The Assistant Secretary for Health and Surgeon General
chaired the third and final review of progress in achieving Healthy People 2000 objectives
for Heart Disease and Stroke. The review was organized by the National Heart, Lung, and
Blood Institute, National Institutes of Health, which serves as the lead agency for this
priority area, designated as chapter 15 in the Healthy People 2000 (HP2000) document. The
discussions addressed three principal topics1) expanding the application of
knowledge to prevent or lower cardiovascular disease (CVD) risk; 2) eliminating
disparities in CVD risk among population groups; and 3) assessing the impact on CVD risk
of increasing overweight/obesity. Through broadcast facilities on the National Institutes
of Health campus, viewers at remote sites were linked with the participants and could pose
questions by telephone and facsimile transmission. During the overview and discussion,
attention was focused on the following HP2000 objectives: 15.1 For the total population, the age-adjusted death rate from coronary heart disease decreased from 135 per 100,000 in 1987 to 105 in 1996. The HP2000 target is 100. For Blacks, the rate decreased from 168 per 100,000 in 1987 to 140 in 1996 (target, 115). 15.2 For stroke, the age-adjusted death rate for the total population decreased from 30.4 per 100,000 in 1987 to 25.9 in 1997 (preliminary data). The HP2000 target is 20.0. The rate for Blacks decreased from 52.5 per 100,000 in 1987 to 42.0 in 1997 (preliminary data). The target is 27.0. 15.3 From 14.4 cases per 100,000 in 1987, the incidence of end-stage renal disease increased to 27.6 cases per 100,000 in 1996. The HP2000 target is 13.0. For Blacks, the incidence increased from 34.0 per 100,000 in 1987 to 65.1 in 1996 (target, 30.0) 15.5 The proportion of people aged 18 and over who took action to control their high blood pressure remained at about 71 percent between 1991 and 1994. The HP2000 target is 90 percent. The proportion of white hypertensive males aged 18-34 who did so decreased from 34 percent in 1991 to 30 percent in 1994. Among black hypertensive males aged 18-34, the proportion taking action increased from 40 percent in 1991 to 50 percent in 1994. The target for both male groups is 80 percent. 15.6 The mean serum cholesterol level among adults aged 20-74 decreased from 213 mg/dL in 1976-80 to 203 mg/dL in 1988-94. The HP 2000 target is 200 mg/dL. 15.7 The prevalence of blood cholesterol levels of 240 mg/dL in adults aged 20-74 decreased from 27 percent in 1976-80 to 19 percent in 1988-94, thus meeting the HP2000 target of 20 percent. 15.10 The prevalence of overweight has increased among the total population, as well as in several select population groups. In 1988-94, the age-adjusted prevalence of overweight or obesity (BMI³25) was 54.9 percentup from 46 percent in 1976-80 and 1971-74 and 43.3 percent in 1960-62. Among men, the age-adjusted prevalence increased from 48.2 percent in 1960-62 to 59.4 percent in 1988-94; among women, overweight increased from 38.7 percent to 50.7 percent. Among black men and women, the prevalence increased from 43.1 to 56.5 percent and from 57.0 to 65.8 percent, respectively. 15.11 In the past decade, less than one-quarter of people aged 18-74 engaged in light to moderate physical activity for at least 30 minutes, 5 or more times per week. The proportion has shown little change since early in the decade. The HP2000 target is 30 percent. 15.12 The prevalence of cigarette smoking among people 18 years of age and older decreased from 27 percent in 1992 to 25 percent in 1995. This represents a decrease from 29 to 27 percent in males and from 25 to 23 percent in females. The HP2000 target is 15 percent. For select population groups aged 18 and over, the highest cigarette smoking prevalence rates in 1995 were36 percent for blue-collar workers, 35 percent for American Indians/Alaska Natives, and 32 percent for military personnel. The target for each of these groups is 20 percent. In 1995, Blacks aged 18 and over showed a prevalence of 26 percent (target, 18 percent). Eighteen percent of Hispanics in that age group smoked cigarettes in 1995 (target, 15 percent). 15.14 The overall aim of this objective is for 75 percent of people aged 18 and over to have had their blood pressure checked within the preceding 5 years. The most recent year for which these data are available is 1993, when the proportion was 66 percent. However, the proportion of people aged 18 and over whose blood pressure had ever been checked increased from 59 percent in 1988 to 75 percent in 1995. HIGHLIGHTS
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