Heart Disease and Stroke

Statistics — 2008 Update

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 550
Deaths in Thousands

500

450

400
79 80 85 90 95 00 04
Years

Males Females

CVD disease mortality trends for males and females

(United States: 1979-2004).
Source: NCHS and NHLBI.
 200
Per 100,000 Population

148.7
150
114.7

100
65.5
47.2 41.9 39.9
50 32.2
23.9

0
Coronary Heart Stroke Lung Cancer Breast Cancer
Dis eas e

White Fem ales Black Fem ales

Age-adjusted death rates for CHD, stroke, lung and breast for
white and black females (United States: 2004).
Source: NCHS and NHLBI.
 900
Deaths in Thousands

800
700
600
500
400
300
200
100
0
00 10 20 30 40 50 60 70 80 90 00 05

Years

Deaths from diseases of the heart (United States: 1900–2005)

Note: See Glossary for an explanation of “Diseases of the Heart.”
Source: NCHS and NHLBI. Note: 2005 data preliminary.
 1200

1000
Deaths in Thousands

800

600

400

200

0
00 10 20 30 40 50 60 70 80 90 00 04
Years

Deaths from cardiovascular disease (I00-I99)

(United States: 1900–2004). Source: NCHS and NHLBI.
 7
Discharges in Millions

0
70 75 80 85 90 95 00 05
Years

Hospital discharges for cardiovascular diseases.

(United States: 1970-2005). Note: Hospital discharges include
people discharged alive, dead and status unknown.
Source: NCHS and NHLBI.
 Coronary Heart
Disease
4 Stroke
6 14
7
HF*

17 High Blood Pressure

52 Diseases of the
Arteries
Other

Percentage breakdown of deaths from cardiovascular diseases

(United States:2004) * - Not a true underlying cause.
Source: NCHS and NHLBI.
 92.0
100
83.0
80 71.3 75.1
Percent of Population

60
39.1 39.5
40

20 14.8
9.4

0
20-39 40-59 60-79 80+

Males Females

Prevalence of CVD in adults age 20 and older by age and sex

(NHANES: 1999-2004). Source: NCHS and NHLBI.
These data include coronary heart disease, heart failure, stroke and hypertension.
 80 74.4
Per 1,000 Person Years

65.2
70
59.2
60
50 40.2
40 34.6
30 21.4 20.0
20 10.1 8.9
10 4.2
0
45-54 55-64 65-74 75-84 85-94
Age

Men Women

Incidence of CVD* by age and sex. FHS, 1980-2003. NHLBI.

* Includes CHD, HF, stroke or intracerebral hemorrhage. Does not
include hypertension alone.
 25
22.0
19.8
Percentage of Population

20
16.1
15 13.4

10
5.4
5 3.5

0
C VD H ypertension O besity
C o n d itio n

U nder 5 Y ears 5 Y ears and O ver

Percent of Foreign-Born Hispanics, Age 18 and Over, with

Selected Health Conditions, by Length of Time Living in the U.S.
(United States: 1998-2003). Note: In this chart, CVD excludes
hypertension. Source: MMWR, vol. 55, No. 12, Apr.7, 2006.
 1,000
870
Deaths in Thousands

800
554
600

400 323
265
130 139 166
200 79 97 80
26 22 47 50
0
<45-54 45-54 55-64 65-74 75-84 85+ Total
Ages

CVD Cancer

CVD deaths vs. cancer deaths by age.

(United States: 2004). Source: NCHS and NHLBI.
 900,000
800,000
700,000
Alzheimer
600,000
CLRD
De aths 500,000 Cancer
400,000 Other CVD
300,000 Stroke
200,000 Heart Disease
100,000
0
All Age s <85 85+

CVD and other major causes of death: both sexes.

