2. Heart Disease and Stroke Statistics 2010 Update

3. Questions on statistics? mailto:nancy.haase@heart.orgQuestions on statistics? mailto:nancy.haase@heart.org mailto:nancy.haase@heart.org Audio-visual questions? mailto:david.brentz@heart.orgAudio-visual questions? mailto:david.brentz@heart.org mailto:david.brentz@heart.org Please keep the red wave and logo attached to these slides.Please keep the red wave and logo attached to these slides.

4. CVD disease mortality trends for males and females United States: 1979-2006). Source: NCHS and NHLBI. CVD disease mortality trends for males and females (United States: 1979-2006). Source: NCHS and NHLBI.

5. Age-adjusted death rates for CHD, stroke, lung and breast for white and black females ( United States: 2006). Source: NCHS.

6. Deaths from diseases of the heart (United States: 1900–2006) Note: See Glossary for an explanation of Diseases of the Heart. Source: NCHS.

7. Deaths from cardiovascular disease (United States: 1900–2006). Source: NCHS and NHLBI.

8. Hospital discharges for cardiovascular diseases. (United States: 1970-2006). Note: Hospital discharges include people discharged alive, dead and status unknown. Source: NCHS and NHLBI.

9. Percentage breakdown of deaths from cardiovascular diseases (United States: 2006) * - Not a true underlying cause. Source: NCHS.

10. Prevalence of CVD in adults age 20 and older by age and sex (NHANES 2003-2006). Source: NCHS and NHLBI. These data include coronary heart disease, heart failure, stroke and hypertension.

11. Incidence of CVD* by age and sex. (FHS, 1980-2003). Source: NHLBI. * Includes CHD, HF, stroke or intermittent claudication. Does not include hypertension alone.

12. CVD deaths vs. cancer deaths by age. (United States: 2006). Source: NCHS.

13. CVD and other major causes of death: both sexes. (United States: 2006). Source: NCHS and NHLBI.

14. CVD and other major causes of death: males (United States: 2006). Source: NCHS and NHLBI.

15. CVD and other major causes of death: females (United States: 2006). Source: NCHS and NHLBI.

16. A CVD (I00-I99; Q20-Q28) B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Alzheimers Disease CVD and other major causes of death for all males and females (United States: 2006). Source: NCHS and NHLBI.

17. A CVD (I00-I99; Q20-28) B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Alzheimers Disease CVD and other major causes of death for white males and females (United States: 2006). Source: NCHS and NHLBI.

18. A CVD (I00-I99; Q20-Q28) B Cancer C Accidents D Assault (Homicide) E Diabetes Mellitus F Nephritis, Nephrotic Syndrome and Nephrosis CVD and other major causes of death for black males and females. (United States: 2006). S ource: NCHS and NHLBI.

19. A CVD (I00-I99) B Cancer C Accidents D Diabetes Mellitus E Assault (Homicide) F CLRD CVD and other major causes of death for Hispanic or Latino males and females (United States: 2006). Source: NCHS and NHLBI.

20. A CVD (I00-I99) B Cancer C Accidents D Chronic Lower Respiratory Diseases E Diabetes Mellitus F Influenza and Pneumonia CVD and other major causes of death for Asian or Pacific Islander males and females (United States: 2006). Source: NCHS and NHLBI.

21. A CVD (I00-I99) B Cancer C Accidents D Diabetes Mellitus E Chronic Liver Disease and Cirrhosis F Chronic Lower Respiratory Diseases CVD and other major causes of death for American Indian or Alaska Native males and females (United States: 2006). Source: NCHS and NHLBI.

22. Hospital Discharges (in millions) for the 10 Leading diagnostic Groups (United States: 2006). Source: NHDS/NCHS and NHLBI.

23. Estimated 10-Year CVD risk in 50 to 54-year-old adults according to levels of various risk factors (Framingham Heart Study). Source: DAgostino et al., Circulation. 2008;117:743-753. A B C D A B C D Age50-54 50-54 50-54 50-54 HDL Cholesterol, mg/dL45-49 45-49 35-34 35-34 Total Cholesterol (mg/dL) 160-199 200-239 200-239 200-239 Systolic BP mm/Hg, no treat. 120-129 130-139 130-139 130-139 Smoker No No No Yes Diabetes No No Yes Yes mm Hg = millimeters of mercury. mg/dL = milligrams per deciliter of blood

24. Prevalence (%) of Coronary Calcium: US Adults Ages 33-45 Years (CARDIA Study). Source: Loria et al., JACC. 2007;49(20):2013-20.

25. Prevalence (%) of Coronary Calcium: US Adults Ages 45-84 Years (The MESA Study). Source: Bild et al., Circulation. 2005;111:1313-1320.

26. Hazard Ratios for CHD Events Associated With Coronary Calcium Scores: US Adults Ages 45-84 Years (Reference Group CAC=0) Source: Detrano et al., NEJM. 2008;358(13):1336-1345.

27. Hazard Ratios for CHD Events Associated With Coronary Calcium Scores: US Adults (Reference Group CAC=0 and Framingham Risk Scores <10%) Source: Greenland et al., JAMA. 2004;291(2):210-15.

