Lifetime Risk of Coronary Heart Disease in the Framingham Study

Lifetime Risk of Coronary Heart Disease in the Framingham StudyMen WomenAt age 40 years:48.6%31.7%At age 70 years:34.9%24.2%

Lloyd-Jones et al. Lancet 1999; 353:89-92 ___________________________________________________________________________________________________________________________________________________________________________________________

First Coronary Events: Framingham Study Percent as Specified EventMyocardialAngina SuddenInfarctionPectoris DeathAgeMen Women Men Women Men Women35-64 43% 28% 41% 59% 9%4%65-84 55% 44% 28% 41% 11%7.4%

Framingham Study 44 year follow-up.________________________________________________________________________________________________________________________________________________________________________________

Estimated 10-Year CHD Risk in 55-Year-Old Adults According to Levels of Various Risk Factors Framingham Heart Study

A B C DBlood Pressure (mm Hg)120/80140/90140/90140/90Total Cholesterol (mg/dL)200 240 240 240HDL Cholesterol (mg/dL) 50 50 40 40Diabetes No No Yes YesCigarettes No No No Yes

Chart15

55

138

2520

3727

Men

Women

Estimated 10-Year Rate (%)

Sheet1

CVDCVD2001 CVD total mortalityLCD BLACK M/F, 2001LCD AM. INDIAN M/F, 2001AgesMenWomenMenWomenNHES IIINHANES INHANES III

MalesFemales145,908141,80125-442.02.8A2.61.1Non-Hispanic WhitesNon-Hispanic BlacksMexican AmericansWhite Males163163155% of Men using PA to lose weight% of Men meeting PA guidelines% of Women using PA to lose weight% of Women meeting PA guidelinesNumber of TransplantsEST. COST OF CV DISEASES 2004

1979500469MALESFEMALESMALESFEMALES45-546.75.5B4.02.0Black Males171165166Whites66.522.863.520.1196823

80510490Coronary Heart Disease54502,18954CVD+cong.A33.5CVD+cong.A40.1D of H/St.A24.4D of H/St.A25.455-6413.18.4C5.43.5Awareness69.573.957.8White Females170166163Blacks70.122.662.816.9197010Heart Disease238.6

81500484Stroke18163,53818CancerB22.4CancerB20.8CancerB17.1CancerB19.165-7417.711.1D8.46.3Treatment60.163.040.3Black Females172174168Hispanics63.817.152.714.3197522Coronary Heart Disease133.2

82495484Congestive Heart Failure652,8286AccidentsC5.9DiabetesF5.1Acc.C14.0Acc.C8.275+18.616.1E14.819.1Control, Treated55.644.644.0Others68.423.063.520.6198057Stroke53.6

83498494High Blood Pressure546,7655Assault(Homicide)D4.6Nephritis, etc.G2.9C. Liver D.D4.8DiabetesE6.7F22.427.0Control, All Hypertensives33.428.117.7Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey1985719Hypertensive Disease55.5

84491493Diseases of the Arteries439,4044HIV(Aids)E3.7AccidentsC2.8DiabetesE4.3C. Lower res.D.F4.1Prevalence of Coronary Heart Disease by Age and SexNHES III, NHANES I, NHANES III: 1966-70, 1971-74 and 1988-94Leisure-time Physical Activity (PA) Patterns Among Overweight Adults by Race/Ethnicity and Sex19902,107Congestive Heart Failure28.8

85491498Rheumatic Fever/Rheumatic Heart Disease0.43,4890.4NHANES III: 1988-94Estimated 10 Year Stroke Risk in 55 Year Old AdultsBRFSS: 199819952,363Total CVD*368.4

86481498Congenital Cardiovascular Defects0.44,1090.4Leading Causes of Death for Black or African American Males and FemalesLeading Causes of Death for American Indian/Alaska Native Males and FemlaesAccording to Levels of Various Risk FactorsExtent of Awareness, Treatment and Control of High Blood Pressure by Race/Ethnicity20002,199

87475499Other13118,78613United States: 2001United States: 2001Framingham Heart StudyNHANES IV: 1999-200020022,154Estimated Direct and Indirect Costs (in Billions of Dollars) of Cardiovascular Diseases and Stroke

88476504100.8931,108100.0United States: 2004

89456486Trend in Heart Transplants

90448478Percentage Breakdown of Deaths From Cardiovascular DiseasesUnitedStates: 1968-2002

91447479United States:2001

92444479

93457500

94452498

95455505

96453506

97450503

98446504

99446513

00439507Non-Hispanic WhitesNon-Hispanic BlacksMexican Americans

01432499YearMalesFemales12% of high school students who participated in vigorous or moderate physical physical activity in past 7 daysMen5.47.68.1

70779597Whites76.644.218.2Women4.79.511.4

Cardiovascular Disease Mortality Trends for Males and FemalesMales71851628Blacks26.724.116.4Non-Hispanic White MalesNon-Hispanic White FemalesNon-Hispanic Black MalesNon-Hispanic Black FemalesHispanic MalesHispanic FemalesMalesFemales

United States: 1979-2001Males72935693ABCDEFCHF PREVALENCEMexican Americans34.317.317.5Vigorous73.759.872.447.868.852.4Non-Hispanic Whites12.45.3Prevalence of Age-Adjusted (2000) Physician-Diagnosed Diabetes in Americans Age 20 and Older by Sex and Race/Ethnicity

73982725Blood Pressure*95-105138-148138-148138-148138-148138-148MalesFemalesModerate29.824.723.716.525.918.5Non-Hispanic Blacks17.514.6NHANES III: 1988-94 NHANES III

741030756DiabetesNoNoYesYesYesYes20-240.10.1Prevalence of Current Smoking for Men Ages 18-24 by Education and Race/EthnicityHispanics21.38.8

751043789Cigarette SmokingNoNoNoYesYesYes25-340.10.1NHANES III: 1988-94Prevalence of Students in Grades 9-12 Who Participated in Sufficient Vigorousu.s. 1979-00

