Reducing Risk of Heart Disease & Stroke - A Life Long Quest

Reducing Risk of Heart Disease & Stroke - A Life Long QuestJeffrey P. Gold, M.D.University of Toledo Medical Center

Coronary Artery Disease

Where will you be in 33 seconds?

Heart Disease & Stroke in 2007

A Few Facts & Figures

Heart Disease in 2007

15.8 Million Americans have CAD0.45 Million Americans die of CAD1234 Americans die of CAD every day

Lifetime Risk for American Male @ 40 - 40%Lifetime Risk for American Female @ 40 - 25%

Percentage breakdown of deaths from cardiovascular diseases (United States:2004) Source: NCHS and NHLBI.

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53

17

6

6

4

0.5

0.4

13

7%

52%

.4%

.5%

PieCVD

2003CVD total mortality2003 CVD total mortality

910,614PreliminaryPercentage Breakdown of Deaths From Cardiovascular Diseases

479,304CHD52.6Coronary Heart Disease53479,30453United States:2003 Preliminary

157,803Stroke17.3Stroke17157,80317

57,218HF6.3HF657,2186

52,604Hyp.5.8High Blood Pressure652,6046

37,647Dis. of Arteries4.1Diseases of the Arteries437,6474

4,178Cong.HD0.5Congenital Cardiovascular Defects0.54,1780.5

3,554RF/RHD0.4Rheumatic Fever/Rheumatic Heart Disease0.43,5540.4

118,306Other13.0Other13118,30613

910614100.0910614100.0

Note: Try to arrange in descending order.

1980 CVD total mortality1980CVD total mortality

959,368Percentage Breakdown of Deaths From Cardiovascular Diseases

529659CHD55.2Coronary Heart Disease54502,18954United States:1980

167,366Stroke17.4Stroke18163,53818

54,920CHF38.9Congestive Heart Failure652,8286




4657Cong.HD0.5Congenital Cardiovascular Defects0.44,1090.4

141114Other15.5Other13118,78613

959368134.0100.8931,108100.0

1990 CVD total mortality1990CVD total mortality

959,368Percentage Breakdown of Deaths From Cardiovascular Diseases

529659CHD55.2Coronary Heart Disease54502,18954United States:1990

167,366Stroke17.4Stroke18163,53818

54,920CHF38.9Congestive Heart Failure652,8286




4657Cong.HD0.5Congenital Cardiovascular Defects0.44,1090.4

141114Other15.5Other13118,78613

959368134.0100.8931,108100.0

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PieCVD

53%

LCDAIAF

LCDWHITEMF

LCDMF

LCD AM. INDIAN M/F, 2002

67505511Leading Causes of Death for American Indian/Alaska Native Males and Females

MALESFEMALES5665United States: 2002

Diseases of the Heart, and StrokeA24.4Diseases of the Heart, and StrokeA24.5

CancerB16.0CancerB19.3

AccidentsC14.9AccidentsC8.6

Diabetes MellitusD5.0DiabetesD7.2

Chronic Liver Disease and CirrhosisE4.7Chronic Lower Respiratory DiseaseF4.1

Leading Causes of Death for American Indian/Alaska Native Males and Femlaes

United States: 2002

Females

Males

MALES

Diseases of the Heart, and Stroke24.4FEMALES

Cancer16.0Diseases of the Heart, and Stroke24.5

Accidents14.9Cancer19.3

Diabetes Mellitus5.0Accidents8.6

Chronic Liver Disease and Cirrhosis4.7Diabetes Mellitus7.2

Chronic Lower Respiratory Disease4.1

Leading Causes of Death for American Indian/Alaska Native MalesLeading Causes of Death for American Indian/Alaska Native Females

United States: 2002United States: 2002

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LCDMF

MALES

Percent of Total Deaths

LCDBLKMF

`

FEMALES


LCDAPI


lcdkids


LCDHISPMF

Leading Causes of Death for White Males and Females

LCD WHITE M/F, 2003United States: 2003

10251961077393

MALESFEMALES

CVD+cong.A36.7CVD+cong.A39.7


AccidentsC5.6Chronic LRDD5.7

Chronic LRDD5.4Alzheimer'sF3.9

DiabetesE2.8AccidentsC3.0

Leading Causes of Death for White Males and Females

United States:2003

Females

Preliminary

PreliminaryMales

MALES

Total CVD36.7FEMALES

Cancer24.2Total CVD39.7

Accidents5.6Cancer21.5

Chronic Lower Respiratory Disease5.4Chronic Lower Respiratory Disease5.7

Diabetes Mellitus2.8Alzheimer's Disease3.9

Leading Causes of Death for White MalesAccidents3.0

United States: 2003

Leading Causes of Death for White Females

United States: 2003

Males

CVD - Cardiovascular disease and congenital heart disease. Preliminary data.Females

CVD - Cardiovascular disease and congenital heart disease. Preliminary data,

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LCDHISPMF

MALES


FEMALES


FEMALES


Percent ofTotal Deaths

LCD MALES AND FEMALES, 2003Leading Causes of Death for All Males and Females

United States: 2003

MALESFEMALES

CVD+cong.A426,772CVD+cong.A483,842

CancerB286,741CancerB267,902

AccidentsC67,923Chronic LRDD65,672

Chronic LRDD60,456Alzheimer'sF45,058

DiabetesE35,217DiabetesE38,748

Leading Causes of Death for All Males and Females

United States: 2003

PreliminaryFemales

Males

Preliminary.

