| FEBRUARY IS AMERICAN HEART MONTH |
| Heart disease is the nation's leading
killer for both men and women and among most racial and ethnic
groups, killing 696,947 Americans in 2002. Though heart disease
death rates are half of what they were in 1950 (586.8 per 100,000 in
1950 vs. 240.8 per 100,000 in 2002), it accounted for 29 percent of
all deaths in 2002. Cancer, the second leading cause of death that
year, accounted for 23 percent of all deaths. |
| The major risk factors for heart disease
include smoking, having high blood pressure, having high blood
cholesterol, having diabetes, being overweight, being physically
inactive, and having a family history of heart disease. Studies
among people with and without heart disease have shown that lowering
high blood cholesterol and high blood pressure can reduce the risk
of developing heart disease, dying of heart disease, having a
nonfatal heart attack, and needing heart bypass surgery or
angioplasty. |
| |
| EXAMPLES OF HEALTH
DISPARITIES RELATED TO HEART
DISEASE |
| Racial and Ethnic Minorities |
| |
 |
Heart disease is the leading cause of death for
American Indians and Alaska Natives (AI/ANs) (157.4 per 100,000),
African Americans (308.4 per 100,000), Hispanics/Latinos (180.5 per
100,000), and whites (236.7 per 100,000). Although cancer is the
leading cause of death for Asian Americans and Pacific Islanders
(AAPIs) (accounting for 26.4 percent of all deaths), heart disease
is a close second (25.4 percent). |
| |
|
In 2002, African Americans had the highest heart
disease death rate of all races/ethnicities (308.4 per 100,000),
followed by white non-Hispanics (239.2 per 100,000). |
| |
|
In 2000, among U.S. adults aged 20 years and older,
the age-adjusted prevalence of heart attacks was 5.2 percent for
non-Hispanic white males and 2.0 percent for females; 4.3 percent
for non-Hispanic black males and 3.3 percent for females; 4.1
percent for Mexican American males and 1.9 percent for females. |
| |
|
Around 40 percent of African American men and women
have some form of heart disease, compared to 30 percent of white men
and 24 percent of white women. |
| |
|
AI/AN women 20 years of
age and older have higher blood pressure levels (36.4 and 36.0,
respectively) than white non-Hispanic women (19.7 percent). |
| Gender |
| |
|
Heart disease is the leading cause of death for both
women and men in the United States (men: 297.4 per 100,000; women:
197.2 per 100,000). About 6.7 million
American women have heart disease. |
| |
|
In 2001, women under age 45 experienced higher rates
of heart disease than men of the same age (49.7 vs. 27.9 per 1,000
population, respectively). However, with increased age, the rates
reversed; climbing to 248.0 for men and 179.5 for women aged 75 and
older. |
| |
|
Females, in general, have poorer outcomes following a
heart attack than do males: 44 percent of females who have a heart
attack die within a year, compared with 27 percent of males. |
| |
|
42 percent of women who have heart
attacks die within 1 year compared with 24 percent of men. |
| |
|
At older ages, females who have a heart attack are
twice as likely as males to die within a few weeks. These
differences are explained, in part, by the presence of coexisting
conditions such as high blood pressure, diabetes, and congestive
heart failure. Complications are more frequent in females than in
males after coronary intervention procedures, such as angioplasty or
bypass surgery, are performed. |
| |
|
About 24 million women aged 60 and older have high
blood pressure. Among all women, American Indian/Alaska Native women
are the least likely to have had a blood pressure screening in the
past 12 months (73 percent). Of Hispanic and Asian American women,
26 percent and 27 percent, respectively, had not had a blood
pressure screening in the past 12 months. In contrast, 20 percent of
white women and 18 percent of African American women reported that
they had not had a blood pressure screening. |
| Age |
| |
|
The death rate for heart disease increases with age
for all races and both genders, from 93.7 per 100,000 for the 45-54
year old age group to 1677.2 per 100,000 for the 75-84 year old age
group. |
| |
|
According to the 2003 Behavioral Risk Factor
Surveillance System (BRFSS), participation in physical activities
decreased with age, from 78.5 percent of those in the 35-44 year age
group reporting physical activity to 67.6 percent for those in the
65+ age group reporting physical activity. |
| Income & Education |
| |
|
Higher prevalences of multiple CVD risk factors among
AI/AN participants who were either unemployed or had completed less
than a high school education corroborate the well-documented
influence of low socioeconomic status on CVD risk factors. |
| |
|
32 percent of people with poor family income have high
blood pressure, compared with 27 percent of those with middle/high
family income. |
| |
|
84 percent of those who did
not graduate high school had their blood pressure measured in the
past 2 years and knew if it was normal or high, compared with 90
percent of high school graduates and 93 percent of those with at
least some college. |
| |
|
58 percent of those who did not graduate high school
had their blood cholesterol measured in the past 5 years, compared
with 69 percent of high school graduates and 78 percent of those
with at least some college. |
| |
|
According to the 2003 BRFSS, participation in physical
activity increased with education, from 55.4 percent of those who
did not graduate high school to 87.7 percent of college graduates.