Prevalence of CVD, U.S. 1988-94 NHANES III761087843Prior AFNoNoNoNoYesYes35-440.70.5or Moderate Physical Activity During the Past 7 Days by Race/Ethnicity and SexPercentage of Overweight Among Students in Grades 9-12 by Sex and Race/EthnicityCatheterizationsOpen-HeartBypassPTCAEndarterectomyPacemakers

771111852Prior CVDNoNoNoNoNoYes45-541.81.3United States: 2001United States: 200119792991721145442

AgeMalesFemales78111084455-646.23.4803501971375544

20-245.54.6791014724* - Closest ranges for women are : 95-104 and 115-124.65-746.86.6814162221597326

25-3410.44.280104973775+9.89.7824732401708231

35-4417.413.6811095765MenWomen835122601919525

45-5434.228.982116084120-349.80.0Prevalence of Congestive Heart Failure by Age and Sex8457627820210339

55-6451.048.183122985235-4417.116.0NHANES III: 1988-948569030823010740

65-7465.265.284104484045-5432.330.5867863702848332

75+70.779.085120584655-6444.153.0878794093321568189

86125088965-7459.970.38894445735321170120

Females87126890175+68.884.18999846836824370107

Prevalence of Cardiovascular Diseases in Americans Age 20 and Older by Age and SexFemales8812208309010465013922666897

NHANES III :1988-94MenWomen891174819Prevalence of High Blood Pressure in Americans Age 20 and Over by Age and Sex91105751840730367121

DR FOR WOMEN, CV AND CANCER 2001A55901151795United States: 1999-200092108459046836791113

LCD HISPANIC M/F, 2001B138911146806WhitesBlacksMexican Americans93107860648536989123

White FemalesBlack Females63,31747,082C252092124788612

Estimated 10-Year Stroke Risk in 55-Year-Old Adults According to Levels of Various Risk Factors Framingham Heart StudyABCDEFSystolic BP*95-105130-148130-148130-148130-148130-148DiabetesNoNoYesYesYesYesCigarettesNoNoNoYesYesYesPrior Atrial Fib.NoNoNoNoYes YesPrior CVDNoNoNoNoNoYesSource: Stroke 1991;22:312-318.*BP in millimeters of mercury (mmHg)

Chart2

2.61.1

42

5.43.5

8.46.3

14.819.1

22.427

Men

Women


Sheet1












88476504100.8931,108100.0United States: 2004




92444479

93457500

94452498

95455505

96453506

97450503

98446504

99446513



70779597Whites76.644.218.2Women4.79.511.4










25-3410.44.280104973775+9.89.7824732401708231

35-4417.413.6811095765MenWomen835122601919525


55-6451.048.183122985235-4417.116.0NHANES III: 1988-948569030823010740

65-7465.265.284104484045-5432.330.5867863702848332

75+70.779.085120584655-6444.153.0878794093321568189

86125088965-7459.970.38894445735321170120

Females87126890175+68.884.18999846836824370107






ABCDEFSystolic BP*95-105130-148130-148130-148130-148130-148DiabetesNoNoYesYesYesYesCigarettesNoNoNoYesYesYesPrior Atrial Fib.NoNoNoNoYes YesPrior CVDNoNoNoNoNoYesEstimated 10-year stroke risk in 55-year-old adults according to levels of various risk factors (FHS). Source: Wolf et al., Stroke.1991;22:312-318.*BP in millimeters of mercury (mmHg)

Chart2

2.61.1

42

5.43.5

8.46.3

14.819.1

22.427

Men

Women


Sheet1












88476504100.8931,108100.0United States: 2004




92444479

93457500

94452498

95455505

96453506

97450503

98446504

99446513



70779597Whites76.644.218.2Women4.79.511.4










25-3410.44.280104973775+9.89.7824732401708231

35-4417.413.6811095765MenWomen835122601919525


55-6451.048.183122985235-4417.116.0NHANES III: 1988-948569030823010740

65-7465.265.284104484045-5432.330.5867863702848332

75+70.779.085120584655-6444.153.0878794093321568189

86125088965-7459.970.38894445735321170120

Females87126890175+68.884.18999846836824370107






Offspring CVD Risk by Parental CVD Status: Framingham StudyRisk Ratio2.521.510.50MenWomen1.01.72.21.01.71.7Adjusted for: age, total/HDL Chol. ratio, SBP, smoking, diabetes, BMIParental CVD

Multivariable RiskRisk imposed by a strong family history of heart attacks varies widely depending on the burden of modifiable risk factors

9Doubts about cholesterol as late as 1989

Risk of Coronary Heart Diseaseby Serum Cholesterol30-Year Follow-up, The Framingham Study*Trends Significant at P.001. +P.07. Age-Adjusted Annual Rate per 1000

Correlation Between Serum Cholesterol and CVD MortalityQ = serum cholesterol quintile. Kannel WB et al. Am Heart J. 1986;112:825-836.Multiple Risk Factor Intervention Trial (MRFIT) N=325,3466-Year CVD Death Rate Per 1000051015202530Q1(244)35-39 years40-44 years45-49 years50-54 years55-57 years Serum Cholesterol Quintile (mg/dL)Untreated Patients

Lifetime Risk of CHD Increases with Serum CholesterolFramingham Study: Subjects age 40 yearsDM Lloyd-Jones et al Arch Intern Med 2003; 1966-1972344457192933Cholesterol__________________________________________________________________________________________________________________________________________________________

Age-adjusted prevalence of Adults age 20 and older with LDL cholesterol of 130 mg/dL or higher, by race/ethnicity and sex (NHANES: 2003-2004). Source: NCHS and NHLBI. NH non-Hispanic.

Chart6

3232

3234

3230

3931

Men

Women

Percent of Population

OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0

Age-Adjusted Prevalence of Obesity* in Americans Ages 20-74 by Sex and Survey

NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 2001-2004

Source:Health US, 2004.

Obesity is defined as BMI of 30 plus.