LCD, 2002

Total CVD433,825

Cancer288,768

Accidents69,257

Chronic Lower Respiratory Disease60,713

Diabetes Mellitus34,301

Leading Causes of Death

United States: 2002

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MALES

Deaths in Thousands

FEMALES

Deaths in Thousands

Deaths in Thousands

LCD BLACK M/F, 2003

146,835143,216Leading Causes of Death for Black Males and Females

MALESFEMALESUnited States: 2003

CVD+cong.A33.4CVD+cong.A39.9


AccidentsC5.5DiabetesF5.2

Assault(Homicide)D4.7Nephritis, etc.G3.0

HIV(Aids)E3.5AccidentsC2.7

Leading Causes of Death for Black Males and Females

United States: 2003

PreliminaryFemales

Males

Preliminary

Charts for "Fact Sheets"

MALESFEMALES

Total CVD33.4Total CVD39.9`

Cancer21.9Cancer20.9

Accidents5.5Diabetes Mellitus5.2

Assault(Homicide)4.7Nephritis, Nephrotic Syndrome and Nephrosis3.0

HIV(Aids)3.5Accidents2.7

Leading Causes of Death for Black MalesLeading Causes of Death for Black Females


CVD - Cardiovascular diseases including congenital cardiovascular defects. Preliminary data.CVD - Cardiovascular diseases including congenital cardiovascular defects. Preliminary data.

PreliminaryPreliminary

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MALES


FEMALES




Males20,483Females17849

Diseases of Heart and StrokeA34.8Diseases of Heart and StrokeA35.8


AccidentsC5.7DiabetesE4.0

Chronic Lower Respiratory DiseaseD3.6AccidentsC3.9

DiabetesE3.2Influenza and PneumoniaF3.0

Leading Causes of Death for Asian/Pacific Islander Males and FemalesLeading Causes of Death for Asian/Pacific Islander Males and Females


MalesFemales

Diseases of Heart and Stroke35.8

Diseases of the Heart, and Stroke34.8Cancer26.9

Cancer25.4Diabetes Mellitus4.0

Accidents5.7Accidents3.9

Chronic Lower Respiratory Disease3.6Influenza and Pneumonia3.0

Diabetes Mellitus3.2

Leading Causes of Death for Asian/Pacific Islander Females

Leading Causes of Death for Asian/Pacific Islander MalesUnited States: 2002

United States: 2002

Females


Males




LCD MALE AND FEMALE Children Age

Cardiovascular disease mortality trends for males and females (United States: 1979-2004). Source: NCHS and NHLBI.

Deaths from diseases of the heart (United States: 19002004.) Note: See Glossary for an explanation of Diseases of the Heart. Total CVD data are not available for much of the period covered by this chart. Source: NCHS and NHLBI.

Chart1

27.427

35.252

75.429

101.429

137.374

188.554

251.153

312.333

385.191

424.329

537.629

585.751

661.712

712.087

735.542

716.215

761.085

771.169

720.058

737.563

711

685

654

Deaths

Years

Deaths in Thousands

Sheet1

HIS cvd prevalence data 1979-94CVD mortality 1979-94CVD Mortality Trends*, 1979-94

CVDCardiovascular Mortality*, United States: 1946 To Date

HIS Prev.CVD46596915

7996952850754249

8099997655824777

79-81474168198392960934907

824726682978942651000147

835033483992281701032638

84525618498420075994513

85527508598849180999976

86518918697854685988491

87525518797420090926079

88537198897978891926061

89504728994189592923416

90510429092607993957598

91533889192606194954720

925482592923416

935416893957598

945556194950203

* These data include congenital heart disease deaths.

National Health Interview Survey CVD Prevalence Estimates*, 1986-94* These data include congenital heart disease deaths.

* These data include RF/RHD, heart disease, hypertension and stroke. Hardening of the arteries,

vericose veins and hemorrhoids are not included.

Note: Data for 1979-81 represent an average and include congenital anomalies of the circulatory

system.

