Transcript The Burden of Cardiovascular Disease in TEXAS Current Toll on Texas TODAY Weihua Li, MD, MPH, MS, Jane Osmond, MPH, RRT, Cardiovascular.

The Burden of Cardiovascular Disease in TEXAS
Current Toll on Texas TODAY
Weihua Li, MD, MPH, MS, Jane Osmond, MPH, RRT, Cardiovascular Health & Wellness Program; Tracy Haywood, Strategic Preparedness Branch, Texas Department of State Health Services
Cardiovascular disease (CVD) refers to any of the disorders that affect the circulatory system, including coronary heart
disease, congestive heart failure and stroke. One in three American adults, or an estimated 80.7 million people, has
one or more types of cardiovascular disease. In 2007, about 1.5 million Texas adults had been diagnosed with CVD or
stroke. The American Heart Association has estimated the direct and indirect cost of CVD in the US for 2008 will be
$448.5 billion.
A. Prevalence
Age-adjusted Rates Per 100,000
ics
s
te
s
an
isp
W
hi
m
al
es
s
es
an
H
African Hispanics
Americans
Am
er
ic
Whites
an
Females
100
60
40
20
0
Total
B. Mortality
Females
Whites
Blacks
Hispanics
Other
C. Financial Burden
Cardiovascular disease is a grouping of vascular diseases that affects the heart and circulatory system. Heart disease and
stroke—the two most common forms of cardiovascular disease (CVD)—are the first and third leading causes of death in
the United States and in Texas. CVD causes more deaths among both genders and all racial and ethnic groups than any
other disease.
The total hospital charges for CVD diagnoses have increased each year from 2001 to 2006. Among the specific CVD diseases,
total hospital charges were highest for ischemic heart disease, followed by congestive heart failure, ischemic stroke, and
hemorrhagic stroke.
Ischemic Heart Disease
The overall age-adjusted mortality rate (AAMR) for ischemic heart disease (IHD) declined from 202.4 per 100,000 in 1999
to 151.8 per 100,000 in 2005. The decrease was statistically significant. AAMR for males and females and for Whites
and African Americans also showed significant decline during the same period. AAMR for Hispanics, however, stayed
relatively level through 2002, and then showed a significant decline after 2005. In addition, among the race/ethnicity
groups, African Americans have a higher risk of dying from IHD than Whites, Hispanics and other races.
5 Year Average Age-Adjusted Mortality Rates for
Ischemic Heart Disease, Texas, 2001—2005
300
250
Total
Females
200
Males
150
African Americans
Hispanics
100
Whites
Other
50
2000
2001
2002
2003
2004
2005
Age-Adjusted Mortality
Rate Per 100,000
Average State Rate 166.7
(165.9-167.6) Per 100,000
Total Hospital Charges for Selected CVD Diagnoses
Texas 2001-2006
$8
Amount in Billions of Dollars
Ischemic Heart Disease (ICD 9 I20-I25), Seven Year
Mortality Rates by Gender & Race, Texas, 1999-2005
Age-Adjusted Mortality Rate Per 100,000
Males
Age-Adjusted Mortality Rate Per 100,000
Average State Rate 58.8 (58.3-59.4) Per 100,000
Data Source: Texas Vital Statistics Unit, Center for Health Statistics, DSHS, 1999-2005
Data source:: BRFSS, Center for Health Statistics, DSHS, 2007
0
1999
1999
2000
2001
2002
2003
2004
2005
80
Af
ric
Males
Fe
Nationwide Texas
-1.0%
M
al
0.0%
1.0%
xa
1.0%
3.0%
Te
2.0%
5.0%
id
e
3.0%
7.0%
nw
4.0%
Stroke (ICD 10 I60-I69), Seven Year Mortality by Gender & Race, Texas, 1999-2005
at
io
5.0%
5 Year Average Age-Adjusted Mortality Rates for
Stroke, Texas, 2001—2005
9.0%
N
6.0%
The overall age-adjusted mortality rate (AAMR) for stroke in Texas declined from 66.3 per 100,000 in 1999 to 52.1 per 100,000 in 2005.
The decrease was statistically significant. Females have significantly higher risk of dying from stroke than males. Among the
race/ethnicity groups, African Americans have significantly higher stroke mortality rates compared to Whites, Hispanics and other races.
AAMR for Whites showed a significant decrease from a high of 65.7 per 100,000 in 2001 to 50.7 per 100,000 in 2005.
Prevalence of Heart Disease by Gender & Race, Adults 18+— Texas 2007
Prevalence ( percent with 95% CI)
Prevalence (percent with 95% CI)
Prevalence of Stroke by Gender & Race, Adults 18+— Texas 2007
Stroke
Medicare
58%
$7
Medicaid
5%
$6
$5
$4
Other
2%
$3
$2
Self Pay
8%
Commercial
27%
$1
$0
2001
2002
2003
Congestive Heart Failure
Data source: Texas Vital Statistics Unit, Center for Health Statistics, DSHS, 1999-2005
Standard Source of Primary Payment for
Cardiovascular Disease in Texas, 2006
2004
2005
2006
Ischemic Stroke
Data Source: Texas Health Care Information Collection (THCIC), DSHS, 2001-2006
Hemorrhagic Stroke
Ischemic Heart Disease
Acknowledgement:
Support provided by Jennifer Smith, Adult Health and Chronic Disease Group,
Texas Department of State Health Services.