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OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild

Estimated Percentage of Children With Serum Cholesterol of 170 mg/dl or More, United States

WhiteBlack

Males 0-9 Years2940

Females 0-9 Years3350

Males 10-19 Years2534


Estimated Percentage of Children With Serum Cholesterol of 170 mg/dL

or More, United States

Trends in Mean Total Blood Cholesterol Among Adolescents Ages 12-17 by Sex and Race and Survey

NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04

White Males163163155156

Black Males171165166161`

White Females170166163164

Black Females172174168161

`

cholchild

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White

Black


diabetes

1976-80

1988-94

1999-02

2003-04

Mean Total Blood Cholesterol

Strokerace

NH WhitesNH BlacksMexican Americans

Men6.710.711.0

Women5.613.210.9

Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Americans Age 20 and Older by Sex and Race/Ethnicity

NHANES: 1999-2004

WhitesBlacksMexican Americans

122.95.46.4

Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Women Ages 25-64

by Education and Race/Ethnicity

NHANES III: 1988-94

OLD

Winkleby et al.


Less than high school7.512.010.1

High school5.69.76.0

More than high school4.29.89.8

Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Americans Age 18+

by Education, Race/Ethnicity and Years of Education

NHANES: 1999-2004

`

NCHS and NHLBI.

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Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool

Less than high school

High school

More than high school


Metsyndr.

Relative Risk of Deaths due to StrokeCompared to Non-Hispanic Whites, by Race/Ethnicity and Age Groups, U.S., 1997

Non-Hispanic BlacksAmerican Indians/ Alaska NativesAsian/Pacific IslandersHispanics

35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5

Risk for Stroke Mortality Among Racial/Ethnic Groups Compared With Non-Hispanic Whites,

by Age Groups

United States: 1997

Metsyndr.

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

PhysicAct.

Estiamted % of Americans Age 20 and Over with High-Risk LDL-Cholesterol of 130 mg/dL or More by Race and Sex

MenWomen

Total Population32.032.0

NH Whites32.034.0

NH Blacks32.030.0

Mexican Americans39.031.0

Age-Adjusted Prevalence of Americans Age 20 and Older With

LDL-Cholesterol of 130 mg/dL or Higher by Race/Ethnicity and Sex

United States: 2003-04

MenWomen

Total259

NH Whites269

NH Blacks167

Mexican Americans2813

Estimated Age-Adjusted (2000) Prevalence of Adults Age 20 and Over With

HDL-Cholesterol Under 40 mg/dL by Race and Sex

United States: NHANES 2003-2004

PhysicAct.

Men

Women


smokmf

Men

Women


NHANESrf

`NH WhitesNH BlacksHispanics

Males24.914.024.8

Females27.011.919.2

Prevalence of High School Students in Grades 9-12 Reporting Current Cigarette Use

Within the last 30 days by Race/Ethnicity and Sex

YRBS: 2005

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NHANESrf

Males

Females


oweight hs

CHD MortalityCVD MortalityTotal Mortality

No MetS or DM2.65.314.4

MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0

Prior CVD and DM17.028.144.1

Total Mortality Rates in US Adults Age 30-75, with Metabolic Syndrome, With and Without Diabetes and Pre-Existing CVD

NHANES1976-80 Follow-Up Study

oweight hs

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM

Deaths/1,000 Person Years

RFNHANES

% of high school students who participated in vigorous or moderate physical physical activity in past 7 days

NH WhiteNH BlackHispanicBMI

Age-adjusted prevalence of Adults age 20 and older with HDL cholesterol

Trends in mean total serum cholesterol among adults age 20 and older, by race/ethnicity, sex and survey (NHANES : 1988-94, 1999-02 and 2003-04). Source: NCHS and NHLBI. NH non-Hispanic.

Chart1

206204202

204199197

205202201

1988-94

1999-02

2003-04

Mean Serum Total Cholesterol

Sheet1

HF PREVALENCECHD MortalityCVD MortalityTotal Mortality

MenWomenNo MetS or DM2.65.314.4

20-390.30.2MetS w/o DM4.37.817.1

40-592.01.5MetS w/DM4.88.621.1

60-797.25.2DM only6.311.526.1

80+11.612.4Prior CVD10.916.730.0


Chart 7A: Prevalence of heart failure by sex and ageChart 10A: Total mortality rates in U.S. adults, ages 3075, with metabolic syndrome (MetS), with and without diabetes mellitus (DM) and pre-existing CVD

NHANES: 199904NHANES II 197680 Follow-Up Study*

Source : NCHS and NHLBI.Source: Malik et al.(10) *Average of 13 years of follow-up.

Chart 7B: Hospital discharges for heart failure by sex

United States: 19702004

Note: Hospital discharges include those inpatients discharged alive, dead or status unknown. Source: NHDS, NCHS and personal communication with NHLBI.

Hospital Discharges for HF

CHF Discharges

-----------In thousands------

MalesFemales

708074

7986

98102

107111

121113

75122131

123143

143152

157173

174203

80176224

182240

195243

208255

228303

85247310

274308

269336

277357

304339

90315386

360405

373449

394481

390484

95378494

377493

431526

438540

430532

00418581

444551

441529

471566

04524575

Chart 7C. Incidence of heart failure* by age and sex

FHS 19802003

* - HF based on physician review of medical records and strict diagnostic criteria.

Source: NHLBI.(10)

7010

7522

8057

85719

902,107

952,363

002,199

052,125

Chart 13A: Trends in heart transplants

UNOS: 19702005

Source: United Network for Organ Sharing (UNOS), scientific registry data.

est. cv oper. & proc

u.s. 1979-03 (000)

CatheterizationsOpen-HeartBypassPTCACarotid EndarterectomyPacemakers

`NH WhitesNH BlacksHispanics792991721145442

Males24.914.024.8803501971375544

Females27.011.919.28569030823010740

9010465013922666897

Chart 9A: Prevalence of high school students in grades 912 reporting current cigarette use951137722573419132136

by sex and race/ethnicity001318686519561124152

YRBS: 2005011314690516571128177

021463709515657134199

04129764642766498170

Chart 13B: Trends in cardiovascular inpatient operations and procedures


Source: MMWR.4 NH indicates non-Hispanic.