Diseases of the Heart

CrudeDiseases of the Heartcvd

RateDeaths (000)Deaths

1900137.4190027Crude Death Rates for Diseases of the Heart: U.S. 1900 to DateM CHDF CHD

5161.953579307.286244.079

10158.9107580310.774254.981

15163.91510181303.929251.229

20159.62013782300.820251.966

25184.82518983297.522254.970

30214.23025184289.461251.827

35245.43531285286.181250.624

40291.94038586274.184246.545

45321.54542487267.757244.381

50355.55053875488264.505245.087

55355.85558682589257.524240.497

603696066293590252.597236.574

65367.465712100091249.736235.702

7036270736103392246.913233.138

75336.27571699593250.362239.701

8033680761100094245.350236.108

853238577198895244.819236.468

90289.59072092696242.036234.088

94281.39573896197237.332228.769

96733

97727

98725

99725

00711

01700Diseases of the Heart (000)

02697YearsDeaths

03685190027

Deaths From Diseases of the Heart*35

United States: 190020041075

101

20137

189

30251

312

40385

424

50538

586

60662

712

70736

716

80761

771

90720

738

00711

685

Note: In the years 1900-45 the ICDA codes were 90-95; for 1950-60 the codes were04654

402-404, 410-443; for 1965 the codes were 402, 404, 410-443; for 1970-75 390-398, 402,

410-429 and for 1980 to date the codes were 390-398, 402, 404-429.

StrokeDeaths From StrokeDeaths From Stroke: United States 1979-96

Deaths(000)Deaths From Stroke: United States, 1900-95YearsDeaths

19002179169.488

52380170.225

104581163.504

155882157.71

208083155.598

259184154.327

3010485153.05

3510986149.643

4012087149.835

4512988150.517

5015789145.551

5517490144.088

6019491143.481

6520192143.769

7020793150.108

7519494153.306

8017095157.991

85153Note: These deaths are as reported. No adjustments have been made for ICDA revisions.96160.431

90144

95158

96160

StrokeAge-adjusted

Death Rates

1900

5

10

15

20Age-Adjusted Death Rates For Stroke: U.S. 1940-93

25

30

35

40105

4598.6

5088.8

5582.7

6079.9

6573.3

7067.7

7554.7

8041.4

8532.8

9029.1

9526.7

Alzheimer's

Total65+

790.8570.653Alzheimer's Deaths: U.S. 1979-93

801.3141.037

811.7571.473

822.6272.261

834.4344.039

846.255.846

858.2587.819

869.4268.984

8711.31110.877

8812.28111.842

8913.1112.734

9013.74413.391

9114.11213.768

9214.43514.088

9316.75416.422

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Years

Deaths

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Years

Deaths

Years

Thousands

Years

Per 100,000 Population

Deaths(000)

Years

Deaths in Thousands

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Years


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Total

65+

Years

Thousands

Years

Thousands

Deaths

Years

Deaths in Thousands

Hospital discharges for cardiovascular diseases. (United States: 1970-2004). Note: Hospital discharges include people discharged alive, dead and status unknown. Source: NCHS and NHLBI.

Chart1

3.34

3.543

3.86

4.11

4.304

4.418

4.585

4.758

4.766

4.907

5.14

5.336

5.488

5.654

5.593

5.47

5.563

5.572

5.296

5.197

5.161

5.338

5.597

5.633

5.779

5.83

6.107

6.097

6.272

6.344

6.294

6.226

6.373

6.434

6.363

Years

Discharges in Millions

CVD

CVD (390-459)Hdis.MalesFemalesHospital Discharges* for Cardiovascular Diseases as First listed Diagnosis

703.34United States: 1970-2004

3.543

3.86

4.11

4.304

754.418

4.585

4.758

4.766

4.907792.4712.436

805.14802.592.549

5.336812.6792.657

5.4882.7852.703

5.6542.8962.758

5.5932.8562.737

855.47852.7832.686

5.5632.8462.717

5.5722.8682.704

5.2962.7222.574

5.1972.672.527

905.161902.6682.493

5.3382.7282.611

5.5972.8662.73

5.6332.8852.747

5.7792.9062.873

955.83952.9732.857

6.1073.1013.006

6.0973.1163.03

6.272983.1393.133

6.344794.907

006.2943.1153.179805.14

6.2263.0583.168815.336

6.3733.2093.164825.488

6.4343,2393.196835.654

046.3633.2273.136845.593

855.47

865.563

875.572

885.296

895.197

905.161

915.338

925.597

935.633

945.779

955.83

966.107

976.097

NOTE: do not include congenital!986.272

996.344

006.294

See Above Chart

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CVD

Years


stroke

Hospital Discharges Where Stroke Was the First Listed Diagnosis

United States: 1979-02

YearMalesFemalesTotal

79335411746

80371425796

368439807

388446834

407469876

420477897

85407499906

398491889

392503895

336448784

344447791

90355453808

371464835

376450826

387452839

407478885

95424501925

438518956

4615551017

4575531010

434527961

00428553981

391539931

432509942

455510965

04416490906



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stroke

Males

Females

Years

Discharges in Thousands

CHF

Hospital Discharges for CHF

CHF Discharges

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

MalesFemalesTotal

708074155

7986165

98102200

107111218

121113234

75122131253

123143267

143152296

157173330

174203377

80176224401

182240423

195243439

208255464

228303531

85247310557

274308582

269336605

277357634

304339643

90315386701

360405764

373449822

394481875

390484874

95378494872

377493870

431526957

438540978

430532962

00418581999

444551995

441529970

4715661,037

04

Hospital Discharges*for Congestive Heart Failure by Sex


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CHF

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#REF!


