Morbidity & Mortality: 2012 Chart Book on Cardiovascular, Lung, and Blood Diseases National Heart, Lung, and Blood Institute February, 2012
Chapter 3 – Cardiovascular Diseases § The term cardiovascular diseases is used here to mean: § Diseases and congenital malformations of the circulatory system as coded in the ICD. - Coronary heart disease - Heart failure - Cardiomyopathy - Atrial fibrillation - Cerebrovascular disease (stroke) - Hypertensive disease - Peripheral artery disease - Congenital malformations of the circulatory system 2
Chart 3– 1 Deaths From Cardiovascular Diseases, Percent by Subgroup, U. S. , 2008 Heart Failure (Underlying)* 7. 0% Diseases of Arteries 3. 4% Hypertensive Diseases 7. 5% Coronary Heart Disease 49. 9% Other Cardiovascular Diseases 15. 6% Stroke 16. 5% * Heart failure as an underlying cause or otherwise mentioned on the death certificate accounted for 35% (281, 437) of total CVD deaths. Total deaths = 811, 940 (100%), including 3, 415 due to congenital CVD defects. Compiled from Vital Statistics of the United States, NCHS. 3
Chart 3– 2 Deaths From Heart Disease, Percent by Subgroup, U. S. , 2008 Other 3. 9% Cardiomyopathy 1. 0% Rhythmic 5. 7% Heart Failure (Underlying)* 6. 9% Rheumatic/Congenital 8. 0% Hypertensive 9. 2% Other Coronary Heart Disease 43. 8% Acute Myocardial Infarction 21. 6% * Heart failure as an underlying cause or otherwise mentioned on the death certificate accounted for 45% (281, 437) of total heart disease deaths. Total deaths = 619, 574 (100%), including 2, 746 due to congenital CVD defects. Compiled from Vital Statistics of the United States, NCHS. 4
Chart 3– 3 Deaths From Stroke, Percent by Subgroup, U. S. , 2008 Cerebral Infarction 4. 9% Subarachnoid Hemorrhage 4. 1% Other Cerebrovascular 17. 6% Unspecified 52. 7% Other Hemorrhage 20. 7% Total Deaths = 134, 148 (100%) * Compiled from Vital Statistics of the United States, NCHS. 5
Chart 3– 5 Change in Age-Adjusted Death Rates* for CV and Non-CV Diseases , U. S. , 1950– 2008 Percent Change ICD-6 ICD-7 ICD-8 ICD-9 Year * The comparability ratio 1. 0502 was applied to death rates reported for 1979– 1998. CV: Cardiovascular. 6 ICD-10
Chart 3– 9 Deaths & Age-Adjusted Death Rates for Cardiovascular Diseases, U. S. , 1979– 2008 Deaths in Thousands (Bar) Deaths/100, 000 Population (Line) Year 7
Chart 3– 10 Percent of All Deaths Due to Cardiovascular Diseases* by Age, U. S. , 2008 Percent of All Deaths Age (Years) * Includes congenital malformations of the circulatory system. 8
Chart 3– 11 Death Rates* for Cardiovascular Diseases by State, U. S. , 2005– 2007 Deaths/100, 000 Population * Age-adjusted. Excludes congenital malformations of the circulatory system. 9
Chart 3– 12 Percent Decline in CVD* Death Rates by State, U. S. , 1996 -1998, 2005 -2007 Percent Decline * CVD: Cardiovascular diseases. Excludes congenital malformations of circulatory system. Age-adjusted. 10
Chart 3– 13 Age-Adjusted Death Rates for Heart Disease by Race/Ethnicity & Sex, U. S. , 2008 Deaths/100, 000 Population * Non-Hispanic. 11
