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12. Heart Disease and Stroke

Goal: Improve cardiovascular health and quality of life through the prevention, detection, and treatment of risk factors; early identification and treatment of heart attacks and strokes; and prevention of recurrent cardiovascular events.

Heart Disease

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
12-1. Reduce coronary heart disease deaths.
Target: 1621 deaths per 100,000 population.
Baseline: 2032 coronary heart disease deaths per 100,000 population in 19992 (age adjusted to the year 2000 standard population).
Target setting method: 20 percent improvement.
Data source : National Vital Statistics System (NVSS), CDC, NCHS.
1 (Target revised from 166 because of baseline revision after November 2000 publication)
2 (Baseline and baseline year revised from 208 and 1998 after November 2000 publication)


ORIGINAL OBJECTIVE
12-2. (Developmental) Increase the proportion of adults aged 20 years and older who are aware of the early warning symptoms and signs of a heart attack and the importance of accessing rapid emergency care by calling 911.
Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
12-2. (Developmental) Increase the proportion of adults aged 20 years and older who are aware of the early warning symptoms and signs of a heart attack and the importance of accessing rapid emergency care by calling 911. 
Target: 50 percent. 
Baseline: 46 percent of adults aged 20 years and older were aware of the early warning symptoms and signs of a heart attack and the importance of accessing rapid emergency care by calling 911 in 2001. 
Target setting method: Better than the best. 
Potential dData source : National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
12-2. Increase the proportion of adults aged 20 years and older who are aware of the early warning symptoms and signs of a heart attack and the importance of accessing rapid emergency care by calling 911.
Target: 50 percent.
Baseline: 46 percent of adults aged 20 years and older were aware of the early warning symptoms and signs of a heart attack and the importance of accessing rapid emergency care by calling 911 in 2001.
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.


ORIGINAL OBJECTIVE
12-3. (Developmental) Increase the proportion of eligible patients with heart attacks who receive artery-opening therapy within an hour of symptom onset.
Potential data source: National Registry of Myocardial Infarction, National Acute Myocardial Infarction Project, HCFA.
OBJECTIVE WITH REVISIONS
12-3. (Developmental) Increase the proportion of eligible patients with heart attacks who receive timely artery-opening therapy within an hour of from symptom onset. 
Target and baseline:
Objective Increase in the Proportion of Eligible Patients With Heart Attacks Who Receive Timely Artery-Opening Therapy From Symptom Onset 2000-04
Baseline 		2010
Target
Percent
12-3a. Fibrinolytics within an hour of symptom onset  4  6 
12-3b. Percutaneous intervention (PCI) within 90 minutes of symptom onset  0.64  0.67 
Target setting method: Better than the best. 
Potential dData source : National Registry of Myocardial Infarction (NRMI–4), National Acute Myocardial Infarction Project, HCFA Centers for Medicare and Medicaid Services (CMS). 
REVISED OBJECTIVE
12-3. Increase the proportion of eligible patients with heart attacks who receive timely artery-opening therapy from symptom onset.
Target and baseline:
Objective Increase in the Proportion of Eligible Patients With Heart Attacks Who Receive Timely Artery-Opening Therapy From Symptom Onset 2000-04
Baseline 		2010
Target
Percent
12-3a. Fibrinolytics within an hour of symptom onset 4 6
12-3b. Percutaneous intervention (PCI) within 90 minutes of symptom onset 0.64 0.67
Target setting method: Better than the best.
Data source : National Registry of Myocardial Infarction (NRMI–4), National Acute Myocardial Infarction Project, Centers for Medicare and Medicaid Services (CMS).


ORIGINAL OBJECTIVE
12-4. (Developmental) Increase the proportion of adults aged 20 years and older who call 911 and administer cardiopulmonary resuscitation (CPR) when they witness an out-of-hospital cardiac arrest.
Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
12-4. (Developmental)Increase the proportion of adults aged 20 years and older who call 911 and administer persons trained in cardiopulmonary resuscitation (CPR) when they witness an out-of-hospital cardiac arrest in the past year.
Target: 12 percent.
Baseline: 8 percent of persons aged 20 years and older were trained in cardiopulmonary resuscitation (CPR) in the past year in 2001.  
Target setting method: Better than the best.
Potential dData source : National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
12-4. Increase the proportion of persons trained in cardiopulmonary resuscitation (CPR) in the past year.
Target: 12 percent.
Baseline: 8 percent of persons aged 20 years and older were trained in cardiopulmonary resuscitation (CPR) in the past year in 2001.
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.


ORIGINAL OBJECTIVE
12-5. (Developmental) Increase the proportion of eligible persons with witnessed out-of-hospital cardiac arrest who receive their first therapeutic electrical shock within 6 minutes after collapse recognition.
Potential data source: Medical Expenditure Panel Survey (MEPS), AHRQ.
OBJECTIVE WITH REVISIONS
12-5. (Developmental) Increase the proportion of eligible persons with witnessed out-of-hospital cardiac arrest who receive their first therapeutic electrical shock within 6 minutes after collapse recognition.
Potential data source: Medical Expenditure Panel Survey (MEPS), AHRQNational EMS Information System (NEMSIS), National Association of State EMS Directors (NASEMSD) in coordination with U.S. Department of Transportation, NHTSA, and HRSA, Trauma/EMS Systems. 
REVISED OBJECTIVE
12-5. (Developmental) Increase the proportion of eligible persons with witnessed out-of-hospital cardiac arrest who receive their first therapeutic electrical shock within 6 minutes after collapse recognition.
Potential data source: National EMS Information System (NEMSIS), National Association of State EMS Directors (NASEMSD) in coordination with U.S. Department of Transportation, NHTSA, and HRSA, Trauma/EMS Systems.


