Morbidity & Mortality: 2012 Chart Book on Cardiovascular, Lung, and Blood Diseases National Heart, Lung, and Blood Institute February, 2012

Chapter 3 – Cardiovascular Diseases The term cardiovascular diseases is used here to mean: Diseases and congenital malformations of the circulatory system as coded in the ICD. Coronary heart disease Heart failure Cardiomyopathy Atrial fibrillation Cerebrovascular disease (stroke) Hypertensive disease Peripheral artery disease Congenital malformations of the circulatory system

Chart 3–1 Deaths From Cardiovascular Diseases, Percent by Subgroup, U Chart 3–1 Deaths From Cardiovascular Diseases, Percent by Subgroup, U.S., 2008 Heart Failure (Underlying)* 7.0% Diseases of Arteries 3.4% Hypertensive Diseases 7.5% Coronary Heart Disease 49.9% Other Cardiovascular Diseases 15.6% Stroke 16.5% * Heart failure as an underlying cause or otherwise mentioned on the death certificate accounted for 35% (281,437) of total CVD deaths. Total deaths = 811,940 (100%), including 3,415 due to congenital CVD defects. Compiled from Vital Statistics of the United States, NCHS.

Chart 3–2 Deaths From Heart Disease, Percent by Subgroup, U.S., 2008 Other 3.9% Cardiomyopathy 1.0% Rhythmic 5.7% Heart Failure (Underlying)* 6.9% Rheumatic/Congenital 8.0% Other Coronary Heart Disease 43.8% Hypertensive 9.2% Acute Myocardial Infarction 21.6% * Heart failure as an underlying cause or otherwise mentioned on the death certificate accounted for 45% (281,437) of total heart disease deaths. Total deaths = 619,574 (100%), including 2,746 due to congenital CVD defects. Compiled from Vital Statistics of the United States, NCHS.

Chart 3–3 Deaths From Stroke, Percent by Subgroup, U.S., 2008 Cerebral Infarction 4.9% Subarachnoid Hemorrhage 4.1% Other Cerebrovascular 17.6% Unspecified 52.7% Other Hemorrhage 20.7% Total Deaths = 134,148 (100%) * Compiled from Vital Statistics of the United States, NCHS.

Chart 3–5 Change in Age-Adjusted Death Rates Chart 3–5 Change in Age-Adjusted Death Rates* for CV and Non-CV Diseases, U.S., 1950–2008 Percent Change ICD-6 ICD-7 ICD-8 ICD-9 ICD-10 Year * The comparability ratio 1.0502 was applied to death rates reported for 1979–1998.  CV: Cardiovascular.

Chart 3–9 Deaths & Age-Adjusted Death Rates for Cardiovascular Diseases, U.S., 1979–2008 Deaths in Thousands (Bar) Deaths/100,000 Population (Line) Year

Chart 3–10 Percent of All Deaths Due to Cardiovascular Diseases Chart 3–10 Percent of All Deaths Due to Cardiovascular Diseases* by Age, U.S., 2008 Percent of All Deaths Age (Years) * Includes congenital malformations of the circulatory system.

Chart 3–11 Death Rates. for Cardiovascular Diseases by State, U. S Deaths/100,000 Population * Age-adjusted.  Excludes congenital malformations of the circulatory system.

Chart 3–12 Percent Decline in CVD. Death Rates by State, U. S * CVD: Cardiovascular diseases. Excludes congenital malformations of circulatory system.  Age-adjusted.

Chart 3–13 Age-Adjusted Death Rates for Heart Disease by Race/Ethnicity & Sex, U.S., 2008 Deaths/100,000 Population * Non-Hispanic.

Chart 3–14 Death Rates for Heart Disease in Males by Age & Race/Ethnicity, U.S., 2008 Deaths/100,000 Population Age (Years) * Non-Hispanic.

Chart 3–15 Death Rates for Heart Disease in Females by Age & Race/Ethnicity, U.S., 2008 Deaths/100,000 Population Age (Years) * Non-Hispanic.

Chart 3–16 Prevalence. of Acute MI by Race & Sex, Ages 25–74, U. S Chart 3–16 Prevalence* of Acute MI by Race & Sex, Ages 25–74, U.S.,1971–1975 to 2005–2008 Percent of Population * Age-adjusted.  MI: Myocardial infarction.

