Coronary Heart Disease Disease Information Packets Slide Sets Public - - PowerPoint PPT Presentation

Coronary Heart Disease

Disease Information Packets – Slide Sets

Public Health Services, Community Health Statistics 12/2012

What is Coronary Heart Disease? What is Coronary Heart Disease?

• Coronary heart disease (CHD) is the

most common heart condition under the broad description of heart the broad description of heart disease in the United States.

• Caused by atherosclerosis –

narrowing of the small blood vessels h l bl d d h that supply blood and oxygen to the heart due to plaque (fatty deposits).

– Impaired blood flow can cause death

• f the heart muscle from lack of
• xygen
• xygen.
• CHD can also cause:

– Heart Attack – Heart Arrhythmia (irregular heartbeat) – Heart Failure – Sudden Cardiac Death

Source: Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention (DHDSP), “Heart Disease Facts and Statistics”, http://www.cdc.gov/heartdisease/statistics.htm.

Demographic Risk Factors g p

• Age

– About 82% of people who die from CHD are 65 or older. p p

• Gender

– Men are more likely than women to have CHD.

• Heredity/Genetic factors
• Heredity/Genetic factors

– Risk of CHD increases 2‐3 times if a close relative has the disease.

• Race/ethnicity

– Blacks and Hispanics are at a higher risk for developing CHD than whites.

• Socio‐economic Status

– Those of low socioeconomic status are at a higher risk for developing CHD than those of high socioeconomic status.

Sources: American Heart Association. My Heart and Stroke News. Coronary Artery Disease. The ABCs of CAD. February 2012. ‐ Scheuner MT, Whitworth WC, McGruder H, Yoon PW, Khoury MJ. Familial risk assessment for early‐onset coronary heart disease. Genet Med 2006:8(8):525‐531.

Behavioral and Social Risk Factors Behavioral and Social Risk Factors

• High blood pressure

– B.P. ≥ 140 mmHg/90 mmHg increases the risk of CHD.

Hi h bl d h l l

• High blood cholesterol

– About 1 of every 3 adult Americans has high blood cholesterol cholesterol.

• Diabetes Mellitus

l f l h – At least 3 out of 4 people with diabetes die from heart or blood vessel disease.

Sources: American Heart Association. My Heart and Stroke News. Coronary Artery Disease‐The ABCs of CAD. February 2012. Schober SE, Carroll MD, Lacher DA, Hirsch R. High serum total cholesterol—an indicator for monitoring cholesterol lowering efforts; U.S. adults, 2005–

• 2006. NCHS data brief no 2, Hyattsville, MD: National Center for Health Statistics. 2007.

Behavioral and Social Risk Factors

• Sedentary lifestyle / Obesity

– Obesity is a major risk factor for CHD Obesity is a major risk factor for CHD. – About 75 million adults are obese.

• Tobacco use

– Smoking cigarettes contributes to the development of atherosclerosis. – The risks of CHD and sudden cardiac death are higher among smokers than non smokers smokers than non‐smokers.

• Poor nutrition
• Poor medical care

Poor medical care

• Stress, depression

Sources: ‐ Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention (DHDSP), “Heart Disease Risk Factors”, http://www.cdc.gov/heartdisease/risk_factors.htm. ‐ American Heart Association. My Heart and Stroke News. Coronary Artery Disease‐The ABCs of

• CAD. February 2012.

Intermediate Outcomes

• Stroke

– A diseased heart increases the risk of stroke.

• Angina pectoris

– Causes chest pain or discomfort from reduced blood supply to the heart.

• High blood pressure
• High cholesterol
• Diabetes

Sources: American Heart Association. My Heart and Stroke News. Coronary Artery Disease‐The ABCs of CAD. February 2012. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary‐Artery‐Disease‐‐‐The‐ABCs‐of‐ CAD_UCM_436416_Article.jsp

National Statistics

• 49.7% of U.S. adults aged ≥20 years (an estimated 107.3

g y ( million persons) have at least one of the three leading risk factors for CHD. (Valderrama, 2011)

• Coronary heart disease caused 1 of every 6 deaths in the

United States in 2008. (AHA)

• In 2007, one‐quarter of all deaths (616,000) were

from diseases of the heart. (Xu, 2010) from diseases of the heart. (Xu, 2010)

Sources: ‐ American Heart Association. Circulation. Executive Summary: Heart Disease and Stroke Statistics—2012. 2012; 125: 188‐197. ‐ Xu JQ, Kochanek KD, Murphy SL, Tejada‐Vera B. Deaths: Final data for 2007. National vital statistics reports; vol 58 no 19. Hyattsville, MD: NCHS; 2010 ‐ Valderrama L, Amy, et al. Million Hearts: Strategies to Reduce the Prevalence of Leading Cardiovascular Disease Risk Factors ‐‐‐ United States, 2011.

• MMWR. 2011; 60(36);1248‐1251

National Disparities

• In the United States,

the rate of death due

Top 5 States with Highest Heart Disease Death Rates, United States, 2000‐2006

to heart disease in 2006 was highest in Mississippi and lowest

• 1. Mississippi

2 Oklahoma

Mississippi and lowest in Minnesota.

• 2. Oklahoma
• 3. Alabama

4 West Virginia

• 4. West Virginia
• 5. Kentucky

Source: Centers for Disease Control and Prevention, Heart Disease Fact Sheet, January 2010.