HF

Males

Females

Years


chd

Hospital Discharge Code=428 FL (1970-2003) Heart Failure

MaleFemale

197011,07111,238

9,5199,157

10,4909,276

9,42910,090

8,9249,555

7510,3259,056

7,4888,974

6,2617,660

5,3346,539

MaleFemale

79185214

80190240

195252

207257Hospital discharges for Heart Failure by Sex

221276United States: 1979-2004

237317

85259326

287328

282347

289375

312351

90325397

370417

384456

404491

395492

95384497

381496

436530

442547

434541

00422586

446554

443530

496597

04524575

chd

Male

Female

Years


Hospital Discharges Where CHD Was the First Listed Diagnosis


(000)(000)

YearMalesFemales

70779597

851628

935693

982725

1030756

751043789

1087843

1111852

1110844

10147241738

801049737

1095765

1160841

1229852

1044840

851205846

1250889

1268901

1220830

1174819

901151795

1146806

1247886

1205872

1219899

951269858

1325933

1249840

1263915

1317945

001274892

1199891

1249875

1175834

0411808011981

Hospital Discharges* for Coronary Heart Diasease by Sex


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Males

Females

Years


Trends in the age-adjusted prevalence of health conditions, U.S. adults ages 20-74 (NHANES: 1971-74 to 1999-2000). Source: Briefel and Johnson. Annu Rev Nutr. 2004;24:401-431. Printed with permission from the Annual Review of Nutrition.

Chart1

484029

474028

562420

652918

Overweight/Obesity

Hypertension

High Blood Cholesterol

Percent of Population

OVERWT

1960-621971-741976-801988-941999-2002

Men10.712.212.820.628.1

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 1999-2002

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

1999-2002


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

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

1966-701971-741988-94

White Males163163155

Black Males171165166`

White Females170166163

Black Females172174168

`

cholchild

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White

Black


diabetes

1966-70

1971-74

1988-94

Mean Total Blood Cholesterol

Strokerace

NH WhitesNH BlacksMexican Americans

Men6.210.310.4

Women4.712.611.3

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

NHANES: 1999-2002

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

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Strokerace

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

Whites

Blacks

Mexican Americans

Years of Education


smokhschool

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

smokhschool

35-44

45-54

55-64

65-74

75-84

85+

Race/Ethnicity

Relative Risk

Metsyndr.

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

MenWomen

Total Population43.135.8

NH Whites43.836.9

NH Blacks36.034.5

Mexican Americans43.731.3

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:1999-2002

MenWomen

Total33.612.6

NH Whites34.512.4

NH Blacks22.711.3


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 1999-2002

Metsyndr.

Men

Women


PhysicAct.

Men

Women


smokmf

`NH WhitesNH BlacksHispanics

Males23.319.319.1

Females26.610.817.7

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

Within the last 30 days by Race/Ethnicity and Sex

YRBS: 2003

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smokmf

Males

Females


NHANESrf

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

NHANESrf

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM

Deaths/1,000 Person Years

oweight hs

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

NH White MalesNH White FemalesNH Black MalesNH Black FemalesHispanic MalesHispanic FemalesBMI

Age-adjusted death rates for coronary heart disease, stroke, and lung and breast cancer for white and black females (United States: 2004). Source: NCHS and NHLBI.

Chart2

115.4148.6

47.464.9

41.639

23.731.9

White Females

Black Females


USCVTREND

CVDCVDCardiovascular Disease Mortality Trends for Males and FemalesCVD *CVD*CVDCVD

MalesFemalesUnited States: 1979-2004MalesFemalesMalesFemales

795004697949746679497466

805104908050648780506487

8150048449748185487495

8249548449248190445475

8349849449549195452503

8449149348749100439505adjusted

854914988548749504410460adjusted

86481498478495

87475499472496

88476504473501

89456486453483

9044847890445475

91447479444477

92444479441477

93457500454498

94452498449496

9545550595452503

96453506451504

97450503448501

98446504Actual MortalityAdjusted Mortality*443502

99446513adjusted by 9-10 comparability ratio. (0.9981)445.024511.929446513

00440506440.175505.661439.339504.70000440506

01432499432.245498.863431.424497.915432499

Source: Final mortality data, NCHS.433.827493.69002433.003492.752434494

Numbers are in thousands.427.891483.37203427.078482.454428483

CVD including congenital CV disease.410.365461.15204409.585460.27604410461

CVDCVDCVDCVD

White MalesWhite FemalesBlack MalesBlack Females* - Since comparability ratio is so close to 1.00

794454184846it is not necessary to adjust. As per TT 9/26/06.