28. Mean Values of Carotid IMT for Different Carotid Artery Segments in Younger Adults by Race and Sex (Bogalusa Heart Study) Source: Urbina et al., Am J Card. 2002;90(9):953-58.

29. Mean Values of Carotid IMT for Different Carotid Artery Segments in Older Adults by Race (MESA Heart Study) Source: Manolio et al., Atherosclerosis 2008;197(1):132-38.

30. A B C D A B C D Blood Pressure (mm Hg)120/80140/90140/90140/90 Total Cholesterol (mg/dL) 200 240 240 240 HDL Cholesterol (mg/dL) 50 50 40 40 Diabetes No No Yes Yes Cigarettes No No No Yes mm Hg = millimeters of mercury. mg/dL = milligrams per deciliter of blood Estimated 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.

31. Annual number of U.S. Adults having diagnosed heart attack by age and sex ( ARIC: 1987-2004 and CHS: 1989-2004 ). Source: NHLBI. Includes MI and fatal CHD but not silent MIs.

32. Prevalence of CHD by age and sex (NHANES :2003-2006). Source: NCHS and NHLBI.

33. Prevalence of low CHD risk, overall and by sex, ages 25-74 (NHANES :1971-2006). Source:Personal communication with NHLBI 6/28/07. Low risk is defined as SBP <120 mm Hg and DBP<80 mm Hg; cholesterol < 200 mg/dL and BMI <25 kg/m2 and currently not smoking cigarettes and no prior MI or DM.

34. Annual rate of first heart attack by age, sex and race. (ARIC Surveillance:1987-2004). Source: NHLBI.

35. Incidence of Myocardial Infarction * by Age, Race and Sex. (ARIC Surveillance: 1987-2004). Source: NHLBI. * MI diagnosed by expert committee based on review of hospital records.

36. Incidence of Angina Pectoris* by Age and Sex. (FHS: 1980-2002/2003). Source: NHLBI. * AP uncomplicated based on physicians interview of patient. Note: Rate for women age 45-54 considered unreliable.

37. Note: Hospital discharges include people discharged alive, dead, and status unknown. Hospital discharges for coronary heart disease by sex (United States: 1970-2006). Source: NHDS/NCHS.

38. Trends in Carotid Endarterectomy Procedures (United States: 1979-2006). Source: NHDS/NCHS and NHLBI.

39. Prevalence of stroke by age and sex (NHANES: 2003-2006). Source: NCHS and NHLBI.

40. Annual age-adjusted incidence of first-ever stroke, by race. Inpatient plus out-of-hospital ascertainment. (GCNKSS: 1993-94 and 1999). Source: Stroke 2005;36;720-23.

41. Annual rate of first cerebral infarction by age, sex and race (GCNKSS: 1999). Source: Unpublished data GCNKSS. Note – rates for ages 45-54 for black males and females and for black males ages 75 and over, are considered unreliable. An estimated 15,000 people have first cerebral infarctions before age 45.

42. Annual rate of all first-ever strokes by age, sex and race (GCNKSS: 1999). S ource: GCNKSS unpublished data. Note: rates for ages 45-54 for black men and women and for black men 75 and over, are considered unreliable.

43. ABCDEF Systolic BP*95-105130-148130-148130-148130-148130-148 DiabetesNoNoYesYesYesYes CigarettesNoNoNoYesYesYes Prior Atrial Fib.NoNoNoNoYes Yes Prior CVDNoNoNoNoNoYes Estimated 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. *Closest ranges for women are: 95-104 and 115-124.

44. Prevalence of high blood pressure in Adults age 20 and older, by age and sex (NHANES: 2003-2006). Source: NCHS and NHLBI.

45. Extent of awareness, treatment and control of high blood pressure by race/ethnicity (NHANES : 2003-2006). Source: NCHS and NHLBI.

46. Age-adjusted prevalence trends for high blood pressure in Adults age 20 and older by race/ethnicity, sex and survey (NHANES: 1988-94, 1999-02 and 2003-06). Source: NCHS and NHLBI. NH- non-Hispanic.

47. Extent of Awareness, Treatment and Control of High Blood Pressure by Age (NHANES: 2003-2006). Source: NCHS and NHLBI.

48. Extent of Awareness, Treatment and Control of High Blood Pressure by Race/Ethnicity and Sex (NHANES: 1999-2006). Source: NCHS and NHLBI.

49. Prevalence of heart failure by age and sex (NHANES: 2003-2006). Prevalence of heart failure by age and sex (NHANES: 2003-2006). Source: NCHS and NHLBI.

50. Note: Hospital discharges include people discharged alive, dead and status unknown. Hospital discharges for heart failure by sex. (United States: 1979-2006). Source: NHDS/NCHS and NHLBI.

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

52. Prevalence of students in grades 9-12 reporting current cigarette smoking by race/ethnicity and sex. (YRBS:2007). Source: MMWR. 2008;57:SS04. NH – non-Hispanic.

53. Prevalence of current smoking for Adults age 18 and older by race/ethnicity and sex (NHIS:2007). Source: MMWR. 2008;57:1221-26. NH – non-Hispanic.

