Healthy People 2010 Focus Area 12: Heart Disease and Stroke Progress Review – April 23, 2003

Heart Disease and Stroke Chapter Framework Knowledge Disparities Race / ethnicity Gender Age Geographic location Socioeconomic factors Health status / behaviors Risk factors Early intervention Important enough to include…but not baseline data. NHLBI committed to measuring Mortality Trends

Coronary Heart Disease and Stroke Death Rates, 1980-2000 Age-adjusted rate per 100,000 Coronary Heart Disease 1980 1985 1990 1995 2000

Coronary Heart Disease and Stroke Death Rates, 1980-2000 Age-adjusted rate per 100,000 Coronary Heart Disease Stroke 1980 1985 1990 1995 2000

Coronary Heart Disease and Stroke Death Rates, 1980-2000 Age-adjusted rate per 100,000 Coronary Heart Disease CHD 2010 target Stroke Stroke 2010 target 1980 1985 1990 1995 2000

Coronary Heart Disease Death Rates, 2000 Age-adjusted rate per 100,000 2010 target Total Hispanic Black, Not Hispanic Female Male White, Not Hispanic American Indian or Alaska Native Asian or Pacific Islander

Coronary Heart Disease Death Rates, 2000 Relative Risk Relative risk compared to the total population Greater Risk Black, Not Hispanic Male White, Not Hispanic Female Hispanic American Indian or Alaska Native Less Risk Asian or Pacific Islander

Coronary Heart Disease Deaths by Health Service Area, 1996-98

Stroke Death Rates, 2000 2010 target Age-adjusted rate per 100,000 Male Total Hispanic Black, Not Hispanic White, Not Hispanic Female American Indian or Alaska Native Asian or Pacific Islander

Smoothed County Stroke Death Rates: Adults 35 and Older, 1991-98 AIAN gap between highest and lowest quintiles is 5fold, but only 2fold for us as a whole. Greatest of all groups North-south trend. If wanted to plan a program aimed at NA, would miss this trend if looked only at the map for all persons.

CVD Risk Factors Adults Adolescents Obesity Current smoker Moderate Baseline Most recent 2010 target Obesity Current smoker Moderate activity Adults Age-adjusted percent Percent 50 Adolescents 40 30 20 10 Overweight Current smoker Moderate activity

Serum Cholesterol Levels > 240 mg/dL, Adults 20 and Older 1988-94 1999-2000 Age-adjusted percent 2010 target Female Male Female Male Female Male Female Male Mexican American Black, Not Hispanic White, Not Hispanic Total

Hypertension Prevalence in Adults, 1999-2000 Age-adjusted percent 2010 target Total Black, Not Hispanic Mexican American White, Not High school graduate Less than high school At least some college 20 years and older 25 years and older

CVD Knowledge: Adults 20 and Older, 2001 10 40 20 30 50 60 70 80 90 Age-adjusted percent Heart attack knowledge (including 911) Stroke knowledge Total Black, Not Hispanic Asian or Pacific Islander American Indian or Alaska Native White, Not Total Black, Not Hispanic Asian or Pacific Islander American Indian or Alaska Native White, Not

Projected Increase in Total Heart Disease Deaths Related to Increased Diabetes Prevalence 21% 29% 724 883 Heart Disease Deaths (thousands) Proportion due to diabetes Important enough to include…but not baseline data. NHLBI committed to measuring

Developmental Objectives 12-3: Artery-opening therapy 12-5: Out of hospital emergency care 12-16: LDL-cholesterol level in CHD patients Important enough to include…but not baseline data. NHLBI committed to measuring

Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm

Obesity in Adults 20 and Older Age-adjusted percent 1988-94 1999-2000 Important enough to include…but not baseline data. NHLBI committed to measuring 2010 target Total Black, Not Hispanic White, Not Hispanic Mexican American

2003 NHIS Planned Updates 12-11: Action to help control blood pressure 12-12: Blood pressure monitoring 12-15: Blood cholesterol screening Updates to baseline data collected in 1998 Healthy People supplement. 12-12 had an update in 1999 periodic chronic disease module (Data available in 2004)

Coronary Heart Disease and Stroke Death Rates, 1980-2000 Age-adjusted rate per 100,000 Coronary Heart Disease CHD 2010 target Stroke Stroke 2010 target 1980 1985 1990 1995 2000