80452435

81444430

82439430

83441438

84434437

85433440

864234405052

874174405052

884174435054White MalesWhite FemalesBlack MalesBlack Females

893984254953903914204851

903914204851913894204852

913894204852923874204752

923874204752933984384954

933984384954943944364854

943944364854953954425055

953954425055963944424855

963944424855973914404854

973914404854983864394955

983864394955993864474956

993864474956003814394857

03814394857

Cardiovascular Disease Mortality Trends by Sex and Race


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USCVTREND

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Males

Females

Years

Deaths in Thousands

drwomencvcan

Males

Females

Years

Deaths in Thousands

chdstrhypmor

White Males

White Females

Black Males

Black Females

Year

Deaths in Thousands

DR FOR WOMEN, CV AND CANCER 1996(1940)DR FOR WOMEN, CV AND CANCER 2004CVD AND CANCER 2001

WhitesBlacksWhite FemalesBlack FemalesTotalMalesFemales

Coronary Heart Disease58.980.0Coronary Heart Disease115.4148.6CVD329.6391.4281.7

Stroke22.939.2Stroke47.464.9Cancer196.0243.7164.7

Breast Cancer19.826.5Lung Cancer41.639.0

Lung Cancer28.027.6Breast Cancer23.731.9

Age-Adjusted Death Rates for Coronary Heart Disease, Stroke, BreastAge-Adjusted Death Rates for Coronary Heart Disease, Stroke and LungAge-Adjusted Death Rates for Cardiovascular Disease and Cancer

and Lung Cancer for White and Black Females(1940)and Breast Cancer for White and Black FemalesUnited States: 2001

United States: 1996 Final MortalityUnited States: 2004

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Whites

Blacks


White Females

Black Females


Total

Males

Females


# OF HEART ATTACK & STROKE DEATHS, U.S. 1979-91# of stroke deaths# OF CHD DEATHS# of hyp deaths

M CHDF CHDM STROKEF STROKEM STROKEF STROKEM CHDF CHDmf

79307.286244.079551.36570.43999.497970.43999.4979307.286244.07913.78618.13

80310.774254.981565.75569.973100.2528069.973100.25280310.774254.98113.94318.69

81303.929251.229555.15866.42997.0758166.42997.07581303.929251.22913.82217.905

82300.820251.966552.78663.85593.8558263.85593.85582300.82251.96613.5517.828

83297.522254.970552.49262.84792.7518362.84792.75183297.522254.9713.80317.993

84289.461251.827541.28861.69792.638461.69792.6384289.461251.82713.47817.863

85286.181250.624536.80560.7892.278560.7892.2785286.181250.62413.50717.926

86274.184246.545520.72959.16490.4798659.16490.47986274.184246.54513.03417.955

87267.757244.381512.13859.06190.7748759.06190.77487267.757244.38113.38217.956

88264.505245.087509.59259.75990.7588859.75990.75888264.505245.08713.39918.295

89257.524240.497498.02157.32188.238957.32188.2389257.524240.49713.64818.466

90252.597236.574489.17156.69787.3919056.69787.39190252.597236.57413.61419.004

91249.736235.702485.43856.71486.7679156.71486.76791249.736235.70213.94719.387

92246.913233.138480.0519256.64587.12492246.913233.13814.5220.09

93250.362239.701490.0639359.04891.0693250.362239.70115.30621.438

94245.350236.108481.4589460.22593.08194245.35236.10815.91522.287

95244.819236.468481.2879561.56396.42895244.819236.46816.6623.321

96242.036234.088476.124

97237.332228.769466.101

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Prevalence of cardiovascular diseases in adults age 20 and older by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI. These data include coronary heart disease, heart failure, stroke and hypertension.

Chart1

14.89.4

39.139.5

71.375.1

8392

Males

Females


Sheet1

Prevalence of CVD, U.S. 2003-2004 NHANES

AgeMalesFemales

20-3914.89.4

40-5939.139.5

60-7971.375.1

80+83.092.0

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


Sheet1

Males

Females


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 Yesmm Hg = millimeters of mercury. mg/dL = milligrams per deciliter of bloodEstimated 10-Year CHD risk in 55-year-old adults according to levels of various risk factors (Framingham Heart Study). Source: Wilson et al., Circulation. 1998;97:1837-47.

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

Annual number of Adults having diagnosed heart attack by age and sex (ARIC: 1987-2000). Source: Extrapolated from rates in the NHLBIs ARIC surveillance study, 1987-2000. These data dont include silent MIs.

Chart1

3400010000

25000088000

410000372000

Men

Women

Ages

New and Recurrent Attacks

HYPPRSEX

1976-801988-941999-001976-801988-94

Non-Hispanic White Men45.025.628.9Non-Hispanic White Men34.225.2OLD!