Chart 3–17 Prevalence of Acute Myocardial Infarction by Age & Sex, U.S., 1999–2008 Percent of Population Age (Years)

Chart 3–18 Prevalence of Acute Myocardial Infarction by Age & Race, U Chart 3–18 Prevalence of Acute Myocardial Infarction by Age & Race, U.S., 1999–2008 Percent of Population Age (Years)

Chart 3–19 Prevalence of Angina Pectoris by Age & Sex, U.S., 2001–2008 Percent of Population Age (Years)

Chart 3–20 Prevalence of Angina Pectoris by Age & Race, U. S Percent of Population Age (Years)

Chart 3–21 Emergency Department Visit Rates for CHD. by Sex, U. S Chart 3–21 Emergency Department Visit Rates for CHD* by Sex, U.S., 1997–1999 to 2006–2008 Visits/10,000 Population Years * CHD: Coronary heart disease.

Chart 3–22 Hospitalization Rates for Acute MI. , Ages 45–64 & ≥ 65, U Chart 3–22 Hospitalization Rates for Acute MI*, Ages 45–64 & ≥ 65, U.S., 1965–2009 Hospitalizations/10,000 Population Ages (Years): Year * MI: Myocardial infarction.  Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–23 Hospital Case-Fatality Rates for Acute MI Chart 3–23 Hospital Case-Fatality Rates for Acute MI*, Ages < 65 & ≥ 65, U.S., 1970–2009 Percent Discharged Dead Year * MI: Myocardial infarction.  Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–24 Age-Adjusted Death Rates for CHD. , Actual & Expected, U. S Deaths/100,000 Population Year * CHD: Coronary heart disease.

-*White -*Black -Hispanic -American Indian -Asian Chart 3–25 Age-Adjusted Death Rates for CHD by Race/Ethnicity & Sex, U.S., 1999–2008 Deaths/100,000 Population -*White -*Black -Hispanic -American Indian -Asian Male Female Year  CHD: Coronary heart disease. * Non-Hispanic.

Chart 3–26 Age-Adjusted Death Rates for CHD by Race & Sex, U. S Deaths/100,000 Population ICD-6 ICD-7 ICD-8 ICD-9 ICD-10 Year  CHD: Coronary heart disease. * Nonwhite from 1950 to 1967.

Chart 3–27 Deaths & Age-Adjusted Death Rates for Coronary Heart Disease, U.S., 1980–2008 Deaths in Thousands (Bar) Deaths/100,000 Population (Line) Year

Chart 3–29 Percent Decline Annually in CHD Death Rates by Age, Race, Sex, US., 1998-2008 Black Male White Male Age (Years) Black Female White Female  CHD: Coronary heart disease.

Chart 3-30 Age-Adjusted Death Rates for CHD by Race/Ethnicity & Sex, U.S., 2008 Deaths/100,000 Population  CHD: Coronary heart disease. * Non-Hispanic.

Chart 3–31 Death Rates for CHD in Males by Age & Race/Ethnicity, U. S Deaths/100,000 Population  CHD: Coronary heart disease. * Non-Hispanic. Age (Years)

Chart 3–32 Death Rates for CHD in Females by Age & Race/Ethnicity, U Chart 3–32 Death Rates for CHD in Females by Age & Race/Ethnicity, U.S., 2008 Deaths/100,000 Population  CHD: Coronary heart disease. * Non-Hispanic. Age (Years)

Chart 3–33 Age-Adjusted Death Rates for CHD* by State, U.S., 2005–2007 Deaths/100,000 Population * CHD: Coronary heart disease.

Chart 3–34 Age-Adjusted Death Rates Chart 3–34 Age-Adjusted Death Rates* for CHD by Country & Sex, Ages 35–74, 2006–2009 * Age-adjusted to European standard. Data for years indicated in parentheses.  CHD: Coronary heart disease.

Chart 3–35 Change in Death Rates Chart 3–35 Change in Death Rates* for CHD in Males by Country, Ages 35–74, 1999–2009 * Age-adjusted to European standard. Data for years indicated in parentheses.  CHD: Coronary heart disease.  Based on log-linear regression of actual rates.

Chart 3–36 Change in Death Rates Chart 3–36 Change in Death Rates* for CHD in Females by Country, Ages 35–74, 1999–2009 * Age-adjusted to European standard. Data for years indicated in parentheses.  CHD: Coronary heart disease.  Based on log-linear regression of actual rates.

