Coronary Heart Disease - SanDiegoCounty.gov...Coronary Artery Disease‐The ABCs of CAD. February...
Transcript of Coronary Heart Disease - SanDiegoCounty.gov...Coronary Artery Disease‐The ABCs of CAD. February...
Coronary Heart DiseaseDisease 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 heartthe broad description of heart disease in the United States.
• Caused by atherosclerosis –narrowing of the small blood vessels h l bl d d hthat supply blood and oxygen to the heart due to plaque (fatty deposits).– Impaired blood flow can cause death
of the heart muscle from lack of oxygenoxygen.
• 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 Factorsg 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 FactorsBehavioral 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 cholesterolcholesterol.
• Diabetes Mellitusl 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 CHDObesity 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 smokerssmokers than non‐smokers.
• Poor nutrition• Poor medical carePoor 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) werefrom 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 OklahomaMississippi and lowest in Minnesota.
2. Oklahoma
3. Alabama
4 West Virginia4. 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
140160180
*Coronary Heart Disease Age‐Adjusted Death Rates*
United States, 2009
126.0
94.8
126.1
94.373.1
99.9
406080100120140
Rate per 100
,000
*
02040R
*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
162.4180
CHD Deaths*: Actual and Age‐Adjusted Rates** San Diego County, 2009
Actual Rate**
107.2119.0
95.5102.5
135.4
106.1
130.1
101.7100
120
140
160
0**
Age‐Adjusted Rate**
84.2
45.2
64.876.6 74.5
40
60
80
100
Rate per 100,000
0
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 pe
r 100,000*
107.2
§ §33.5
102.5
0
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
107.298.7
135.7
92.6102.8 105.8 112.0
100
120
140
160
0,000*
40
60
80
Rate per 100
0
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 pe
r 100,000*
South
East
0
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
consumptionp• See a doctor regularly to:
– Monitor cholesterol level– Check blood pressureCheck 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 kHeart Attack
1. Pain or discomfort in the jaw, neck, or back1. Pain or discomfort in the jaw, neck, or back2. Feeling weak, light‐headed, or faint3 Chest pain or discomfort3. Chest pain or discomfort4. Pain or discomfort in arms or shoulder5 Shortness of breath5. Shortness of breath
If you think that you or someone DIAL 9 1 1If you think that you or someoneyou 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
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