(United States: 2004). Source: NCHS and NHLBI.
 450,000
400,000
350,000 CLRD
300,000 Accidents
De a ths 250,000
Cancer
200,000 Other CVD
150,000 Stroke
100,000 Heart Disease
50,000
0
All Ages <85 85+

CVD and other major causes of death: males

(United States: 2004). Source: NCHS and NHLBI.
 500,000

400,000 A lz heim er
C LR D
D e a th s 300,000
C anc er
200,000 O ther C V D
S trok e
100,000 H eart D is eas e

0
A ll A g e s < 85 85+

CVD and other major causes of death: females

(United States: 2004). Source: NCHS and NHLBI.
 500,000
410,628 459,096
400,000
286,830 267,058
300,000
Deaths

200,000

72,050 58,646 63,341 39,962

100,000 35,267 46,991

0
A B C D E A B D F C

Males Females

A Total CVD D Chronic Lower Respiratory

B Cancer Diseases
C Accidents E Diabetes Mellitus
CVD and other F Alzheimer’s
major causes of death Disease
for all males and
females (United States: 2004). Source: NCHS and NHLBI.
 45
Percent of Total Deaths

40 37.7
35.1
35
30 24.6
25 22.0
20
15
10 6.1 5.3 5.7
2.8 4.1 3.3
5
0
A B C D E A B D F C

Males Females

A Total CVD D Chronic Lower Respiratory

B Cancer Diseases
C Accidents E Diabetes Mellitus
F Alzheimer’s Disease
CVD and other major causes of death for white males and
females (United States: 2004). Source: NCHS and NHLBI.
 45
Percent of Total Deaths

40 38.1
32.9
35
30
25 22.2 21.3
20
15
10 5.9 4.7 5.1
3.8 3.0 2.9
5
0
A B C D E A B E F C

Males Females

A Total CVD D Assault (Homicide)

B Cancer E Diabetes Mellitus
C Accidents F Nephritis, Nephrotic Syndrome and Nephrosis
CVD and other major causes of death for black or African
American males and females. (United States: 2004).
Source: NCHS and NHLBI.
 45
Percent of Total Deaths

40
35
26.5 30.4
30
25 21.4
19.0
20
15 11.4
10 4.2 4.1 5.8 4.8 2.8
5
0
A B C D E A B D C F

Males Females

A Diseases of the Heart, and Stroke D Diabetes Mellitus

B Cancer E Assault (Homicide)
C Accidents F Influenza & Pneumonia
Diseases of Heart and Stroke and other major causes of death for Hispanic
or Latino males and females, (United States: 2004). Source: NCHS.
 45
Percent of Total Deaths

40
32.9 33.5
35
30 26.7 26.9
25
20
15
10 5.5 4.0 4.0
3.5 3.3 3.4
5
0
A B C D E A B E C F

Males Females

A Diseases of the Heart, and Stroke D Chronic Lower Respiratory

B Cancer Diseases
C Accidents E Diabetes Mellitus
Diseases of the heart and strokeFand otherand
Influenza major causes of
Pneumonia
death for Asian or Pacific Islander males and females
(United States: 2004). Source: NCHS.
 Percent of Total Deaths

45
40
35
30 25.0
23.6
25
19.2
20 17.4
14.2
15
8.5
10 5.1 6.4
4.5 4.2
5
0
A B C D E A B C D E

Males Females

A Diseases of the Heart, and D Diabetes Mellitus

Stroke E Chronic Liver Disease and Cirrhosis
B Cancer
Diseases of the heart and stroke and other major causes of
C Accidents
death for American Indian or Alaska Native males and females
(United States: 2004). Source: NCHS.
 A B C D
Blood Pressure (mm Hg) 120/80 140/90 140/90 140/90
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.
 350000
New and Recurrent MI or

290000
300000 265000
235000
250000
Fatal CHD

200000 180000
150000
95000 95000
100000
50000 30000
10000
0
35-44 45-64 65-74 75+
Ages

Men W omen

Annual number of U.S. Adults having diagnosed heart attack

by age and sex (ARIC: 1987-2004). Source: NHLBI. Includes MI
and fatal CHD but not silent MI’s.
 35
32.7
30
Percent of Population

25 22.8 21.6
20 15.4
15
10 7.8
5.5
5 0.6 0.6
0
20-39 40-59 60-79 80+

M en W om en

Prevalence of CHD by age and sex

(NHANES :1999-2004). Source: NCHS and NHLBI.
 16
14
Per 1,000 Persons

12
10
8
6
4
2
0
35-44 45-54 55-64 65-74

White Men Black Men White Women Black Women

Annual rate of first heart attack by age, sex and race.