Non-Hispanic White Women33.719.724.7Non-Hispanic White Women25.920.5

Non-Hispanic Black Men50.736.538.0Non-Hispanic Black Men44.836.7

Non-Hispanic Black Women51.136.441.0Non-Hispanic Black Women46.736.6

Mexican Men25.625.930.6Mexican-American Men31.024.2

Mexican Women22.522.325.0Mexican-American Women31.422.4

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

NHANES II, III & IV: 1976-80, 1988-94 and 1999-2000United States: 197680 and 1988-94

1988-94

MenWomen

Non-Hispanic Whites25.220.5

Non-Hispanic Blacks36.736.6

Hispanics24.222.4

Estimated Age-Adjusted(2000) Prevalence for High Blood Pressure in Adults Ages 20-74 By Sex and Race


MenWomenMenWomen

20-348.110.6WRONG!20-349.80.0

35-4414.329.535-4417.116.0

45-5429.144.345-5432.330.5

55-6443.058.055-6444.153.0

65-7454.965.265-7459.970.3

75+59.071.375+68.884.1

Prevalence of High Blood Pressure in Americans Age 20 and Over by Age and SexPrevalence of High Blood Pressure in Americans Age 20 and Over by Age and Sex

United States: 1999-2000NHANES IV: 1999-2000

MenWomen

20-3411.15.8

35-4421.318.1

45-5434.134.0

55-6446.655.5

65-7460.974.0

75+69.283.4

Prevalence of High Blood Pressure in Americans Age 20 and Over by Age and Sex

NHANES: 1999-2002

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HYPPRSEX

Non-Hispanic Whites

Non-Hispanic Blacks

Hispanics


HYPREV

1976-80

1988-94


HYPAWARE

Men

Women

Ages


strokeprev

Men

Women

Ages


INCHA

1976-80

1988-94

1999-00


FHSrisk

Men

Women

Ages


MenWomen

1960-6241.334.9

1971-7443.935.8

1976-8045.135.8

1988-9426.421.5

Estimated Age-Adjusted (2000 Standard) Prevalence for High Blood Pressure, Ages 2074 by Sex and Survey

United States: 196062, 197174, 197680, to 198894

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1960-62

1971-74

1976-80

1988-94


1976-801988-941991-94

On Medication, Controlled102818-3940-5960+

On Medication, Uncontrolled2126Awareness51.873.369.8

Not on Medication2017Treatment27.762.962.7

Unaware4929Control, Treated51.966.443.7

Awareness Treatment and Control Rates for High Blood PressureControl, All Hypertensives14.441.627.4

United States: 1976-80 and 1988-94

Extent of Awareness, Treatment and Control of High Blood Pressure by Age

NHANES IV: 1999-2000

1976-801988-911991-94

Awareness51.073.068.4

Treatment31.055.053.6Non-Hispanic WhitesNon-Hispanic BlacksMexican Americans

Control10.029.027.4

Awareness69.573.957.8

Treatment60.163.040.3

High Blood Pressure* Awareness, Treatment and Control RatesControl, Treated55.644.644.0

United States: 1976-94Control, All Hypertensives33.428.117.7

Extent of Awareness, Treatment and Control of High Blood Pressure by Race/Ethnicity

NHANES IV: 1999-2000

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1976-80

1988-94

Percent of People With High Blood Pressure

1976-80

1988-91

1991-94

Percent of People With HBP

51.873.369.8

27.762.962.7

51.966.443.7

14.441.627.4

18-39

40-59

60+


69.573.957.8

60.16340.3

55.644.644

33.428.117.7

Non-Hispanic Whites

Non-Hispanic Blacks

Mexican Americans


Stroke Prevalence NHANES 1999-2002

AgesMenWomen

20-340.40.3

35-441.10.8

45-541.22.1

55-643.13.0

65-746.66.3

75+12.011.5

Prevalence of Stroke by Age and Sex

NHANES: 1999-2002

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Men

Women

Ages


MenWomen

29-4434,00010,000

45-64250,00088,000

65+410,000372,000

Annual Number of Americans Having Diagnosed Heart Attack by Age and Sex

ARIC: 1987 - 2000

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Men

Women

Ages

New and Recurrent Attacks

MenWomen

A55MenWomen

B138A2.61.1

C2520B4.02.0

D3727C5.43.5

D8.46.3

Estimated 10-Year CHD Risk in 55 Year-Old AdultsE14.819.1

According to Levels of Various Risk Factors - Framingham Heart StudyF22.427.0

Framingham Heart Study

Estimated 10 Year Stroke Risk in 55 Year Old Adults

According to Levels of Various Risk Factors

Framingham Heart Study

ABCD

Blood Pressure120/80140/90140/90140/90

Cholesterol200240240240

HDL-C50504040

DiabetesNoNoYesYesABCDEF

CigarettesNoNoNoYesBlood Pressure*95-105138-148138-148138-148138-148138-148

DiabetesNoNoYesYesYesYes

Source: PWF Wilson, et al., "Prediction of Coronary Heart Disease Using Risk Factor Categories",Cigarette SmokingNoNoNoYesYesYes

Circulation 97:1837-47, 1998.Prior AFNoNoNoNoYesYes

Prior CVDNoNoNoNoNoYes

* - Closest ranges for women are : 95-104 and 115-124.