Chart 3– 14 Death Rates for Heart Disease in Males by Age & Race/Ethnicity, U. S. , 2008 Deaths/100, 000 Population * Non-Hispanic. 12 Age (Years)
Chart 3– 15 Death Rates for Heart Disease in Females by Age & Race/Ethnicity, U. S. , 2008 Deaths/100, 000 Population * Non-Hispanic. 13 Age (Years)
Chart 3– 16 Prevalence* of Acute MI by Race & Sex, Ages 25– 74, U. S. , 1971– 1975 to 2005– 2008 Percent of Population * Age-adjusted. MI: Myocardial infarction. 14
Chart 3– 17 Prevalence of Acute Myocardial Infarction by Age & Sex, U. S. , 1999– 2008 Percent of Population Age (Years) 15
Chart 3– 18 Prevalence of Acute Myocardial Infarction by Age & Race, U. S. , 1999– 2008 Percent of Population Age (Years) 16
Chart 3– 19 Prevalence of Angina Pectoris by Age & Sex, U. S. , 2001– 2008 Percent of Population Age (Years) 17
Chart 3– 20 Prevalence of Angina Pectoris by Age & Race, U. S. , 2001– 2008 Percent of Population Age (Years) 18
Chart 3– 21 Emergency Department Visit Rates for CHD* by Sex, U. S. , 1997– 1999 to 2006– 2008 Visits/10, 000 Population Years * CHD: Coronary heart disease. 19
Chart 3– 22 Hospitalization Rates for Acute MI*, Ages 45– 64 & ≥ 65, U. S. , 1965– 2009 Hospitalizations/10, 000 Population Ages (Years): Year * MI: Myocardial infarction. Break represents change in National Hospital Discharge Survey design in 1988. 20
Chart 3– 23 Hospital Case-Fatality Rates for Acute MI*, Ages < 65 & ≥ 65, U. S. , 1970– 2009 Percent Discharged Dead Year * MI: Myocardial infarction. Break represents change in National Hospital Discharge Survey design in 1988. 21
Chart 3– 24 Age-Adjusted Death Rates for CHD*, Actual & Expected, U. S. , 1950– 2008 Deaths/100, 000 Population Year * CHD: Coronary heart disease. 22
Chart 3– 25 Age-Adjusted Death Rates for CHD by Race/Ethnicity & Sex, U. S. , 1999– 2008 Deaths/100, 000 Population -*White -*Black -Hispanic -American Indian -Asian Male Female Year CHD: Coronary heart disease. * Non-Hispanic. 23
Chart 3– 26 Age-Adjusted Death Rates for CHD by Race & Sex, U. S. , 1950– 2008 Deaths/100, 000 Population ICD-6 ICD-7 CHD: Coronary heart disease. * Nonwhite from 1950 to 1967. 24 ICD-8 ICD-9 Year ICD-10
Chart 3– 27 Deaths & Age-Adjusted Death Rates for Coronary Heart Disease, U. S. , 1980– 2008 Deaths in Thousands (Bar) Deaths/100, 000 Population (Line) Year 25
Chart 3– 29 Percent Decline Annually in CHD Death Rates by Age, Race, Sex, US. , 1998 -2008 Black Male Black Female White Female CHD: 26 Coronary heart disease. Age (Years) White Male
Chart 3 -30 Age-Adjusted Death Rates for CHD by Race/Ethnicity & Sex, U. S. , 2008 Deaths/100, 000 Population CHD: Coronary heart disease. * Non-Hispanic. 27
Chart 3– 31 Death Rates for CHD in Males by Age & Race/Ethnicity, U. S. , 2008 Deaths/100, 000 Population CHD: Coronary heart disease. * Non-Hispanic. 28 Age (Years)
Chart 3– 32 Death Rates for CHD in Females by Age & Race/Ethnicity, U. S. , 2008 Deaths/100, 000 Population CHD: Coronary heart disease. * Non-Hispanic. 29 Age (Years)
Chart 3– 33 Age-Adjusted Death Rates for CHD* by State, U. S. , 2005– 2007 Deaths/100, 000 Population 30 * CHD: Coronary heart disease.
