Men
Source: CDC/NCHS and NHLBI.
Women
65-74
75+
Congenital Heart and Blood
Vessel Defects
• Congenital cardiovascular defects,
also known as congenital heart
defects, are structural problems
arising from abnormal formation of
the heart or major blood vessels
• At least 15 distinct types of
congenital defects are recognized,
with many additional anatomic
variations.
Impact
• About 1 million Americans have a
congenital cardiovascular defect.
• 9.0 defects per 1,000 live births are
expected, or 36,000 babies per year in
the United States.
• Congenital cardiovascular disease is the
most common cause of infant death
from birth defects; one in three infants
who die from a birth defect have a heart
defect.
Peripheral Arterial Disease
• Peripheral arterial disease (PAD) in the legs is
due to atherosclerosis causing narrowing or
obstruction in the major arteries serving the
lower limbs.
• Affects about 8 million Americans and is
associated with significant morbidity and
mortality.
• Affects 12 to 20 percent of Americans 65 years
of age or older.
• People with PAD have impaired function and
quality of life.
Cost of Cardiovascular Disease
• The estimated direct and indirect
cost of CVD for 2006 is $403.1
billion.
• In 2001, $11.6 billion was paid to
Medicare beneficiaries for CHD
– $11,201 per discharge for acute MI
– $11,308 per discharge for coronary
atherosclerosis
– $3,513 per discharge for other
ischemic heart disease).
Cost of Cardiovascular Disease
• The 15 most costly medical conditions and the
estimated percent increase in total healthcare
spending for each condition from 1987–2000,
by order of rank, and their percentage impact
on health care spending (Health Affairs. Aug.
25, 2004):
–
–
–
–
–
heart disease (1) +8.06 percent
hypertension (5) +4.24 percent
cerebrovascular disease (7) +3.52 percent
diabetes (9) +2.37 percent
kidney disease (15) +1.03 percent
Estimated Direct and Indirect Costs of
Major Cardiovascular Diseases and
Stroke
Billions of Dollars
United States: 2006
160
140
120
100
80
60
40
20
0
142.5
57.9
63.5
Source: Heart Disease and Stroke Statistics – 2006 Update.
29.6
Hospital Discharges for Cardiovascular
Diseases as First Listed Diagnosis
United States: 1970-2003
Discharges in Millions
7
6
5
4
3
2
1
0
00
90
80
70
Years
Note: Hospital discharges include people discharged
both alive and dead.
Source: CDC/NCHS and NHLBI.
Trends in Cardiovascular Operations and
Procedures
United States: 1979-2003
Note: Inpatient procedures only.
Source: CDC/NCHS and NHLBI.
Additional Information
Jill Birnbaum
State Advocacy Consultant
[email protected]
952-278-3643
Q
A
Questions?