54. Trends in mean total serum cholesterol among adolescents ages 12-17 by race, sex, and survey (NHANES: 1976-80, 1988-94, 1999-02, 2003-04, and 2005-06). Source: NCHS and NHLBI.

55. Trends in mean total serum cholesterol among adults age 20 and older, by race/ethnicity and survey (NHANES : 1988-94, 1999-02, 2003-04 and 2005-06). Source: NCHS and NHLBI. NH – non-Hispanic.

56. Trends in the prevalence of total serum cholesterol (200+mg/dL) in adults age 20 and older, by sex, race/ethnicity and survey. (NHANES: 2003-04 and 2005-06) Source: NCHS and NHLBI. NH – non-Hispanic. MA – Mexican Am.

57. 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. Prevalence of students in grades 9-12 who met currently recommended levels of physical activity during the past 7 days by race/ ethnicity and sex (YRBS: 2007). Source: MMWR. 2008;57:No. SS-4. NH – non-Hispanic.

58. Prevalence of regular leisure-time physical activity among adults age 18 and older by race/ethnicity, and sex. (BRFSS: 2001 and 2005). Source: MMWR, 2007;56:No. 46. NH – non-Hispanic.

59. Prevalence of students in grades 9-12 who did not meet currently recommended MVPA during the past 7 days by race/ethnicity, and sex. (YRBS: 2007). Source: MMWR 2008;57 (No.SS-4). NH – non-Hispanic.

60. Prevalence of children ages 6-19 who attained sufficient MVPA to meet public health recommendations of >60 minutes/day on >5 of 7 days by sex and age. (NHANES: 2003-04). Source: MSSE 2008;40:181-8.

61. Prevalence of overweight among students in grades 9-12 by race/ethnicity and sex (YRBS: 2007). Source: MMWR. 2008 57: No. SS-4. BMI 95th percentile or higher by age and sex of the CDC 2000 growth chart. NH – non-Hispanic.

62. Note: Obesity is defined as a BMI of 30.0 or higher. Age-adjusted prevalence of obesity in Adults ages 20-74 by sex and survey. (NHES, 1960-62; NHANES, 1971-74, 1976-80, 1988- 94 and 2003-2006). Source: Health, United States, 2008. NCHS.

63. Trends in prevalence of overweight among U.S. children and adolescents by age and survey. (NHANES, 1976-80, 1988-94 and 2003-2006). Source: Health, United States, 2008. NCHS.

64. Prevalence of physician-diagnosed diabetes in Adults age 20 and older by race/ethnicity and sex (NHANES: 2003-2006). Source: NCHS and NHLBI. NH – non-Hispanic.

65. Prevalence of Physician Diagnosed Type 2 diabetes in Adults age 20+ by Race/Ethnicity, and Years of Education (NHANES: 2003- 2006). Source: NCHS and NHLBI. NH – non-Hispanic.

66. Trends in diabetes prevalence in adults age 20+ by Sex (NHANES: 1988-94 and 2003-2006). Undiagnosed 03-06 for females considered unreliable. Source: NCHS and NHLBI. NH – non-Hispanic.

67. Diabetes Awareness, Treatment and Control (NHANES: 2003-2006). Source: NHLBI.

68. 19772007 Figure 16-3. Total U.S. Food Expenditures Away from Home and At Home, 1977 and 2007. Source: United States Department of Agriculture Economic Research Service

69. Figure 16-2. Per Capita Calories Consumed from Different Beverages by U.S. Adults (age 19 and older), 1965-2002. Source: Nationwide Food Consumption Surveys (1965, 1977-78) and NHANES (1988-94, 1999-02); Duffey & Popkin, Obesity (Silver Spring) 2007

70. Figure 16-1. Age-Adjusted Trends in Macronutrients and Total Calories Consumed by U.S. Adults (20-74 years), 1971-2004. Source: National Center for Health Statistics. Health, United States 2008, With Special Focus on Young Adults. NCHS; 2009 Men Women

71. Trends in Heart Transplants (UNOS: 1975-2008). Source: United Network for Organ Sharing (UNOS), scientific registry data.

72. Trends in Cardiovascular Operations and Procedures (United States: 1979-2006). Source: NCHS and NHLBI. Note: In-hospital procedures only.

73. Number of Surgical Procedures in the 10 Leading Diagnostic Groups (United States: 2006). Source: NHDS/NCHS and NHLBI.

74. Direct Costs of the 10 Leading Diagnostic Groups (Billions of dollars) (United States: 2010). Source: NHLBI. 87.4 93.8 102.7 126.1 159.1 172.9 175.4 177.7 225.2 324.1 0.050.0100.0150.0200.0250.0300.0350.0 Endocrine System 240-279 Genitourinary System 580-629 Neoplasms 140-239 Musculoskeletal system 710-739 Respiratory System 460-519 Injury and Poisoning 800-999 Nervous System 320-389 Mental 290-319 Digestive System 520-579 Cardiovascular 390-459

75. Estimated direct and indirect costs (in billions of dollars) of major cardiovascular diseases and stroke (United States: 2010). Source: NHLBI.