Chart 3– 34 Age-Adjusted Death Rates* for CHD by Country & Sex, Ages 35– 74, 2006– 2009 * Age-adjusted to European standard. Data for years indicated in parentheses. CHD: Coronary heart disease. 31
Chart 3– 35 Change in Death Rates* for CHD in Males by Country, Ages 35– 74, 1999– 2009 * Age-adjusted to European standard. Data for years indicated in parentheses. CHD: Coronary heart disease. Based on log-linear regression of actual rates. 32
Chart 3– 36 Change in Death Rates* for CHD in Females by Country, Ages 35– 74, 1999– 2009 * Age-adjusted to European standard. Data for years indicated in parentheses. CHD: Coronary heart disease. Based on log-linear regression of actual rates. 33
Chart 3– 37 Prevalence* of HF by Race & Sex, Ages 25– 74, U. S. , 1988– 1994 to 2005– 2008 Percent of Population * Age-adjusted. HF: Heart failure. 34
Chart 3– 38 Hospitalization Rates for HF*, Ages 45– 64 & ≥ 65, U. S. , 1971– 2009 Hospitalizations/10, 000 Population Year * HF: Heart failure. Break represents change in National Hospital Discharge Survey design in 1988. 35
Chart 3– 39 Hospital Case-Fatality Rates for HF*, Ages 45– 64 & ≥ 65, U. S. , 1980– 2009 Percent Discharged Dead Year * HF: Heart failure. Break represents change in National Hospital Discharge Survey design in 1988. 36
Chart 3– 40 Death Rates* for HF as the Underlying Cause by Race & Sex, U. S. , 1981– 2008 Deaths/100, 000 Population ICD-9 * Age-adjusted. Year HF: Heart failure. Break represents revisions to US death certificate in 1989. 37 ICD-10
Chart 3– 41 Age-Adjusted Death Rates for Any-Mention HF* by Race & Sex, U. S. , 1981– 2008 Deaths/100, 000 Population ICD-9 ICD-10 Year * HF: Heart failure. Break represents revisions to US death certificate in 1989. 38
Chart 3– 42 Death Rates for HF as the Underlying Cause by Race/Ethnicity & Sex, U. S. , 2008 Deaths/100, 000 Population Age-adjusted. HF: Heart failure. * Non-Hispanic. 39
Chart 3– 43 Death Rates for Any Mention of HF by Race/Ethnicity & Sex, U. S. , 2008 Deaths/100, 000 Population Age-adjusted. HF: Heart failure. * Non-Hispanic. 40
Chart 3– 44 Death Rates for HF* as the Underlying Cause by Age, Race, & Sex. U. S. , 2008 Deaths/100, 000 Population * HF: Heart failure. 41 Age (Years)
Chart 3– 45 Death Rates for Any Mention of HF* by Age, Race, & Sex, U. S. , 2008 Deaths/100, 000 Population * HF: Heart failure. 42 Age (Years)
Chart 3– 46 Age-Adjusted Death Rates for Cardiomyopathy by Race & Sex, U. S. , 2008 Deaths/100, 000 Population 43
Chart 3– 47 Death Rates for Cardiomyopathy by Age, Race, & Sex, U. S. , 2008 Deaths/100, 000 Population Age (Years) 44
Chart 3– 48 Hospitalizations for AF* by Primary & Secondary Diagnosis, U. S. , 1982– 2009 Hospitalizations (Thousands) Year * AF: Atrial fibrillation. Break represents change in National Hospital Discharge Survey design in 1988. 45
Chart 3– 49 Hospitalization Rates for Atrial Fibrillation by Age, U. S. , 1982– 2009 Hospitalizations/10, 000 Population Year * Break represents change in National Hospital Discharge Survey design in 1988. 46
Chart 3– 50 Prevalence of Stroke by Race & Sex, Ages 25– 74, U. S. , 1971– 1975 to 2005– 2008 Percent of Population * Age-adjusted. 47
Chart 3– 51 Prevalence of Stroke by Age & Sex, U. S. , 1999– 2008 Percent of Population Age (Years) 48
Chart 3– 52 Prevalence of Stroke by Age & Race, U. S. , 1999– 2008 Percent of Population Age (Years) 49
Chart 3– 53 ER* Visit Rates for Stroke by Age, U. S. , 1997– 1999 to 2006– 2008 Visits/10, 000 Population Years * ER: Emergency Department. 50
Chart 3– 54 Hospitalization Rates for Stroke, Ages 45– 64 & ≥ 65, U. S. , 1971– 2009 Hospitalizations/10, 000 Population Year * Break represents change in National Hospital Discharge Survey design in 1988. 51
Chart 3– 55 Hospital Case-Fatality Rate for Stroke, Ages < 65 & ≥ 65, U. S. , 1971– 2009* Percent Discharged Dead Year * Estimates are not available for 1976 and 1977. Break represents change in National Hospital Discharge Survey design in 1988. 52
