Title: The Burden of Cardiovascular Disease in Virginia
1The Burden of Cardiovascular Disease in Virginia
- Stephanie Gruss,
- Epidemiologist
- Virginia Department of Health
- April 14, 2005
- Work (804) 864-7868
Stephanie.Gruss_at_vdh.virginia.gov
2Critical Issues- Chronic Disease is Costly
- Seven of every 10 U.S. residents who die each
year (1.7 million persons) do so as a result of
a chronic disease. - Chronic diseases are the most preventable causes
of death. - Chronic diseases affect the quality of life of 90
million U.S. residents. - The cost of medical care for persons with these
diseases accounts for 70 of total medical care
expenditures.
Source http//www.cdc.gov/mmwr/preview/mmwrhtml/r
r5311a1.htm
3Critical Issues- Heart Disease in the U.S.
- Heart disease is the leading cause of death for
both women and men in the U.S. - In 2001, 700,142 people died of heart disease
(52 women 48 men), accounting for 29 of all
U.S. deaths. - Heart disease is the leading cause of death for
American Indians and Alaska Natives, blacks,
Hispanics, and whites. Although cancer is the
leading cause of death for Asians and Pacific
Islanders (accounting for 26.4 of all deaths),
heart disease is a close second (25.4). - At the end of 2004, heart disease cost 238.6
billion, including health care services,
medications, and lost productivity.Â
Source http//www.cdc.gov/cvh/maps/methods/dataso
urces.htm
4Critical Issues- State Level
- Cardiovascular disease- CVD (heart disease
stoke) is the number one killer of Virginians - 14,881 people in Virginia died from heart disease
and 3,938 died from stroke in 2002 this is more
than died from cancer, injuries, and diabetes
combined - Planning District 2- Buchanan County, Dickenson
County, Russell County, and Tazwell County had a
heart disease death rate of 317 per 100,000
population- the highest in the state - Planning District 1- Lee County, Scott County,
Wise County, and Norton City had the
second-highest rate at 278 per 100,000
Source VDH, Center for Health Statistics, 2004
5VA Population by Race and Ethnicity, 2002
Source U.S. Bureau of Census Center for Health
Statistics- VDH, 2003
6Deaths Due to Cardiovascular Disease
7Causes of Death in VA, 2002
Source VDH, Center for Health Statistics, 2004
8Cardiovascular Deaths in Virginia, 2002
Source VDH, Center for Health Statistics, 2004
9CVD Deaths and Gender
- The decline of CVD deaths in Virginia is less for
women than men - between 1995 and 2002 the number
of CVD deaths decreased 6 for men but only 1
for women. - Although stroke mortality rates are similar for
men and women, women are more likely to have a
stroke at a younger age (40s or 50s) and are more
likely to die from stroke. - Nationally, women account for more than 60 of
the annual deaths due to stroke, making it the
second leading cause of death among American
women.
Sources VDH, Center for Health Statistics, 2004
http//www.cdc.gov/mmwr/
10CVD Deaths and Race/Ethnicity
- Virginia 2002 age-adjusted CVD mortality rates
are significantly higher for blacks (384.4) than
whites (295.3). - White females had the highest non-age-adjusted
CVD mortality rate in 2002 at 306.7 per 100,000
population, followed secondly by black females at
282.3. - For Hispanics in Virginia, there were only 300
deaths due to CVD in years 2001 2002, combined.
Source VDH, Center for Health Statistics, 2004
11CVD Deaths and Age
- In Virginia, about 31 of all CVD deaths were to
individuals ages 75-84, across gender and race - Almost 10 of all CVD deaths were to individuals
ages 55-64 - Both white and black females had the highest
percentage of CVD deaths occurring in the 85 and
up age range - Both white and black males had the highest
percentage of CVD deaths occurring in the 75-84
age range - About 14.3 of all CVD deaths occurred before age
55
Source VDH, Center for Health Statistics, 2004
12Total CVD Death Rates by Gender Race
- In Virginia in 2002, males had a higher
age-adjusted mortality rate per 100,000
population than females - Both white males and black males had higher
age-adjusted rates than their female counterparts
(N 20,126)
Source VDH, Center for Health Statistics, 2004
13Stroke Death Rates by Gender Race
- In Virginia in 2002, males had a higher
age-adjusted stroke mortality rate per 100,000
population than females - White males and females had similar stroke
mortality rates - Black males had a higher age-adjusted stroke
mortality rate than their female counterparts
(N 3,938)
Source VDH, Center for Health Statistics, 2004
14Other Diseases of the Heart Death Rates by Gender
Race
- In Virginia in 2002, males had a higher
age-adjusted DOH mortality rate per 100,000
population than females - Both white males and black males had a higher
age-adjusted DOH mortality rate than their female
counterparts
(N 4,814)
Source VDH, Center for Health Statistics, 2004
15Heart Attack Death Rates by Gender Race
- In Virginia in 2002, males had a higher
age-adjusted heart attack mortality rate per
100,000 population than females - Both white males and black males had higher
age-adjusted heart attack mortality rates than
their female counterparts
(N 9,534)
Source VDH, Center for Health Statistics, 2004
16BUT, look at the actual counts for VA for
2002
Females die with greater frequency than males
in every CVD category except heart attack.
Source VDH, Center for Health Statistics, 2004
17Risk Factors Associated with Cardiovascular
Disease
18Risk Factors and CVD, VA
Five A Day is recommended
In 2002, 75.4 of males ate less than the
recommended amount per day, as compared to 68.8
of females, and 76.0 of Blacks ate less than
recommended as compared to 72.3 of Whites.