Chart 3–37 Prevalence. of HF by Race & Sex, Ages 25–74, U. S Chart 3–37 Prevalence* of HF by Race & Sex, Ages 25–74, U.S.,1988–1994 to 2005–2008 Percent of Population * Age-adjusted.  HF: Heart failure.

Chart 3–38 Hospitalization Rates for HF. , Ages 45–64 & ≥ 65, U. S Hospitalizations/10,000 Population Year * HF: Heart failure.  Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–39 Hospital Case-Fatality Rates for HF. , Ages 45–64 & ≥ 65, U Chart 3–39 Hospital Case-Fatality Rates for HF*, Ages 45–64 & ≥ 65, U.S., 1980–2009 Percent Discharged Dead Year * HF: Heart failure.  Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–40 Death Rates* for HF as the Underlying Cause by Race & Sex, U.S., 1981–2008 Deaths/100,000 Population ICD-9 ICD-10 * Age-adjusted.  HF: Heart failure.  Break represents revisions to US death certificate in 1989. Year

Chart 3–41 Age-Adjusted Death Rates for Any-Mention HF Chart 3–41 Age-Adjusted Death Rates for Any-Mention HF* by Race & Sex, U.S., 1981–2008 Deaths/100,000 Population ICD-9 ICD-10 Year * HF: Heart failure.  Break represents revisions to US death certificate in 1989.

Chart 3–42 Death Rates for HF as the Underlying Cause by Race/Ethnicity & Sex, U.S., 2008 Deaths/100,000 Population  Age-adjusted.  HF: Heart failure. * Non-Hispanic.

Chart 3–43 Death Rates for Any Mention of HF by Race/Ethnicity & Sex, U.S., 2008 Deaths/100,000 Population  Age-adjusted.  HF: Heart failure. * Non-Hispanic.

Chart 3–44 Death Rates for HF Chart 3–44 Death Rates for HF* as the Underlying Cause by Age, Race, & Sex. U.S., 2008 Deaths/100,000 Population Age (Years) * HF: Heart failure.

Chart 3–45 Death Rates for Any Mention of HF* by Age, Race, & Sex, U.S., 2008 Deaths/100,000 Population Age (Years) * HF: Heart failure.

Chart 3–46 Age-Adjusted Death Rates for Cardiomyopathy by Race & Sex, U.S., 2008 Deaths/100,000 Population

Chart 3–47 Death Rates for Cardiomyopathy by Age, Race, & Sex, U. S Deaths/100,000 Population Age (Years)

Chart 3–48 Hospitalizations for AF* by Primary & Secondary Diagnosis, U.S., 1982–2009 Hospitalizations (Thousands) Year * AF: Atrial fibrillation.  Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–49 Hospitalization Rates for Atrial Fibrillation by Age, U. S Hospitalizations/10,000 Population Year * Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–50 Prevalence of Stroke by Race & Sex, Ages 25–74, U. S Chart 3–50 Prevalence of Stroke by Race & Sex, Ages 25–74, U.S., 1971–1975 to 2005–2008 Percent of Population * Age-adjusted.

Chart 3–51 Prevalence of Stroke by Age & Sex, U.S., 1999–2008 Percent of Population Age (Years)

Chart 3–52 Prevalence of Stroke by Age & Race, U.S., 1999–2008 Percent of Population Age (Years)

Chart 3–53 ER. Visit Rates for Stroke by Age, U. S Chart 3–53 ER* Visit Rates for Stroke by Age, U.S., 1997–1999 to 2006–2008 Visits/10,000 Population Years * ER: Emergency Department.

Chart 3–54 Hospitalization Rates for Stroke, Ages 45–64 & ≥ 65, U. S Hospitalizations/10,000 Population Year * Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–55 Hospital Case-Fatality Rate for Stroke, Ages < 65 & ≥ 65, U.S., 1971–2009* Percent Discharged Dead Year * Estimates are not available for 1976 and 1977.  Break represents change in National Hospital Discharge Survey design in 1988.

Chart 3–56 Age-Adjusted Death Rates for Stroke by Race & Sex, U. S Deaths/100,000 Population ICD-6 ICD-7 ICD-8 ICD-9 ICD-10 The picture for stroke is similar to that for CHD. Though for stroke, the decline in mortality has slowed some since the 1980’s. Year * Nonwhite from 1950 to 1967.

Chart 3-57 Deaths & Age-Adjusted Death Rates for Stroke, U. S Deaths in Thousands (Bar) Deaths/100,000 Population (Line) Year * The comparability ratio 1.0502 was applied to the deaths and rates reported in vital statistics for 1979–1998.