(ARIC :1987-2004). Source: NHLBI.
 12
10.3
Per 1,000 Person Years

10 9.2

8 5.1 7.2
6.1 6.2
6
2.4 4.3
3.5
4 3.0
1.8
2 0.9 1.2 0.7
1.0
0.3
0
35-44 45-54 55-64 65-74

White Men Black Men White Women Black Women

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.
 Per 1,000 Person Years

12
10.1 10.5
10
7.6
8
5.6 5.3
6 5.0
4.0 4.2
4 3.1

2 0.9
0
45-54 55-64 65-74 75-84 85-94
Age

Men Women

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.
Discharges in Thousands

1400
1200
1000
800
600
400
200
0
70 75 80 85 90 95 00 05
Years

Males Females

Hospital discharges for coronary heart disease by sex

(United States: 1970-2005). Source: NHDS/NCHS and NHLBI.
Note: Hospital discharges include people discharged alive,
dead, and status unknown.
 16
15.1
14
11.4
Prevalence (%)

12 10.4
10 8.6
8.3 7.9
8
6.2 5.6 5.1
6 5.1
3.6
4
2.2
2
0
All Women Men

1971-75 1976-1980 1988-1994 1999-2002

Prevalence of Low CHD Risk, overall and by sex, age 25-74

(NHANES: 1971-2002). Source: Personal communication with
NHLBI, June 28, 2007. “Low risk” is defined as SBP <120 mm Hg and
diastolic BP <80 mm Hg; cholesterol <200 mg/dL and BMI <25 kg/m2 and
currently not smoking cigarettes and no prior MI or DM.
 140
Procedures in Thousands

120
100
80
60
40
20
0
79 80 85 90 95 00 05
Years

Trends in Carotid Endarterectomy Procedures

(United States: 1979-2005). Source: NHDS/NCHS and NHLBI.
 16
14.8
14 12.4
Percent of Population

12
10
8 6.5 6.2
6
4 2.3
2 1.2
0.5 0.5
0
20-39 40-59 60-79 80+

Men W omen

Prevalence of stroke by age and sex (NHANES: 1999-2004).

Source: NCHS and NHLBI.
 Incidence per 100,000

250
226 219
200 181
156
150

100
42 44
50 20 24
6 7 11 11
0
Ischemic Intracerebral Subarachnoid
hemorrhage hemorrhage

White '93-94 White '99 Black '93-94 Black '99

Annual age-adjusted incidence of first-ever stroke, by race

Inpatient plus out-of-hospital ascertainment.
(GCNKSS: 1993-94 and 1999). Source: Stroke 2006;37;2473-2478.
 35
32.1
30
Per 1,000 Persons

25 19.6 20.2
14.7
20
15 12.5 12.4 12.5
8.4
7.6 7.2
10 5.7 5.6 5.6
2.7 2.2 2.7 1.9 4.1
5 1.1 0.7
0
45-54 55-64 65-74 75-84 85+
Ages

WM WF BM BF

Annual rate of first cerebral infarction by age, sex and race

(GC/NKSS: 1999). Source: Unpublished data GC/NKSS.
Note – rates for ages 45-54 for black males and females and for black
males ages 75 and over, are considered unreliable.
 35 32.1
30
Per 1,000 Persons

25 19.5 20.9
14.7
20
13.5 13.8 13.6
15 8.9
10 7.7 6.6 8.06.6
5.3
3.5 2.9 2.9 2.2 4.9
5 1.4 1.0
0
45-54 55-64 65-74 75-84 85+
Ages

WM WF BM BF

Annual rate of all first-ever strokes by age, sex and race

(GCNKSS: 1999).
Source: Unpublished data GCNKSS. Note: Rates for ages 45-54 for
black males and females, and rates for ages 75 and older for black
males, are considered unreliable.
 A B C D E F
Systolic BP* 95-105 130-148 130-148 130-148 130-148 130-148
Diabetes No No Yes Yes Yes Yes
Cigarettes No No No Yes Yes Yes
Prior Atrial Fib. No No No No Yes Yes
Prior CVD No No No No No Yes
*Closest ranges for women are: 95-104 and 115-124.
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.
 90.0 83.8
80.0 73.9
69.5
70.0 63.6
Percent of Population

60.0 55.4
49.1
50.0
37.5 37.4
40.0
30.0 23.2
18.3
20.0 11.2
10.0 6.4
0.0
20-34 35-44 45-54 55-64 65-74 75+

Men Women

Prevalence of high blood pressure in Adults by age and sex

(NHANES: 1999-2004). Source: NCHS and NHLBI.
 74.6 75.3
Percent of Population With