Physical activity also increased with income, from 62.2
percent of those earning less that 15,000 to 86.5 percent of those
earning 50,000 or more. |
|
|
| PROMISING
INTERVENTION STRATEGIES |
|
Diet is one of the things that can affect your heart health, and your
risk for getting heart disease. |
|
Physical activity reduces the risk of premature mortality in general,
and of coronary heart disease, hypertension, and other diseases.
Significant health benefits can be obtained by including a moderate
amount of physical activity (e.g., 30 minutes of brisk walking or
raking leaves, 15 minutes of running, or 45 minutes of playing
volleyball) on most, if not all, days of the week. Additional health
benefits can be gained through greater amounts of physical activity.
People who can maintain a regular regimen of activity that is of
longer duration or of more vigorous intensity are likely to derive
greater benefit. |
|
A key strategy for addressing these risk factors is to educate the
public and health care practitioners about the importance of
prevention. Current guidelines recommend that all adults have their
blood pressure checked regularly and their blood cholesterol levels
checked every 5 years. Systems changes are also needed to help
practitioners adhere to guidelines for treating patients with or at
risk for heart disease and stroke, such as prescribing beta-blockers
and aspirin. Preventive actions can help people at any level of
blood pressure or cholesterol to reduce their risk. |
|
People also need to be educated about the signs and symptoms of heart
attacks and stroke and the importance of calling 911 quickly.
Forty-seven percent of heart attack victims and about the same
percentage of stroke victims die before emergency medical personnel
arrive. Other important risk factors for heart disease and
stroke—such as diabetes, tobacco use, physical inactivity, poor
nutrition, and overweight and obesity—need to be addressed through
lifestyle changes and appropriate use of medications. |
|
|
|
PROGRAMS |
|
REACH 2010 |
|
REACH 2010 is part of the national initiative to eliminate disparities
in health status experienced by racial and ethnic minority
populations in six priority areas, including cardiovascular
diseases. REACH 2010 supports community coalitions in designing,
implementing, and evaluating community-driven strategies to
eliminate health disparities. Each coalition comprises a
community-based organization and three other organizations, of which
at least one is either a local or state health department or a
university or research organization. |
|
The Heart Truth |
|
The campaign is especially aimed at women ages 40 to 60, the time when
a woman's risk of heart disease starts to rise. But its messages are
also important for younger women, since heart disease develops
gradually and can start at a young age—even in the teenage years.
Older women have an interest too—it's never too late to take action
to prevent and control the risk factors for heart disease. Even
those who have heart disease can improve their heart health and
quality of life. |
|
Generations |
|
In 2001, the Department of Health and Human Services' (HHS) Office on
Women's Health (OWH) funded a pilot program, called Generations, to
prevent cardiovascular disease in African American women. The
program was conducted in six African-American churches in Atlanta,
Minneapolis, Los Angeles, Mississippi, and Chicago by the
Association of Black Cardiologists. Generations was designed to
encourage African American women to reduce their risk for
cardiovascular disease. The program included personal risk
assessment, cooperative support groups, and regularly scheduled
educational sessions on risk factors for cardiovascular disease and
risk modification. |
|
For Your Heart Pilot Project |
|
In 2003, OWH funded the National Black Nurses Foundation to develop
and coordinate a project aimed at reducing cardiovascular disease
among African-American women. The goal of this project was to
promote and pilot the "For
Your Heart" web based health education tool and notebook among
African American Women, to create awareness around the seriousness
of heart disease, and to encourage women to change behavior to lower
their risk factors. The National Black Nurses Foundation trained
1-20 members of the New York Black Nurses Association (NYBNA) to
provide health education services using the For Your Heart notebook.
These nurses used the notebook in their professional settings, and
in the community, and found the web site to be well received.
Recommendations to improve the For Your Heart web site were made. |
|
|
| FOR MORE INFORMATION |
| |
National Center for Chronic Disease Prevention and Health Promotion
(NCCDPHP) |
| |
|
Preventing Heart Disease and Stroke |
| |
Agency for Healthcare Research and Quality |
| |
|
Research on Cardiovascular Disease in Women |
| |
Healthy People 2010 |
| |
|
Chapter 12: Heart Disease and Stroke |
| |
National Heart, Lung, and Blood Institute |
| |
|
Heart and Vascular Diseases |
| |
|
Minority Populations Gateway |
| |
American Heart Association |