-*White -*Black -American Indian -Hispanic -Asian Chart 3–58 Age-Adjusted Death Rates for Stroke by Race/Ethnicity & Sex, U.S., 1999–2008 Deaths/100,000 Population -*White -*Black -American Indian -Hispanic -Asian Male Female Year * Non-Hispanic.

Chart 3–60 Age-Adjusted Death Rates for Stroke by Race/Ethnicity and Sex, U.S., 2008 Deaths/100,000 Population * Non-Hispanic.

Chart 3–61 Death Rates for Stroke in Males by Age & Race/Ethnicity, U Chart 3–61 Death Rates for Stroke in Males by Age & Race/Ethnicity, U.S., 2008 Deaths/100,000 Population Age (Years) * Non-Hispanic.

Chart 3–62 Death Rates for Stroke in Females by Age & Race/Ethnicity, U.S., 2008 Deaths/100,000 Population Age (Years)  Data unreliable for American Indian females aged 45-54 years. * Non-Hispanic.

Chart 3-63 Age-Adjusted Death Rates for Stroke by State, U. S Deaths/100,000 Population

Chart 3–64 Age-Adjusted Death Rates Chart 3–64 Age-Adjusted Death Rates* for Stroke by Country & Sex, Ages 35–74, 2006–2009 * Age-adjusted to European standard. Data for years indicated in parentheses.

Chart 3–65 Change in Death Rates Chart 3–65 Change in Death Rates* for Stroke in Males by Country, Ages 35–74, 1999–2009 * Age-adjusted to European standard. Data for years indicated in parentheses.  Based on log-linear regression of actual rates

Chart 3–66 Change in Death Rates Chart 3–66 Change in Death Rates* for Stroke in Females by Country, Ages 35–74, 1999–2009 * Age-adjusted to European standard. Data for years indicated in parentheses.  Based on log-linear regression of actual rates

Chart 3–67 Prevalence of Hypertension. & Prehypertension by Age, U. S Percent of Population Age (Years) * Hypertension: systolic BP ≥140 mmHg, or diastolic BP ≥ 90 mmHg, or on medication.  Prehypertension: systolic BP 120–139 mmHg or diastolic BP 80–89 mmHg.

Chart 3–68 Hypertension by Race/Ethnicity & Sex, Ages 20–74, U. S Percent of Population  Age-adjusted prevalence. Hypertension: systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg, or on medication. * Non-Hispanic.

Chart 3–69 Hypertension by Race/Ethnicity & Sex, Ages 20–74, U. S Percent of Population  Age-adjusted prevalence. Hypertension: systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg, or on medication. * Non-Hispanic.

Chart 3–70 Hypertensive* Population Aware, Treated, & Controlled, Ages 18–74, U.S. Percent of Hypertensive Population Years * Hypertension: systolic BP ≥160 mmHg, or diastolic BP ≥ 95 mmHg, or on medication.  For years 1971-1974 to 2005-2008.

Chart 3–71 Hypertensive* Population Aware, Treated, & Controlled, Ages 18–74, U.S. Percent of Hypertensive Population Years * Hypertension: systolic BP ≥ 140 mmHg, or diastolic BP ≥ 90 mmHg, or on medication.  For years 1976-1980 to 2005-2008.

Chart 3–72 ER. Visit Rates for Hypertension by Age, U. S Chart 3–72 ER* Visit Rates for Hypertension by Age, U.S., 1997–1999 to 2006–2008 Visits/10,000 Population Years * ER: Emergency Department.

Chart 3–73 Death Rates. for Diseases of the Arteries by Race & Sex, U Chart 3–73 Death Rates* for Diseases of the Arteries by Race & Sex, U.S., 2008 Deaths/100,000 Population * Age-adjusted.

Chart 3–74 Death Rates for Diseases of the Arteries by Age, Race, & Sex, U.S., 2008 Deaths/100,000 Population Age (Years)

Chart 3–75 Percent of Deaths Chart 3–75 Percent of Deaths* From Congenital Malformations of Circulatory System, Age <1 Year Percent of Deaths Year * US, 1940 - 2008.

Chart 3–76 Infant Mortality From Congenital Malformations of the Circulatory System by Race Deaths/100,000 Live Births ICD-8 ICD-9 ICD-10 Year  US, 1970 - 2008. * HD: Heart disease; CVD: Cardiovascular disease