National Disparities

126.0 166.9 126.1 166.7 140 160 180

*

Coronary Heart Disease Age‐Adjusted Death Rates* United States, 2009

126.0 94.8 126.1 94.3 73.1 99.9 40 60 80 100 120 140

Rate per 100,000*

20 40

R

*Age‐adjusted rates are per 100,000 2000 U.S. Standard population. Source: Source: National Vital Statistics System, CDC, NCHS. Online database accessed 11/07/2012, http://www.wonder.cdc.gov. P d b C f S Di (C SD) H l h & H S i A (HHSA) P bli H l h S i C i H l h S i i 11/07/2012

In 2009, the age‐adjusted death rate from CHD was highest for blacks, followed by whites and higher for men than women

Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Public Health Services, Community Health Statistics, 11/07/2012.

followed by whites, and higher for men than women.

Source: National Vital Statistics System, CDC, NCHS. Online database accessed 11/07/2012, http://www.wonder.cdc.gov. Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Public Health Services, Community Health Statistics, 11/07/2012.

Local Statistics and Disparities

162.4 180

CHD Deaths*: Actual and Age‐Adjusted Rates** San Diego County, 2009

Actual Rate** 107.2 119.0 95.5 102.5 135.4 106.1 130.1 101.7 100 120 140 160 0** Age‐Adjusted Rate** 84.2 45.2 64.8 76.6 74.5 40 60 80 100 Rate per 100,000 20 Total Male Female White Black Hispanic API‡ R

* h f ( d l f d h) d * CHD Death refers to (underlying cause of death) ICD‐10 codes I11,I20‐I25. ** County actual rates are per 100,000 individuals. County age‐adjusted rates per 100,000 2000 US standard population. § Rates not calculated for fewer than 5 events. ‡ API includes Asian and Pacific Islander. Source: Death Statistical Master Files (CADPH), County of San Diego, Health & Human Services Agency, Epidemiology & Immunization Services Branch; SANDAG, Current Population Estimates, 10/2010. Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Community Health Statistics, 9/19/2012.

Local Statistics and Disparities

900

CHD Death* Rates** by Age Group, San Diego County, 2009

Actual Rate** 773.7 600 700 800 ** Age‐Adjusted Rate** 200 300 400 500 ate per 100,000* 107.2 § § 33.5 102.5 100 200 Total 0‐14 Years 15‐24 Years 25‐64 Years 65+ Years Ra

* CHD Death refers to (underlying cause of death) ICD‐10 codes I11,I20‐I25. ** County actual rates are per 100,000 individuals. County age‐adjusted rates per 100,000 2000 US standard population. § Rates not calculated for fewer than 5 events. ‡ API includes Asian and Pacific Islander. Source: Death Statistical Master Files (CADPH), County of San Diego, Health & Human Services Agency, Epidemiology & Immunization Services Branch; SANDAG, Current Population Estimates, 10/2010. Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Community Health Statistics, 9/19/2012. Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Community Health Statistics, 9/19/2012.

Local Statistics and Disparities

160 180

Coronary Heart Disease† Rates* San Diego County, 2009

107.2 98.7 135.7 92.6 102.8 105.8 112.0 100 120 140 160 0,000* 40 60 80 Rate per 100 20 San Diego County Central East North Central North Coastal North Inland South

*R t 100 000 l ti *Rates are per 100,000 population. †Coronary Heart Disease death refers to (underlying cause of death) ICD‐10 codes I11, I20‐I25. §Rates not calculated for fewer than 5 events. Rates not calculated in cases where zip codes is unknown or outside San Diego. Source: San Diego County Community Profiles, CoSD, HHSA, Epidemiology and Immunization Services Branch; SANDAG, Current Population Estimates, 10/2010. Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Community Health Statistics, 6/28/2012.

Local Statistics and Disparities

200

Coronary Heart Disease Death Rates* San Diego County, 2000‐2009

120 140 160 180 North Coastal North Central Central 60 80 100 120 e per 100,000* South East 20 40 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Rate North Inland San Diego County

*Rates are per 100,000 population. †Coronary Heart Disease death refers to (underlying cause of death) ICD‐10 codes I11, I20‐I25. §Rates not calculated for fewer than 5 events. Rates not calculated in cases where zip codes is unknown or outside San Diego. Source: San Diego County Community Profiles, CoSD, HHSA, Epidemiology and Immunization Services Branch; SANDAG, Current Population Estimates, 10/2010. Prepared by County of San Diego (CoSD), Health & Human Services Agency (HHSA), Community Health Statistics, 6/28/2012.

Disease Prevention

• Avoid smoking
• Be physically active
• Control weight

E t h lth f d

• Eat healthy foods
• Avoid excessive alcohol

consumption p

• See a doctor regularly to:

– Monitor cholesterol level – Check blood pressure Check blood pressure – Control diabetes

Source: American Heart Association. Risk Factors and Coronary Heart Disease and Stroke. American Heart Association, Inc. February 2012.

Know the 5 Major Symptoms of a H A k Heart Attack

• 1. Pain or discomfort in the jaw, neck, or back
• 1. Pain or discomfort in the jaw, neck, or back
• 2. Feeling weak, light‐headed, or faint

3 Chest pain or discomfort

• 3. Chest pain or discomfort
• 4. Pain or discomfort in arms or shoulder

5 Shortness of breath

• 5. Shortness of breath

If you think that you or someone

DIAL 9 1 1

If you think that you or someone you know is having a heart attack, call 9–1–1 immediately

DIAL 9‐1‐1

call 9 1 1 immediately.

Source: American Heart Association. My Heart and Stroke News. Coronary Artery Disease-The ABCs of CAD. February 2012.

Critical Pathway for Coronary Heart Disease

Contact Us

County of San Diego County of San Diego Health and Human Services Agency bli l h S i Public Health Services Community Health Statistics (619)285‐6479 www SDHealthStatistics com www.SDHealthStatistics.com