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Coronary Heart Disease CHD Fact Sheet pub

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					Coronary Heart Disease   General Information

                         Background1
                         Coronary heart disease (CHD) occurs when the coronary arteries become narrowed or clogged by cholesterol and
                         fat deposits (atherosclerosis) and cannot supply enough blood to the heart muscle. CHD can cause angina (chest
                         pain) and heart attack. Heart disease is the leading cause of death for all people in the United States.

                         Risk Factors2
                         Risk factors for CHD include:
                             • Increasing age                                     •   Physical inactivity
                             • Male sex (gender)                                  •   Obesity and overweight
                             • Heredity, including race                           •   Diabetes
                             • Smoking or exposure to tobacco smoke               •   Stress
                             • High blood cholesterol                             •   Excessive alcohol consumption
                             • High blood pressure
                         Prevention1
                         Recommendations for reducing the risk of developing CHD include:
                            • Quit smoking and/or eliminate exposure to tobacco smoke
                            • Begin or sustain regular physical activity
                            • Lose excess weight and maintain healthy weight
                            • Eat a healthful diet
                            • Maintain healthy cholesterol and blood pressure levels
                            • Control diabetes
                            • Reduce stress
                            • Limit alcohol consumption


                         Size

                         San Diego County
                             • The 2001 prevalence of CHD among persons 18 years of age and over living in San Diego County was
                                 6.5%. This equates to approximately 134,000 persons with CHD.3
                         California
                             • The 2001 prevalence of CHD among Californians 18 years of age and over was 7.2%. This equates to
                                 approximately 1,726,400 persons with CHD.3
                         National
                             • The 2001 prevalence of CHD among persons 18 years of age and over was 6.4%. This equates to ap-
                                 proximately 13,200,000 persons with CHD.4

                         High-risk Populations5
                         Individuals at higher risk for developing CHD include:
                             • Adults with diabetes
                             • Those of increased age
                             • Males
                             • Non-Hispanic whites
                             • Individuals with low education levels

                         Healthy People 2010 Objective 12-1: Reduce CHD deaths to 166 deaths per 100,000 population.6




                                                                                                                                    41
                                                                                                                                                     Coronary Heart Disease



Size (continued)


                                Coronary Heart Disease Prevalence
                                                       United States – 2002 Select Characteristics4

                                                      30%
                                                                                                    25%
                                                      25%
                               Age-adjusted percent




                                                      20%                                   19%

                                                      15%

                                                      10%   8%                       7%                        6%       6%
                                                                   5%                                                             5%      5%
                                                      5%
                                                                             1%
                                                      0%




                                                                                                                                          Hispanic
                                                            Male




                                                                                                                       American

                                                                                                                                  Asian
                                                                   Female



                                                                            years


                                                                                    years


                                                                                            years

                                                                                                    75 years
                                                                            18-44


                                                                                    45-64


                                                                                            65-74




                                                                                                               White

                                                                                                                        African
                                                                                                      plus


Seriousness

Mortality
   • Since 2000, 13,311 San Diego County residents have died from CHD.7 During 2002 in San Diego County, the age-
        adjusted death rate from CHD was 162.8 per 100,000 population.7
   • In San Diego County, mortality rates from CHD per 100,000 are highest among the following populations:7
        • African Americans (265.5)
        • Males (206.8)
        • Persons aged 65 or older (age 65-74, 419.6; age 75-84, 1182.2; age 85 or older, 3840.6)
   • Between 2000 and 2002, an average of 56,735 Californians died annually from CHD.8 From 2000 to 2002, the age-
        adjusted death rate from CHD for California was 186.0 per 100,000 population.8
   • Nationally, there were approximately 519,480 deaths related to CHD in 2002.9
   • From 1999 to 2002, the age-adjusted death rate from CHD for the U.S. decreased from 194.2 to 171.1.9

Health Care Impacts and Economic Costs of Coronary Heart Disease4
The total estimated direct and indirect costs of CHD in the U.S. during 2004 were $132.2 billion.
    • The estimated direct costs of CHD in 2004 were $66.3 billion. That includes hospital, nursing, and physician care, as well
         as drugs, medical technologies, and supplies.
    • The estimated indirect costs of CHD in 2004 were $57.8 billion. That includes the costs of lost productivity due to mortal-
         ity and morbidity.
    • CHD is the primary cause of permanent disability among U.S. workers, constituting some 19% of Social Security disabili-
         ties.
    • Medicare spent $10.7 billion for treating CHD in 1999.