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Men

Women


Men

Women


Prevalence of coronary heart disease by age and sex (NHANES :1999-2004). Source: NCHS and NHLBI.

Chart1

0.60.6

7.85.5

22.815.4

32.721.6

Men

Women


Sheet1

AgesMenWomen

20-390.60.6

40-597.85.5

60-7922.815.4

80+32.721.6

Prevalence of Coronary Heart Disease by Age and Sex

NHANES: 1999-2004

Sheet1

Men

Women


Note: Hospital discharges include people discharged alive, dead, and status unknown.Hospital discharges for coronary heart disease by sex (United States: 1970-2004). Source: NHDS, /NCHS and NHLBI.

Chart1

779597

851628

935693

982725

1030756

1043789

1087843

1111852

1110844

1014724

1049737

1095765

1160841

1229852

1044840

1205846

1250889

1268901

1220830

1174819

1151795

1146806

1247886

1205872

1219899

1269858

1325933

1249840

1263915

1317945

1274892

1199891

1249875

1175834

1180801

Males

Females

Years


CVD



3.543

3.86

4.11

4.304

754.418

4.585

4.758

4.766

4.907792.4712.436

805.14802.592.549

5.336812.6792.657

5.4882.7852.703

5.6542.8962.758

5.5932.8562.737

855.47852.7832.686

5.5632.8462.717

5.5722.8682.704

5.2962.7222.574

5.1972.672.527

905.161902.6682.493

5.3382.7282.611

5.5972.8662.73

5.6332.8852.747

5.7792.9062.873

955.83952.9732.857

6.1073.1013.006

6.0973.1163.03

6.272983.1393.133

6.344794.907

006.2943.1153.179805.14

6.2263.0583.168815.336

6.3733.2093.164825.488

6.4343,2393.196835.654

046.3633.2273.136845.593

855.47

865.563

875.572

885.296

895.197

905.161

915.338

925.597

935.633

945.779

955.83

966.107

976.097


996.344

006.294

See Above Chart

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CVD

Years


stroke




79335411746

80371425796

368439807

388446834

407469876

420477897

85407499906

398491889

392503895

336448784

344447791

90355453808

371464835

376450826

387452839

407478885

95424501925

438518956

4615551017

4575531010

434527961

00428553981

391539931

432509942

455510965

04416490906



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stroke

Males

Females

Years


CHF


CHF Discharges

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

MalesFemalesTotal

708074155

7986165

98102200

107111218

121113234

75122131253

123143267

143152296

157173330

174203377

80176224401

182240423

195243439

208255464

228303531

85247310557

274308582

269336605

277357634

304339643

90315386701

360405764

373449822

394481875

390484874

95378494872

377493870

431526957

438540978

430532962

00418581999

444551995

441529970

4715661,037

04



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CHF

1

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#REF!


HF

Males

Females

Years


chd


MaleFemale

197011,07111,238

9,5199,157

10,4909,276

9,42910,090

8,9249,555

7510,3259,056

7,4888,974

6,2617,660

5,3346,539

MaleFemale

79185214

80190240

195252



237317

85259326

287328

282347

289375

312351

90325397

370417

384456

404491

395492

95384497

381496

436530

442547

434541

00422586

446554

443530

496597

04524575

chd

Male

Female

Years




(000)(000)

YearMalesFemales

70779597

851628

935693

982725

1030756

751043789

1087843

1111852

1110844

10147241738

801049737

1095765

1160841

1229852

1044840

851205846

1250889

1268901

1220830

1174819

901151795

1146806

1247886

1205872

1219899

951269858

1325933

1249840

1263915

1317945

001274892

1199891

1249875

1175834

0411808011981



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Males

Females

Years


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

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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





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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

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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.


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.



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

Mexican Americans2813




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


NH WhiteNH BlackHispanicBMI

Prevalence of heart failure by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI.

Chart1

0.30.2

21.5

7.25.2

11.612.4

Men

Women


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


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.

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


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

Mean Serum Total Cholesterol

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


MBD0006C71F.xls

Chart9

259

269

167

2813

Men

Women


OVERWT

1960-621971-741976-801988-942001-2004

Men10.712.212.820.630.2

Women15.716.817.126.034.0





&A

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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


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

000

000

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

000

000

000

000

Whites

Blacks

Mexican Americans

Years of Education


smokhschool

000

000

000


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.

000000

000000

000000

000000

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

00

00

00

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

000000

000000

000000

No MetS or DM

MetS w/o DM

MetS w/DM

DM only

Prior CVD

Prior CVD and DM


RFNHANES


NH WhiteNH BlackHispanicBMI

Note: Hospital discharges include people discharged alive, dead and status unknown..Hospital discharges for heart failure by sex(United States: 1979-2004). Source: NHDS, NCHS and NHLBI.