MenWomen

NH White24.120.4

NH Black23.920.2

Hispanic18.915

Asian17.811.3Source: NHDS. NCHS and NHLBI. Note: In-hospital procedures only.

American Indian or Alaska Native37.333.4

Chart 9B: Prevalence of current smoking for Americans age 18 and older by race/ethnicity and sexEST. COST OF CV DISEASES 2007

NHIS: 2004Coronary Heart Disease142.5

Stroke57.9

Hypertensive Disease63.5

Heart Failure29.6

Chart 14A: Estimated direct and indirect costs (in billions of dollars) of major cardiovascular diseases and stroke

United States: 2007


1988-941999-022003-04

NH White206204202

NH Black204199197

Mexican American205202201Source: NHLBI

Chart 9C: Trends in mean total serum cholesterol among adults by race, sex and survey

NHANES: 198894, 199902 and 200304

Source: NCHS and NHLBI.

Note: Needs split scale.

1976-801988-941999-022003-04


Black Males171165166161



Chart 9D: Trends in mean total serum cholesterol among adolescents ages 1217 by race, sex and survey

NHANES:1976-80,1988-94, 1999-02 and 2003-04


Note: Needs split scale.

MenWomen


NH Whites32.034.0

NH Blacks32.030.0


Chart 9E: Age-adjusted prevalence of Americans age 20 and older with

LDL cholesterol of 130 mg/dL or higher by race/ethnicity and sex

NHANES: 200304


MenWomen

Total259

NH Whites269

NH Blacks167


Chart 9F: Age-adjusted prevalence of Americans age 20 and older with

HDL cholesterol under 40 mg/dL by race/ethnicity and sex

NHANES: 200304


NH WhiteNH BlackHispanic

Male46.938.239

Female30.221.326.5

Chart 9G: Prevalence of students in grades 912 who met currently recommended

levels of physical activity during the past 7 days by race/ethnicity and sex

YRBS: 2005

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 60 minutes/day on 5 or more of the 7 days preceding the survey. Source: MMWR.1

Source:YRBS (4)

19942004

NH White Male26.418.4

NH Black Male34.227.0

Hispanic Male37.532.5

Asian/Pacific Islander Male25.020.4

Am. Indian/Alaska Native Male34.423.8

NH White Female28.321.6

NH Black Female45.733.9

Hispanic Female44.839.6

Asian/Pacific Islander Female31.524.0

Am. Indian/Alaska Native Female36.331.8

Chart 9H: Prevalence of leisure-time physical inactivity among adults age 18 and older by race/ethnicity and sex

BRFSS: 1994 and 2004

Source: MMWR.(11) NH indicates non-Hispanic.

MalesFemales

NH Whites15.28.2

NH Blacks15.916.1

Hispanics21.312.1

Chart 9i: Prevalence of overweight among students in grades 912 by sex and race/ethnicity

YRBS: 2005

Source: BMI 95th percentile or higher by age and sex of the CDC 2000 growth chart. MMWR.(2) NH indicates non-Hispanic.

MenWomen

65-749.24.7

75-8422.314.8

85-9443.030.7

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0

Chart 9J: Age-adjusted prevalence of obesity in Americans ages 2074 by sex and survey

NHES 196062; NHANES: 197174, 197680, 198894 and 200104

Note: Obesity is defined as a BMI of 30.0 or higher. Source: Health, United States, 2006; Unpublished data, NCHS.

6-1112-19

1971-744.33.6

1976-806.66.4

1988-9411.611.0

2001-200418.716.3

Chart 9K: Trends in the prevalence of overweight among U.S. children and adolescents by age and survey

NHANES: 197174, 197680; 198894 and 200104

Source: Health, United States, 2006. Unpublished data. NCHS.


Men69.89.9

Women4.512.211

Chart 9L: Prevalence of physician-diagnosed diabetes in Americans age 20 and older by race/ethnicity and sex

NHANES: 19992004

NCHS and NHLBI





Chart 9M. Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Americans Age 18+


NHANES: 1999-2004


Sheet1

10.712.212.820.630.2

15.716.817.12634

1960-62

1971-74

1976-80

1988-94

2001-2004


Sheet2

4.36.611.618.7

3.66.41116.3

1971-74

1976-80

1988-94

2001-2004


Sheet3

185.303214.49

190.125240.37

194.834252.488

207.11257.35

221.391275.644

236.69317.084

258.645326.377

287.202327.978

281.616347.436

288.585374.508

312.253351.142

324.63397.288

369.68417.005

383.856455.757

403.565490.614

395.02491.788

383.917496.515

381.013496.109

436.463530.027

442.23547.189

433.785540.992

421.896585.791

446.166553.626

442.772530.311

495.774597.144

524575

Male

Female

Years

Discharges in Thousands

299172114795442

350197137805544

6903082308510740

10465013922666897

1137722573419132136

1318686519561124152

129764642766498170

Catheterizations

Open-Heart

Bypass

PCI

Carotid Endarterectomy

Pacemakers

Years

Procedures in Thousands

24.927

1411.9

24.819.2

Males

Females


24.123.918.917.837.3

20.420.21511.333.4

NH White

NH Black

Hispanic

Asian

American Indian or Alaska Native


46.938.239

30.221.326.5

NH White

NH Black

Hispanic

Sex and Race/Ethnicity


151.6

62.7

66.4

33.2

Billions of Dollars

0.30.2

21.5

7.25.2

11.612.4

Men

Women


206204202

204199197

205202201

1988-94

1999-02

2003-04


2.64.34.86.310.917

5.37.88.611.516.728.1

14.417.121.126.13044.1

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


MBD000CD551.xls

Chart3

163163155156

171165166161

170166163164

172174168161

1976-80

1988-94

1999-02

2003-04


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





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OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild


WhiteBlack

Males 0-9 Years2940







NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04





`

cholchild

&A

Page &P

White

Black


diabetes

1976-80

1988-94

1999-02

2003-04


Strokerace


Men69.89.9

Women4.512.211


NHANES: 1999-2002


122.95.46.4



NHANES III: 1988-94

DELETE

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

smokhschool

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

Metsyndr.