42
2004 Community Health Needs Assessment


Seriousness (continued)


 Coronary Heart Disease Mortality Rates                                                                           Coronary Heart Disease Mortality Rates
                                                                                                     9,7                                                                           by Gender
                                          U.S. & San Diego County 2000 – 2002                                                                                                                                      7
                                                                                                                                                                      San Diego County 2000 - 2002

                                  190            187.2                                                                                              252               231.8
                                                                                                                                                                                          218.3
                                                                                                                                                    232
                                                                                                                                                                                                                    206.8
  Deaths per 100,000 population




                                  185




                                                                                                                    Deaths per 100,000 population
                                                                                                                                                    212
                                                185.1                                                                                                                                                                         Male
                                                                          176.3                                                                     192
                                  180
                                                                                                                                                    172
                                  175                                     178.3                  171.1                                              152
                                                                                                         U.S.                                       132               148.3                146.3                             Female
                                  170
                                                                                                                                                    112
                                                                                                                                                                                                                   127.9
                                  165                                                                                                                92
                                                                                                      San Diego                                      72
                                  160                                                            162.8 County
                                                                                                                                                     52
                                                2000                      2001                   2002                                                               2000                  2001                     2002




  Coronary Heart Disease Mortality Rates                                                                           Coronary Heart Disease Mortality Rates
                                                           By Race/Ethnicity                                                                                                     By Age Category
                                                                                           7                                                                                                                 7
                                                         San Diego County 2002                                                                                                San Diego County 2002

                                  300                                                                                                               4500
                                                                                       265.5
                                                                                                                                                                                                                       3,840.6
                                                                                                                                                    4000
  Deaths per 100,000 population




                                  250
                                                                                                                    Deaths per 100,000 population




                                                                                                                                                    3500
                                  200                                 167.3                                                                         3000
                                         162.8
                                                          141.2                                                                                     2500
                                  150
                                                                                                    111.6
                                                                                                                                                    2000
                                  100
                                                                                                                                                    1500                                                    1,182.2
                                   50                                                                                                               1000
                                                                                                                                                                                                   419.6
                                                                                                                                                     500                          47.6    160.1
                                    0                                                                                                                         1.7        11.3
                                         Overall         Hispanic         White        African      Asian /                                               0
                                                                                      American       other                                                    25-34      35-44    45-54   55-64    65-74     75-84        85 plus




  Coronary Heart Disease Mortality Rates                                                                          Coronary Heart Disease Mortality Rates
                                                        By Geographic Region                                                                                                       By Gender
                                                                                           7                                                                                                                 7
                                                         San Diego County 2002                                                                                                San Diego County 2002

                                  250                                                                                                               250
                                                                              205.5      199.0       198.9                                                               206.8
  Deaths per 100,000 population




                                                                                                                  Deaths per 100,000 population




                                  200                                                                                                               200

                                        141.9       135.8
                                  150                             126.9                                                                             150                                                    127.9

                                  100
                                                                                                                                                    100

                                   50
                                                                                                                                                     50

                                    0
                                         North       North         North     Central      East       South                                            0
                                        Coastal     Central       Inland                                                                                                   Male                            Female




                                                                                                                                                                                                                                      43
                                                                                                                    Coronary Heart Disease



 Community Concern*
 Focus Group Discussion Points
 Seniors and older adults found heart disease and stroke to be of significant concern.

 Key Informant Scoring
 Overall, key informants scored heart disease and stroke as ninth most important out of 14 health issues presented. Moreover, key
 informants identified heart disease and stroke as the second most important health issue for individuals aged 25 to 64 years and the
 most important health issue for those aged 65 and older.


 *Please note that focus groups and key informant surveys are qualitative in nature and findings presented may not be representative of a larger
 population.


 References

 1.   National Heart, Lung, and Blood Institute. Retrieved September, 2004 from http://nhlbisupport.com

 2.   American Heart Association. Retrieved September, 2004 from www.americanheart.org

 3.   L. Lund,: Prevalence of Heart Disease in California Counties, 2001. California Department of Health Services, Center for
      Health Statistics, February 2004.

 4.   American Heart Association, 2004 Heart and Stroke Statistical Update, Dallas, Texas: American Heart Association, 2003.

 5.   Centers for Disease Control and Prevention. Self-Reported Heart Disease and Stroke Among Adults With and Without Diabe-
      tes—United States, 1999-2001. MMWR 2003;52:1-4.

 6.   U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Wash-
      ington, DC: U.S. Government Printing Office, November 2000.

 7.   County of San Diego data provided by the County of San Diego Health and Human Services Agency, Department of Commu-
      nity Epidemiology, based on data provided by the California Department of Health Services, Center for Health Statistics, Vital
      Statistics Section, Death Statistical Master Files; SANDAG January 1 population estimates.

 8.   Kichanek KD, Smith BL, Deaths: Preliminary Data for 2002. National vital statistics reports; Vol. 52, no. 13, Hyattsville,
      Maryland: National Center for Heath Statistics. 2004.

 9.   Lethbridge-Cejku M, Schiller JS, Bernadel L. Summary health statistics for U.S. Adults: National Health Interview Survey,
      2002. National Center for Health Statistics. Vital Health Stat 10(222). 2004.




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