74.2
2003
Source http//apps.nccd.cdc.gov/brfss/Trends/
19Consumption of Fruits Vegetables, VA 2001-2003
Source VCU, SERL, BRFSS Analysis Aggregated
years 2001-2003
20Risk Factors and CVD, VA
Reported in 30 Days
In 2002, 28.3 of females reported no physical
activity as compared to 20.2 of males, and
35.7 of Blacks reported no physical activity as
compared to 21.5 of Whites.
24.4
Source http//apps.nccd.cdc.gov/brfss/Trends/
21Physical Activity, VA 2001-2003
Source VCU, SERL, BRFSS Analysis Aggregated
years 2001-2003
22Risk Factors and CVD, VA
Overweight Body Mass Index (BMI) 25-29
35.1
Source http//apps.nccd.cdc.gov/brfss/Trends/
23Risk Factors and CVD, VA
Obese (BMI) over 30
In 2002, males (25.0) were slightly more obese
than females (22.5), and Blacks (34) were more
obese than Whites (22.4) rates decreased with
increasing education level.
23.7
Source http//apps.nccd.cdc.gov/brfss/Trends/
24BMI, VA 2001-2003
Source VCU, SERL, BRFSS Analysis Aggregated
years 2001-2003
25Risk Factors and CVD, VA
The good news! More people than ever before are
having their cholesterol checked.
17.9
2003
Source http//apps.nccd.cdc.gov/brfss/Trends/
26Risk Factors and CVD, VA
- In 2002, high cholesterol rates in males (35.1)
were slightly higher than females (32.3) and
rates were higher among Whites (34.6) than
Blacks (27.4).
Sources Virginia BRFSS Core Modules Report, 2003
http//apps.nccd.cdc.gov/brfss/Trends/
27High Cholesterol, VA 2001-2003
Source VCU, SERL, BRFSS Analysis Aggregated
years 2001-2003
28Risk Factors and CVD, VA
Rates are slightly higher among females (26.6)
than males (24.3), and higher among Blacks
(31.5) than Whites (24.5).
Source BRFSS State Data Report, Virginia 2003,
VDH
29Hypertension, VA 2001-2003
Source VCU, SERL, BRFSS Analysis Aggregated
years 2001-2003
30Risk Factors and CVD, VA
Source http//apps.nccd.cdc.gov/brfss/Trends/
31Risk Factors and CVD, VA
18-34 year olds have the highest smoking
prevalence rates.
31.4
Source http//apps.nccd.cdc.gov/brfss/Trends/
32Risk Factors and CVD, VA
Source BRFSS State Data Report, Virginia 2003,
VDH
33Hospitalizations and Cardiovascular Disease
34Critical Issues- Cost of CVH at State Level
- TOTAL Virginia CVH Hospitalization Costs, 2002
- Primary diagnosis of cardiovascular disease-
2,546,432,363 - Any Diagnosis of cardiovascular disease-
14,875,546,605
35Hospitalizations Due to CVD, VA 2002
Source VHI Dataset, 2004 Diseases of the Heart
ICD-9 405 409, 418, 419 (for hospitalization
data purposes per http//www.cdc.gov/cvh/maps/meth
ods/datasources.htm)
36Hospitalizations Due to CVD, VA 2002
Source VHI Dataset, 2004
37Hospitalizations Due to CVD, VA 2002
Source VHI Dataset, 2004
38Hospitalizations Due to CVD, VA 2002
Source VHI Dataset, 2004
39CVD Hospital-izations by Region, VA 2002
5
2
1
4
ALLEGHANY
3
Source VHI Dataset, 2004
40Cardiovascular Disease and Diabetes
41CVD and Co-morbidity with Diabetes
- Diabetes is an independent risk factor for
several types of CVD coronary heart disease,
stroke, peripheral artery disease,
cardiomyopathy, and congestive heart failure. - People with diabetes are two to four times more
likely to have a heart attack or stroke than
people without diabetes. - People with diabetes are more likely to die from
a second heart attack than people with CVD who do
not suffer from diabetes.
Source http//www.ndep.nih.gov/control/CVD.htm
42CVD and Co-morbidity with Diabetes
- Total number of CVD hospital discharges in
Virginia in 2002 (any diagnosis) was 827,116 - Of those 827,116 CVD discharges, 29.53 were
persons with diabetes - About 10 of all CVD deaths in Virginia in 2002
were to people with diabetes - A secondary diagnosis of CVD is found in about
75 of all diabetes-coded deaths.
Source VHI Dataset, 2004
43CVD and Co-morbidity with Diabetes
Cardiovascular Disease Deaths with Diabetes
Listed as Contributing Cause, Virginia 2002
Source Center for Health Statistics, VDH, 2004
44Where Can One Find Local-level Data?
- BRFSS sample size is too small to calculate risk
factor rates by locality (i.e. individual city or
county) - For locality-level rates for some hospital
discharges and census data (demographic and
economic) with a mapping program go to
http//www.vahealthycommunities.com/default.asp,
and click on Virginia ATLAS of Community Health
to access the free, ATLAS database - For a free mapping program displaying heart
disease and stroke death rates per locality go
to http//www.cdc.gov/cvh/maps/statemaps.htm,
and click on Go to state maps - For age-adjusted death rates per county for
Virginias leading causes of death go to - http//www.vdh.state.va.us/healthstats/DeathsByAg
e02.pdf