MenWomen


NH Whites32.034.0

NH Blacks32.030.0





MenWomen

Total259

NH Whites269

NH Blacks167





Metsyndr.

Men

Women


PhysicAct.

Men

Women


smokmf


Males24.914.024.8

Females27.011.919.2



YRBS: 2005

&A

Page &P

smokmf

Males

Females


NHANESrf



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




NHANESrf

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


oweight hs



Trends in mean total blood cholesterol among adolescents ages 12-17 by race, sex, and survey (NHES: 1966-70; NHANES: 1971-74 and 1988-94). Source: NCHS and NHLBI.

Chart3

163163155156

171165166161

170166163164

172174168161

1976-80

1988-94

1999-02

2003-04


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild


WhiteBlack

Males 0-9 Years2940







NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04





`

cholchild

&A

Page &P

White

Black


diabetes

1976-80

1988-94

1999-02

2003-04


Strokerace


Men69.89.9

Women4.512.211


NHANES: 1999-2002


122.95.46.4



NHANES III: 1988-94

DELETE

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

smokhschool

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

Metsyndr.


MenWomen


NH Whites32.034.0

NH Blacks32.030.0





MenWomen

Total259

NH Whites269

NH Blacks167





Metsyndr.

Men

Women


PhysicAct.

Men

Women


smokmf


Males24.914.024.8

Females27.011.919.2



YRBS: 2005

&A

Page &P

smokmf

Males

Females


NHANESrf



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




NHANESrf

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


oweight hs



CK Friedberg on Hypertension: Diseases of the Heart 1996 There is a lack of correlation in most cases between the severity and duration of hypertension and development of cardiac complications._______________________________________________________________________________________________________________________

Relation of Non-Hypertensive Blood Pressure to Cardiovascular DiseaseVasan R, et al. N Engl J Med 2001; 345:1291-129710-year Age- Adjusted Cumulative IncidenceHazard Ratio*SBPWomenMen

Prevalence of high blood pressure in Adults by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI.

Chart1

11.26.4

23.218.3

37.537.4

49.155.4

63.673.9

69.583.8

Men

Women


HYPPRSEX

MenWomen

20-3411.26.4

35-4423.218.3

45-5437.537.4

55-6449.155.4

65-7463.673.9

75+69.583.8

Prevalence of High Blood Pressure in Americans Age 18 and Over by Age and Sex

NHANES: 1999-2004

&A

Page &P

HYPPRSEX

Men

Women


Extent of awareness, treatment and control of high blood pressure by age (NHANES : 1999-2004.) Source: NCHS and NHLBI.

Chart1

52.374.675.3

35.862.568.4

24.639.834.3

20-39

40-59

60+


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild


WhiteBlack

Males 0-9 Years2940







NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04





`

cholchild

&A

Page &P

White

Black


diabetes

1976-80

1988-94

1999-02

2003-04


Strokerace


Men6.710.711.0

Women5.613.210.9


NHANES: 1999-2004


122.95.46.4



NHANES III: 1988-94

OLD

Winkleby et al.







NHANES: 1999-2004

`

NCHS and NHLBI.

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool


High school



Metsyndr.



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

Metsyndr.

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

PhysicAct.


MenWomen


NH Whites32.034.0

NH Blacks32.030.0





MenWomen

Total259

NH Whites269

NH Blacks167





PhysicAct.

Men

Women


smokmf

Men

Women


NHANESrf


Males24.914.024.8

Females27.011.919.2



YRBS: 2005

&A

Page &P

NHANESrf

Males

Females


oweight hs



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




oweight hs

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


RFNHANES



Age-adjusted prevalence trends for high blood pressure in Adults age 20 and older by race/ethnicity, sex and survey (NHANES: 1988-94 and 1999-2004). Source: NCHS and NHLBI.

Chart1

25.628.5

22.928

37.539

38.241.4

26.926.2

2527

1988-94

1999-04


Sheet1 (2)

1988-941999-022003-041988-941999-04

NH White-Only Men25.627.531.0NH White-Only Men25.628.5

NH White- Only Women22.928.428.4NH White- Only Women22.928.0

NH Black or AA Men37.540.440.3NH Black or AA Men37.539.0

NH Black or AA Women38.243.441.6NH Black or AA Women38.241.4

Mexican Men26.926.727.3Mexican Men26.926.2

Mexican Women25.027.829.9Mexican Women25.027.0

Age-Adjusted Prevalence Trends for High Blood Pressure in Americans,Age-Adjusted Prevalence Trends for High Blood Pressure in Americans,

Ages 20 and Over by Race/Ethnicity, Sex and SurveyAges 20 and Over by Race/Ethnicity, Sex and Survey

NHANES:1988-94, 1999-2002 and 2003-2004NHANES:1988-94 and 1999-2004

Elevated BP or taking antihypertensive medication.

Sheet1 (2)

1988-94

1999-02

2003-04


Sheet1

1988-94

1999-04


1976-801988-941999-00

Non-Hispanic White Men45.025.628.9

Non-Hispanic White Women33.719.724.7

Non-Hispanic Black Men50.736.538.0

Non-Hispanic Black Women51.136.441.0

Mexican Men25.625.930.6

Mexican Women22.522.325.0

Age-Adjusted Prevalence Trends for High Blood Pressure in Americans, Ages 2074 by Race/Ethnicity, Sex and Survey

NHANES: 197680, 1988-94 and 1999-2000

4525.628.9

33.719.724.7

50.736.538

51.136.441

25.625.930.6

22.522.325

1976-80

1988-94

1999-00


Extent of Awareness, Treatment and Control of High Blood Pressure by Race/Ethnicity (NHANES: 1999-2004).Source: NCHS and NHLBI.