NO CHANGE IN OBJECTIVE
12-6. Reduce hospitalizations of older adults with congestive heart failure as the principal diagnosis.
Target and baseline:
Objective Reduction in Hospitalizations of Older Adults With Congestive Heart Failure as the Principal Diagnosis 1997
Baseline 		2010
Target
Per 1,000 Population
12-6a. Adults aged 65 to 74 years 13.2 6.5
12-6b. Adults aged 75 to 84 years 26.7 13.5
12-6c. Adults aged 85 years and older 52.7 26.5
Target setting method: Better than the best.
Data source : National Hospital Discharge Survey (NHDS), CDC, NCHS.


Stroke

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
12-7. Reduce stroke deaths.
Target: 501 deaths per 100,000 population.
Baseline: 622 deaths from stroke per 100,000 population occurred in 19992 (age adjusted to the year 2000 standard population).
Target setting method: 20 percent improvement.
Data source : National Vital Statistics System–Mortality (NVSS–M), CDC, NCHS.3
1 (Target revised from 48 because of baseline revision after November 2000 publication)
2 (Baseline and baseline year revised from 60 and 1998 after November 2000 publication)
3 (Name of data source changed from National Vital Statistics System [NVSS])


ORIGINAL OBJECTIVE
12-8. (Developmental) Increase the proportion of adults who are aware of the early warning symptoms and signs of a stroke.
Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
12-8. (Developmental) Increase the proportion of adults who are aware of the early warning symptoms and signs of a stroke and the importance of accessing rapid emergency care by calling 911. 
Target: 83 percent. 
Baseline: 78 percent of adults were aware of the early warning symptoms and signs of a stroke and the importance of accessing rapid emergency care by calling 911 in 2001. (Current baseline data does not include importance of accessing 911; the baseline will be updated with data regarding the importance of 911 when the data have been analyzed.) 
Target setting method: Better than the best. 
Potential dData source : National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
12-8. Increase the proportion of adults who are aware of the early warning symptoms and signs of a stroke and the importance of accessing rapid emergency care by calling 911.
Target: 83 percent.
Baseline: 78 percent of adults were aware of the early warning symptoms and signs of a stroke and the importance of accessing rapid emergency care by calling 911 in 2001. (Current baseline data does not include importance of accessing 911; the baseline will be updated with data regarding the importance of 911 when the data have been analyzed.)
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.


Blood Pressure

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
12-9. Reduce the proportion of adults with high blood pressure.
Target: 141 percent.
Baseline: 262 percent of adults aged 20 years and older had high blood pressure in 1988–94 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
1 (Target revised from 16 percent because of baseline revision after November 2000 publication)
2 (Baseline revised from 28 percent after November 2000 publication)


NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
12-10. Increase the proportion of adults with high blood pressure whose blood pressure is under control.
Target: 681 percent.
Baseline: 252 percent of adults aged 18 years and older with high blood pressure had it under control in 1988–94 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
1 (Target revised from 50 percent because of baseline revision after November 2000 publication)
2 (Baseline revised from 18 percent after November 2000 publication)


NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
12-11. Increase the proportion of adults with high blood pressure who are taking action (for example, losing weight, increasing physical activity, or reducing sodium intake) to help control their blood pressure.
Target: 981 percent.
Baseline: 842 percent of adults aged 18 years and older with high blood pressure were taking action to control it in 1998 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.
1 (Target revised from 95 because of baseline revision after November 2000 publication)
2 (Baseline revised from 82 after November 2000 publication)


NO CHANGE IN OBJECTIVE
12-12. Increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high.
Target: 95 percent.
Baseline: 90 percent of adults aged 18 years and older had their blood pressure measured in the past 2 years and could state whether it was normal or high in 1998 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.


Cholesterol

NO CHANGE IN OBJECTIVE
12-13. Reduce the mean total blood cholesterol levels among adults.
Target: 199 mg/dL (mean).
Baseline: 206 mg/dL was the mean total blood cholesterol level for adults aged 20 years and older in 1988–94 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.


NO CHANGE IN OBJECTIVE
12-14. Reduce the proportion of adults with high total blood cholesterol levels.
Target: 17 percent.
Baseline: 21 percent of adults aged 20 years and older had total blood cholesterol levels of 240 mg/dL or greater in 1988–94 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.


NO CHANGE IN OBJECTIVE
12-15. Increase the proportion of adults who have had their blood cholesterol checked within the preceding 5 years.
Target: 80 percent.
Baseline: 67 percent of adults aged 18 years and older had their blood cholesterol checked within the preceding 5 years in 1998 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.


ORIGINAL OBJECTIVE
12-16. (Developmental) Increase the proportion of persons with coronary heart disease who have their LDL-cholesterol level treated to a goal of less than or equal to 100 mg/dL.
Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
OBJECTIVE WITH REVISIONS
12-16. (Developmental) Increase the proportion of persons with coronary heart disease who have their LDL-cholesterol level treated to a goal of less than or equal to 100 mg/dL. 
Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
REVISED OBJECTIVE
12-16. (Developmental) Increase the proportion of persons with coronary heart disease who have their LDL-cholesterol level treated to a goal of less than 100 mg/dL.
Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

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