Chart 3– 56 Age-Adjusted Death Rates for Stroke by Race & Sex, U. S. , 1950– 2008 Deaths/100, 000 Population ICD-6 ICD-7 * Nonwhite from 1950 to 1967. 53 ICD-8 ICD-9 Year ICD-10
Chart 3 -57 Deaths & Age-Adjusted Death Rates for Stroke, U. S. , 1979– 2008* Deaths in Thousands (Bar) Deaths/100, 000 Population (Line) Year * The comparability ratio 1. 0502 was applied to the deaths and rates reported in vital statistics for 1979– 1998. 54
Chart 3– 58 Age-Adjusted Death Rates for Stroke by Race/Ethnicity & Sex, U. S. , 1999– 2008 Deaths/100, 000 Population -*White -*Black -American Indian -Hispanic -Asian Male Female Year * Non-Hispanic. 55
Chart 3– 60 Age-Adjusted Death Rates for Stroke by Race/Ethnicity and Sex, U. S. , 2008 Deaths/100, 000 Population * Non-Hispanic. 56
Chart 3– 61 Death Rates for Stroke in Males by Age & Race/Ethnicity, U. S. , 2008 Deaths/100, 000 Population Age (Years) * Non-Hispanic. 57
Chart 3– 62 Death Rates for Stroke in Females by Age & Race/Ethnicity , U. S. , 2008 Deaths/100, 000 Population Age (Years) Data unreliable for American Indian females aged 45 -54 years. * Non-Hispanic. 58
Chart 3 -63 Age-Adjusted Death Rates for Stroke by State, U. S. , 2005– 2007 Deaths/100, 000 Population 59
Chart 3– 64 Age-Adjusted Death Rates* for Stroke by Country & Sex, Ages 35– 74, 2006– 2009 * Age-adjusted to European standard. Data for years indicated in parentheses. 60
Chart 3– 65 Change in Death Rates* for Stroke in Males by Country, Ages 35– 74, 1999– 2009 * Age-adjusted to European standard. Data for years indicated in parentheses. Based on log-linear regression of actual rates 61
Chart 3– 66 Change in Death Rates* for Stroke in Females by Country, Ages 35– 74, 1999– 2009 * Age-adjusted to European standard. Data for years indicated in parentheses. Based on log-linear regression of actual rates 62
Chart 3– 67 Prevalence of Hypertension* & Prehypertension by Age, U. S. , 1999– 2008 Percent of Population Age (Years) * Hypertension: systolic BP ≥ 140 mm. Hg, or diastolic BP ≥ 90 mm. Hg, or on medication. Prehypertension: systolic BP 120– 139 mm. Hg or diastolic BP 80– 89 mm. Hg. 63
Chart 3– 68 Hypertension by Race/Ethnicity & Sex, Ages 20– 74, U. S. , 1999– 2008 Percent of Population Age-adjusted prevalence. Hypertension: systolic BP ≥ 140 mm. Hg, diastolic BP ≥ 90 mm. Hg, or on medication. * Non-Hispanic. 64
Chart 3– 69 Hypertension by Race/Ethnicity & Sex, Ages 20– 74, U. S. , 1976– 2008 Percent of Population Age-adjusted prevalence. Hypertension: systolic BP ≥ 140 mm. Hg, diastolic BP ≥ 90 mm. Hg, or on medication. * Non-Hispanic. 65
Chart 3– 70 Hypertensive* Population Aware, Treated, & Controlled, Ages 18– 74, U. S. Percent of Hypertensive Population Years * Hypertension: systolic BP ≥ 160 mm. Hg, or diastolic BP ≥ 95 mm. Hg, or on medication. For years 1971 -1974 to 2005 -2008. 66
Chart 3– 71 Hypertensive* Population Aware, Treated, & Controlled, Ages 18– 74, U. S. Percent of Hypertensive Population Years * Hypertension: systolic BP ≥ 140 mm. Hg, or diastolic BP ≥ 90 mm. Hg, or on medication. For years 1976 -1980 to 2005 -2008. 67
Chart 3– 72 ER* Visit Rates for Hypertension by Age, U. S. , 1997– 1999 to 2006– 2008 Visits/10, 000 Population Years * ER: Emergency Department. 68
Chart 3– 73 Death Rates* for Diseases of the Arteries by Race & Sex, U. S. , 2008 Deaths/100, 000 Population * Age-adjusted. 69
Chart 3– 74 Death Rates for Diseases of the Arteries by Age, Race, & Sex, U. S. , 2008 Deaths/100, 000 Population Age (Years) 70
Chart 3– 75 Percent of Deaths* From Congenital Malformations of Circulatory System, Age <1 Year Percent of Deaths Year * US, 1940 - 2008. 71
Chart 3– 76 Infant Mortality From Congenital Malformations of the Circulatory System by Race Deaths/100, 000 Live Births ICD-8 ICD-9 ICD-10 Year US, 1970 - 2008. * HD: Heart disease; CVD: Cardiovascular disease 72
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