80 68.4
70 62.5
60 52.3
Hypertension

50 39.8
35.8 34.3
40
30 24.6
20
10
0
Awareness Treatment Controlled

20-39 40-59 60+

Extent of awareness, treatment and control of high blood

pressure by age (NHANES : 1999-2004). Source: NCHS and NHLBI.
 50
Percent of Population

37.5 39.0 38.2 41.4

40
28.5 28.0 27.0
30 25.6 26.9 26.2 25.0
22.9
20
10
0
NH White- NH White- NH Black orNH Black or Mexican Mexican
Only Men Only AA Men AA Wom en Am erican Am erican
Wom en Men Wom en

1988-94 1999-04

Age-adjusted prevalence trends for high blood pressure in

Adults age 20 and older by race/ethnicity, sex and survey
(NHANES: 1988-94 and 1999-2004). Source: NCHS and
NHLBI. NH- non-Hispanic; AA- African American.
 90
Percent of Population With

80 72.9 76.9
66.9
70 62.4 63.4
Hypertension

60 49.1
50
37.2
40 33.6
30 25.1
20
10
0
Awareness Treatment Controlled

NH Whites NH Blacks Mexican Americans

Extent of Awareness, Treatment and Control of High

Blood Pressure by Race/Ethnicity (NHANES: 1999-2004).
Source: NCHS and NHLBI.
 14
12.4
11.6
12
Percent of Population

10
8 7.2
6 5.2

4
2
2 1.5
0.3 0.2
0
20-39 40-59 60-79 80+

Men Women

Prevalence of heart failure by age and sex

(NHANES: 1999-2004). Source: NCHS and NHLBI.
Discharges in Thousands

700
600
500
400
300
200
100
0
79 80 85 90 95 00 05
Years

Male Female

Hospital discharges for heart failure by sex

(United States: 1979-2005). Source: NHDS, NCHS and NHLBI.
Note: Hospital discharges include people discharged alive, dead
and status unknown.
 50
43.0
Per 1,000 Person Years

40
30.7
30
22.3
20 14.8
9.2
10 4.7

0
65-74 75-84 85-94
Age

Men Women

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.
 45
Percent of Population

40
35
30 24.9
27
24.8
25
19.2
20
14
15 11.9
10
5
0
NH Whites NH Blacks Hispanics

Males Females

Prevalence of students in grades 9-12 reporting current cigarette

smoking by race/ethnicity and sex. (YRBS:2005). Source: MMWR.
2006;55:SS-5. June 9, 2006. NH – non-Hispanic.
 37.5
40
Percent of Population

35
30 26.7 26.8
24.0
25 21.1 20.6 20.0
20 17.3
15 11.1
10 6.1
5
0
Men Women

NH White NH Black
Hispanic NH Asian
NH American Indian/Alaska Native

Prevalence of current smoking for Adults age 18 and older

by race/ethnicity and sex (NHIS:2005).
Source: MMWR. 2006;55:1145-48. NH – non-Hispanic.
 180
174
Mean Total Blood Cholesterol

175 172
171 170
170 168
165 166 166
165 163 163 163 164
161 161
160
155 156
155
150
145
White Males Black Males White Females Black Females

1976-80 1988-94 1999-02 2003-04

Trends in mean total serum cholesterol among adolescents

ages 12-17 by race, sex, and survey (NHANES: 1976-80,
1988-94, 1999-02 and 2003-04). Source: NCHS and NHLBI.
 Mean Serum Total Cholesterol

208
206
206 205
204 204
204
202 202
202 201
200 199
198 197
196
194
192
NH White NH Black Mexican American

1988-94 1999-02 2003-04

Trends in mean total serum cholesterol among adults

age 20 and older, by race/ethnicity and survey
(NHANES : 1988-94, 1999-02 and 2003-04).
Source: NCHS and NHLBI. NH – non-Hispanic.
 46.9
Percent of Population

50
45
38.2 39
40
35 30.2
30 26.5
25 21.3
20
15
10
5
0
Male Female

NH White NH Black Hispanic

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: 2005). Source: MMWR. 2006;55:No. SS-5. NH – non-Hispanic.
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.
 50
45.7 44.8
45
Percent of Population