Chart1

72.976.962.4

63.466.949.1

37.233.625.1

NH Whites

NH Blacks

Mexican Americans


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild


WhiteBlack

Males 0-9 Years2940







NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04





`

cholchild

&A

Page &P

White

Black


diabetes

1976-80

1988-94

1999-02

2003-04


Strokerace


Men6.710.711.0

Women5.613.210.9


NHANES: 1999-2004


122.95.46.4



NHANES III: 1988-94

OLD

Winkleby et al.







NHANES: 1999-2004

`

NCHS and NHLBI.

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool


High school



Metsyndr.



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

Metsyndr.

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

PhysicAct.


MenWomen


NH Whites32.034.0

NH Blacks32.030.0





MenWomen

Total259

NH Whites269

NH Blacks167





PhysicAct.

Men

Women


smokmf

Men

Women


NHANESrf


Males24.914.024.8

Females27.011.919.2



YRBS: 2005

&A

Page &P

NHANESrf

Males

Females


oweight hs



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




oweight hs

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


RFNHANES



CK Friedberg on HypertensionDiseases of the Heart 1966 Hypertension imposes a load on the heart which for many years may be compensated by left ventricular hypertrophy

_______________________________________________________________

CVD Risk Imposed by ECG-LVH Framingham Study 36-yr. Follow-upAge-adjusted Risk Excess Risk Rate per 1000 Ratio per 1000Age Men Women Men Women Men Women35-64 164 135 4.7*** 7.4*** 129 11765-94 234 235 2.8*** 4.1*** 51 178

Biennial Rate per 1000. CVD=CHD, stroke, peripheral vascular disease, heart failure***P

Smoking Statement Issued in 1956 by American Heart Association It is the belief of the committee that much greater knowledge is needed before any conclusions can be drawn concerning relationships between smoking and death rates from coronary heart disease. The acquisition of such knowledge may well require the use of techniques and research methods that have not hitherto been applied to this problem.Circulation 1960; vol. 23__________________________________________________________________________________________________________________________________________________________________________________

CHD Risk by Cigarette Smoking. Filter Vs. Non-filter. Framingham Study. Men

Prevalence of current smoking for Adults age 18 and older by race/ethnicity and sex (NHIS:2004).Source: MMWR. 2004;54:1121-24. NH non-Hispanic.

Chart1

24.123.918.917.837.3

20.420.21511.333.4

NH White

NH Black

Hispanic

Asian



OVERWT

1960-621971-741976-801988-941999-2002

Men10.712.212.820.628.1

Women15.716.817.126.034.0





&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

1999-2002


cholchild


WhiteBlack

Males 0-9 Years2940







NHES:1966-70; NHANES:1971-74 and 1988-94

1966-701971-741988-94





`

cholchild

&A

Page &P

White

Black


diabetes

1966-70

1971-74

1988-94


Strokerace


Men6.210.310.4

Women4.712.611.3


NHANES: 1999-2002


122.95.46.4



NHANES III: 1988-94

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

smokhschool

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

Metsyndr.


MenWomen


NH Whites43.836.9

NH Blacks36.034.5




United States:1999-2002

MenWomen

Total33.612.6

NH Whites34.512.4

NH Blacks22.711.3





Metsyndr.

Men

Women


PhysicAct.

Men

Women


smokmf


Males23.319.319.1

Females26.610.817.7



YRBS: 2003

&A

Page &P

smokmf

Males

Females


NHANESrf



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




NHANESrf

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


oweight hs


NH White MalesNH White FemalesNH Black MalesNH Black FemalesHispanic MalesHispanic FemalesBMI

Prevalence of high school students in grades 9-12 reporting current cigarette smoking by race/ethnicity and sex. (YRBS:2005). Source: MMWR. 2006;55:SS-5. June 9, 2006. . NH non-Hispanic.

Chart2

24.927

1411.9

24.819.2

Males

Females


Sheet1

HF PREVALENCECHD MortalityCVD MortalityTotal Mortality

MenWomenNo MetS or DM2.65.314.4

20-390.30.2MetS w/o DM4.37.817.1

40-592.01.5MetS w/DM4.88.621.1

60-797.25.2DM only6.311.526.1

80+11.612.4Prior CVD10.916.730.0


Chart 7A: Prevalence of heart failure by sex and ageChart 10A: Total mortality rates in U.S. adults, ages 3075, with metabolic syndrome (MetS), with and without diabetes mellitus (DM) and pre-existing CVD

NHANES: 199904NHANES II 197680 Follow-Up Study*

Source : NCHS and NHLBI.Source: Malik et al.(10) *Average of 13 years of follow-up.

Chart 7B: Hospital discharges for heart failure by sex


Note: Hospital discharges include those inpatients discharged alive, dead or status unknown. Source: NHDS, NCHS and personal communication with NHLBI.

Hospital Discharges for HF

CHF Discharges

-----------In thousands------

MalesFemales

708074

7986

98102

107111

121113

75122131

123143

143152

157173

174203

80176224

182240

195243

208255

228303

85247310

274308

269336

277357

304339

90315386

360405

373449

394481

390484

95378494

377493

431526

438540

430532

00418581

444551

441529

471566

04524575

Chart 7C. Incidence of heart failure* by age and sex

FHS 19802003

* - HF based on physician review of medical records and strict diagnostic criteria.

Source: NHLBI.(10)

7010

7522

8057

85719

902,107

952,363

002,199

052,125

Chart 13A: Trends in heart transplants

UNOS: 19702005

Source: United Network for Organ Sharing (UNOS), scientific registry data.

est. cv oper. & proc

u.s. 1979-03 (000)

CatheterizationsOpen-HeartBypassPTCACarotid EndarterectomyPacemakers

`NH WhitesNH BlacksHispanics792991721145442

Males24.914.024.8803501971375544

Females27.011.919.28569030823010740

9010465013922666897

Chart 9A: Prevalence of high school students in grades 912 reporting current cigarette use951137722573419132136

by sex and race/ethnicity001318686519561124152

YRBS: 2005011314690516571128177

021463709515657134199

04129764642766498170

Chart 13B: Trends in cardiovascular inpatient operations and procedures



MenWomen

NH White24.120.4

NH Black23.920.2

Hispanic18.915

Asian17.811.3Source: NHDS. NCHS and NHLBI. Note: In-hospital procedures only.