Chart1

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


CVD



3.543

3.86

4.11

4.304

754.418

4.585

4.758

4.766

4.907792.4712.436

805.14802.592.549

5.336812.6792.657

5.4882.7852.703

5.6542.8962.758

5.5932.8562.737

855.47852.7832.686

5.5632.8462.717

5.5722.8682.704

5.2962.7222.574

5.1972.672.527

905.161902.6682.493

5.3382.7282.611

5.5972.8662.73

5.6332.8852.747

5.7792.9062.873

955.83952.9732.857

6.1073.1013.006

6.0973.1163.03

6.272983.1393.133

6.344794.907

006.2943.1153.179805.14

6.2263.0583.168815.336

6.3733.2093.164825.488

6.4343,2393.196835.654

046.3633.2273.136845.593

855.47

865.563

875.572

885.296

895.197

905.161

915.338

925.597

935.633

945.779

955.83

966.107

976.097


996.344

006.294

See Above Chart

&A

Page &P

CVD

Years


stroke




79335411746

80371425796

368439807

388446834

407469876

420477897

85407499906

398491889

392503895

336448784

344447791

90355453808

371464835

376450826

387452839

407478885

95424501925

438518956

4615551017

4575531010

434527961

00428553981

391539931

432509942

455510965

04416490906



&A

Page &P

stroke

Males

Females

Years


CHF


CHF Discharges

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

MalesFemalesTotal

708074155

7986165

98102200

107111218

121113234

75122131253

123143267

143152296

157173330

174203377

80176224401

182240423

195243439

208255464

228303531

85247310557

274308582

269336605

277357634

304339643

90315386701

360405764

373449822

394481875

390484874

95378494872

377493870

431526957

438540978

430532962

00418581999

444551995

441529970

4715661,037

04



&A

Page &P

CHF

1

&A

Page &P

#REF!


HF

Males

Females

Years


chd


MaleFemale

197011,07111,238

9,5199,157

10,4909,276

9,42910,090

8,9249,555

7510,3259,056

7,4888,974

6,2617,660

5,3346,539

MaleFemale

79185214

80190240

195252



237317

85259326

287328

282347

289375

312351

90325397

370417

384456

404491

395492

95384497

381496

436530

442547

434541

00422586

446554

443530

496597

04524575

chd

Male

Female

Years




(000)(000)

YearMalesFemales

70779597

851628

935693

982725

1030756

751043789

1087843

1111852

1110844

10147241738

801049737

1095765

1160841

1229852

1044840

851205846

1250889

1268901

1220830

1174819

901151795

1146806

1247886

1205872

1219899

951269858

1325933

1249840

1263915

1317945

001274892

1199891

1249875

1175834

0411808011981



&A

Page &P

Males

Females

Years


Incidence of Heart Failure* by age and sex. (FHS: 1980-2003). Source: NHLBI.* HF based on physicians review of medical records and strict diagnostic criteria.

Chart12

9.24.7

22.314.8

4330.7

Men

Women

Age

Per 1,000 Person Years

IncCVD

MenWomen

45-5410.14.2

55-6421.48.9

65-7434.620.0

75-8459.240.2

85-9474.465.2

Incidence of Cardiovascular Disease* by Age and Sex

FHS, 1980-2003

* - CHD, HF, stroke or IC.

IncCVD

Men

Women

Age


IncMI

White MenBlack MenWhite WomenBlack Women

35-441.01.30.30.7

45-543.13.61.02.0

55-646.36.32.54.6

65-749.510.35.47.1

Incidence of Myocardial Infarction* by Age, Race and Sex

ARIC Surveillance, 1987-2001

* - MI diagnosis by expert committee based on review of hospital records.

IncMI

White Men

Black Men

White Women

Black Women

Age


IncAP

MenWomen

45-544.81.1

55-648.94.0

65-749.95.6

75-8413.06.2

Incidence of Angina Pectoris* by Age, Race and Sex

FHS 1980-2003

* - AP based on physician interview of patient. + - Rate for women age 45-54 considered unreliable.

IncAP

Men

Women

Age


IncHF

MenWomen

65-749.24.7

75-8422.314.8

85-9443.030.7

Incidence of Heart Failure* by Age and Sex

FHS 1980-2003


IncHF

Men

Women

Age


IncPAD

TotalMenWomenWhite MenBlack MenWhite WomenBlack Women

6.96.86.96.67.26.97.3

Age-Adjusted Incidence of Peripheral Arterial Disease* by Race and Sex, ages 45-74

ARIC Cohort, 1987-2001

* - PAD based on ABI

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


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


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

Mean Serum Total Cholesterol

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


MBD0006C71F.xls

Chart9

259

269

167

2813

Men

Women


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

000

000

NH Whites

NH Blacks

Mexican Americans


Hdl&Ldl

000

000

000

000

Whites

Blacks

Mexican Americans

Years of Education


smokhschool

000

000

000


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

Risk for Stroke Mor

Reducing Risk of Heart Disease & Stroke - A Life Long Quest

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