32.5 39.6
40 37.5 36.3
34.2 34.4 31.8
35 27.0 33.9 31.5 23.8
28.3
30 26.4 25.0
20.4 24.0
25 18.4 21.6
20
15
10
5
0
NH White NH Black Hispanic Asian/Pac. Isl. Am. Ind./Al.
Native

Male '94 Female '94 Male '04 Female '04

Prevalence of leisure-time physical inactivity among adults age

18 and older by race/ethnicity, and sex. (BRFSS: 1994 and
2004). Source: MMWR, 2005;54:No. 39:991-994. NH – non-Hispanic.
 24
21.3
20
Percent of Population

15.9 16.1
16 15.2
12.1
12
8.2
8

0
Males Females

NH W hites NH Blacks Hispanics

Prevalence of overweight among students in grades 9-12 by

race/ethnicity and sex (YRBS: 2005). Source: MMWR. 2006 55:
No. SS-5. BMI 95th percentile or higher. NH – non-Hispanic.
 40
34
Percent of Population

30.2
30
26
20.6
20 16.8 17.1
15.7
10.7 12.2 12.8

10

0
Men Women

1960-62 1971-74 1976-80 1988-94 2001-2004

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 2001-2004). Source: Health, United States, 2006, NCHS.
Note: Obesity is defined as a BMI of 30.0 or higher.
 20
18 17.5 17.0
Percent of Population

16
14
11.3
12 10.5
10
8 6.5 6.1
6 5.0
4.0
4
2
0
6-11 12-19

1971-74 1976-80 1988-94 2001-2004

Trends in prevalence of overweight among U.S. children and

adolescents by age and survey. (NHANES, 1971-74, 1976-80,
1988-94 and 2001-2004). Source: Health, United States, 2006, NCHS.
 14.0 13.2

12.0 11.0 10.9

10.7
Percent of Population

10.0

8.0 6.7
5.6
6.0

4.0

2.0

0.0
Men Women

NH Whites NH Blacks Mexican Americans

Age-adjusted prevalence of physician-diagnosed diabetes in Adults

age 18 and older by race/ethnicity and sex
(NHANES: 1999-2004). Source: NCHS and NHLBI. NH – non-Hispanic.
 14
12.0
12
Percent of Population

9.7 9.8 10.1 9.8

10
7.5
8
5.6 6.0
6 4.2
4
2
0
NH W hites NH Blacks Mexican Americans

Less than high school High school More than high school

Prevalence of Physician Diagnosed Type 2 diabetes in Adults age

18+ by Race/Ethnicity, and Years of Education (NHANES: 1999-
2004). Source: NCHS and NHLBI. NH – non-Hispanic.
 2,363
2,500
2,107 2,199 2,192
Number of Transplants

2,000

1,500

1,000 719

500
22 57
0
75 80 85 90 95 00 06
Years

Trends in Heart Transplants (UNOS: 1975-2006).

Source: United Network for OrganSharing (UNOS), scientific
registry data.
Procedures in Thousands

1400
1200
1000
800
600
400
200
0
79 80 85 90 95 00 05
Years
Catheterizations Open-Heart
Bypass PCI
Carotid Endarterectomy Pacemakers

Trends in Cardiovascular Operations and Procedures

(United States: 1979-2005). Source: NCHS and NHLBI.
Note: Inpatient procedures only.
 50
44.1
45
Deaths/1,000 Person Years

40 No MetS or DM
35 30.0 MetS w/o DM
28.1 26.1
30 MetS w/DM
21.1
25
16.7 17.1 DM only
20 17.0
11.5 14.4 Prior CVD
15 10.9
6.3 7.88.6 Prior CVD and DM
10 4.3 4.8 5.3
2.6
5
0
CHD Mortality CVD Mortality Total Mortality

Mortality rates in U.S. adults, age 30-75, with metabolic syndrome (MetS),
with and without diabetes mellitus (DM) and pre-existing CVD
(NHANES II: 1976-80 Follow-up Study). **
Source: Malik et al., Circulation. 2004;110:1245-50.
** Average of 13 years of follow-up. Note: Age and gender adjusted.
 180
156.4
160
Billions of Dollars

140
120
100
80 65.5 69.4
60
34.8
40
20
0

Heart Failure
Stroke

Hypertensive
Coronary

Disease
Heart

Disease

Estimated direct and indirect costs (in billions of dollars) of

major cardiovascular diseases and stroke
(United States: 2008). Source: NHLBI.