American Indian or Alaska Native37.333.4

Chart 9B: Prevalence of current smoking for Americans age 18 and older by race/ethnicity and sexEST. COST OF CV DISEASES 2007

NHIS: 2004Coronary Heart Disease142.5

Stroke57.9

Hypertensive Disease63.5

Heart Failure29.6

Chart 14A: Estimated direct and indirect costs (in billions of dollars) of major cardiovascular diseases and stroke

United States: 2007


1988-941999-022003-04

NH White206204202

NH Black204199197

Mexican American205202201Source: NHLBI

Chart 9C: Trends in mean total serum cholesterol among adults by race, sex and survey

NHANES: 198894, 199902 and 200304


1976-801988-941999-022003-04


Black Males171165166161



Chart 9D: Trends in mean total serum cholesterol among adolescents ages 1217 by race, sex and survey

NHANES:1976-80,1988-94, 1999-02 and 2003-04


MenWomen


NH Whites32.034.0

NH Blacks32.030.0


Chart 9E: Age-adjusted prevalence of Americans age 20 and older with

LDL cholesterol of 130 mg/dL or higher by race/ethnicity and sex

NHANES: 200304


MenWomen

Total259

NH Whites269

NH Blacks167


Chart 9F: Age-adjusted prevalence of Americans age 20 and older with

HDL cholesterol under 40 mg/dL by race/ethnicity and sex

NHANES: 200304


NH WhiteNH BlackHispanic

Male46.938.239

Female30.221.326.5

Chart 9G: Prevalence of students in grades 912 who met currently recommended

levels of physical activity during the past 7 days by race/ethnicity and sex

YRBS: 2005

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 60 minutes/day on 5 or more of the 7 days preceding the survey. Source: MMWR.1

Source:YRBS (4)

19942004

NH White Male26.418.4

NH Black Male34.227.0

Hispanic Male37.532.5

Asian/Pacific Islander Male25.020.4

Am. Indian/Alaska Native Male34.423.8

NH White Female28.321.6

NH Black Female45.733.9

Hispanic Female44.839.6

Asian/Pacific Islander Female31.524.0

Am. Indian/Alaska Native Female36.331.8

Chart 9H: Prevalence of leisure-time physical inactivity among adults age 18 and older by race/ethnicity and sex

BRFSS: 1994 and 2004

Source: MMWR.(11) NH indicates non-Hispanic.

MalesFemales

NH Whites15.28.2

NH Blacks15.916.1

Hispanics21.312.1

Chart 9i: Prevalence of overweight among students in grades 912 by sex and race/ethnicity

YRBS: 2005

Source: BMI 95th percentile or higher by age and sex of the CDC 2000 growth chart. MMWR.(2) NH indicates non-Hispanic.

MenWomen

65-749.24.7

75-8422.314.8

85-9443.030.7

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0

Chart 9J: Age-adjusted prevalence of obesity in Americans ages 2074 by sex and survey

NHES 196062; NHANES: 197174, 197680, 198894 and 200104

Note: Obesity is defined as a BMI of 30.0 or higher. Source: Health, United States, 2006; Unpublished data, NCHS.

6-1112-19

1971-744.33.6

1976-806.66.4

1988-9411.611.0

2001-200418.716.3

Chart 9K: Trends in the prevalence of overweight among U.S. children and adolescents by age and survey

NHANES: 197174, 197680; 198894 and 200104

Source: Health, United States, 2006. Unpublished data. NCHS.


Men69.89.9

Women4.512.211

Chart 9L: Prevalence of physician-diagnosed diabetes in Americans age 20 and older by race/ethnicity and sex

NHANES: 19992004

NCHS and NHLBI





Chart 9M. Prevalence of Non-Insulin-Dependent (Type 2) Diabetes in Americans Age 18+


NHANES: 1999-2004


Sheet1

10.712.212.820.630.2

15.716.817.12634

1960-62

1971-74

1976-80

1988-94

2001-2004


Sheet2

4.36.611.618.7

3.66.41116.3

1971-74

1976-80

1988-94

2001-2004


Sheet3

185.303214.49

190.125240.37

194.834252.488

207.11257.35

221.391275.644

236.69317.084

258.645326.377

287.202327.978

281.616347.436

288.585374.508

312.253351.142

324.63397.288

369.68417.005

383.856455.757

403.565490.614

395.02491.788

383.917496.515

381.013496.109

436.463530.027

442.23547.189

433.785540.992

421.896585.791

446.166553.626

442.772530.311

495.774597.144

524575

Male

Female

Years

Discharges in Thousands

299172114795442

350197137805544

6903082308510740

10465013922666897

1137722573419132136

1318686519561124152

129764642766498170

Catheterizations

Open-Heart

Bypass

PCI

Carotid Endarterectomy

Pacemakers

Years

Procedures in Thousands

24.927

1411.9

24.819.2

Males

Females


24.123.918.917.837.3

20.420.21511.333.4

NH White

NH Black

Hispanic

Asian



46.938.239

30.221.326.5

NH White

NH Black

Hispanic

Sex and Race/Ethnicity


151.6

62.7

66.4

33.2

Billions of Dollars

0.30.2

21.5

7.25.2

11.612.4

Men

Women


206204202

204199197

205202201

1988-94

1999-02

2003-04


2.64.34.86.310.917

5.37.88.611.516.728.1

14.417.121.126.13044.1

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


MBD000CD551.xls

Chart3

163163155156

171165166161

170166163164

172174168161

1976-80

1988-94

1999-02

2003-04


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild


WhiteBlack

Males 0-9 Years2940







NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04





`

cholchild

&A

Page &P

White

Black


diabetes

1976-80

1988-94

1999-02

2003-04


Strokerace


Men69.89.9

Women4.512.211


NHANES: 1999-2002


122.95.46.4



NHANES III: 1988-94

DELETE

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

smokhschool

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

Metsyndr.


MenWomen


NH Whites32.034.0

NH Blacks32.030.0





MenWomen

Total259

NH Whites269

NH Blacks167





Metsyndr.

Men

Women


PhysicAct.

Men

Women


smokmf


Males24.914.024.8

Females27.011.919.2



YRBS: 2005

&A

Page &P

smokmf

Males

Females


NHANESrf



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




NHANESrf

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


oweight hs



Diseases of The HeartCharles K Friedberg MD, WB Saunders Co. Philadelphia, 1949 The proper control of diabetes is obviously desirable even though there is uncertainty as to whether coronary atherosclerosis is more frequent or severe in the uncontrolled diabetic ______________________________________________________________________________________________________________________________

Risk of Cardiovascular Events in Diabetics Framingham Study Age-adjusted Biennial Rate Age-adjusted Per 1000 Risk RatioCardiovascular Event Men Women Men WomenCoronary Disease 39 21 1.5** 2.2***Stroke15 6 2.9*** 2.6***Peripheral Artery Dis. 18 18 3.4*** 6.4***Cardiac Failure 23 21 4.4*** 7.8***All CVD Events 76 65 2.2*** 3.7***

Subjects 35-64 36-year Follow-up **P

Age-adjusted prevalence of physician-diagnosed diabetes in Adults age 18 and older by race/ethnicity and sex (NHANES: 1999-2004). Source: NCHS and NHLBI. NH non-Hispanic.

Chart3

6.710.711

5.613.210.9

NH Whites

NH Blacks

Mexican Americans


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

2001-2004


cholchild


WhiteBlack

Males 0-9 Years2940







NHANES:1976-80,1988-94, 1999-02 and 2003-04

1976-801988-941999-022003-04





`

cholchild

&A

Page &P

White

Black


diabetes

1976-80

1988-94

1999-02

2003-04


Strokerace


Men6.710.711.0

Women5.613.210.9


NHANES: 1999-2004


122.95.46.4



NHANES III: 1988-94

OLD

Winkleby et al.







NHANES: 1999-2004

`

NCHS and NHLBI.

&A

Page &P

Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool


High school



Metsyndr.



35-444.01.91.31.3

45-543.91.31.31.3

55-643.01.51.41.2

65-741.90.91.10.9

75-841.20.81.00.6

85+0.90.40.70.5


by Age Groups

United States: 1997

Metsyndr.

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

PhysicAct.


MenWomen


NH Whites32.034.0

NH Blacks32.030.0





MenWomen

Total259

NH Whites269

NH Blacks167





PhysicAct.

Men

Women


smokmf

Men

Women


NHANESrf


Males24.914.024.8

Females27.011.919.2



YRBS: 2005

&A

Page &P

NHANESrf

Males

Females


oweight hs



MetS w/o DM4.37.817.1

MetS w/DM4.88.621.1

DM only6.311.526.1

Prior CVD10.916.730.0




oweight hs

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


RFNHANES



Mortality rates in U.S. adults, age 30-75, with metabolic syndrome (MetS), with and without diabetes mellitus (DM) and pre-existing CVD (NHANES II: 1976-80 Follow-up Study). ** Source: Malik et al., Circulation. 2004;110:1245-50. ** Average of 13 years of follow-up. Note: Age and gender adjusted.

Chart7

2.64.34.86.310.917

5.37.88.611.516.728.1

14.417.121.126.13044.1

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM

Deaths/1000 Person Years

OVERWT

1960-621971-741976-801988-941999-20021960-621971-741976-801988-941999-2000

Men10.712.112.720.627.6Overweight43.346.146.054.464.5

Women15.816.617.025.933.2Obese13.414.51523.330.5

Age-Adjusted Prevalence of Obesity* in Americans Ages 20-74 by Sex and SurveyOverweight and Obesity for Americans age 20-74 by Survey

NHES and NHANES: 1960--62, 1971--74, 1976--80, 1988--94 and 1999-2002United States: 1960--62, 1971--74, 1976--80, 1988--94 and 1999-2000

??????

Source:Respective health examination surveys,CDC/NCHS.



1225.428.327.5

Mean BMI for Women Ages 25-64 by Education and Race/Ethnicity


&A

Page &P

OVERWT

1960-62

1971-74

1976-80

1988-94

1999-2002


CHOL240

1960-62

1971-74

1976-80

1988-94

1999-2000


CHOL200

Whites

Blacks

Mexican Americans

Years of Education

Mean BMI, kg/m2

cholchild

Non-HispanicNon-HispanicNon-HispanicNon-Hispanic

White MalesWhite FemalesBlack MalesBlack Females

20-3498.29.47

35-4419.711.314.59.5

45-5426.32518.226.8

55-6431.539.927.847.7

65-7427.644.129.142.8

75+19.739.426.635.9

Estimated Percentage of Americans Age 20 and Over With Serum Cholesterol

of 240 mg/dL or More by Age, Sex and Race


Non-Hispanic White MenNon-Hispanic White WomenNon-Hispanic Black MenNon-Hispanic Black WomenMexican-American MenMexican-American Women

182015181817

Estimated Age-Adjusted (2000) Prevalence of Americans Ages 20-74 With Blood Cholesterol of 240 mg/dL or More by Sex and Race


&A

Page &P

cholchild

&A

Page &P

Non-Hispanic White Males

Non-Hispanic White Females

Non-Hispanic Black Males

Non-Hispanic Black Females

Ages


diabetes


strokerr

EST. PERCENTAGE OF AMERICAN ADULTS 20-74, WITH

SERUM CHOLESTEROL O

Lifetime Risk of Coronary Heart Disease in the Framingham Study

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