Cardiovascular Disease in Tennessee Audrey M Bauer, DVM, MPH Surveillance, Epidemiology and Evaluation Tennessee Department of Health Practical Strategies in Medication Adherence for Cardiac and Stroke Patients – June 8, 2012

Overview Tennessee vs. the United States CVD risk factors CVD hospitalizations CVD mortality

Tennessee vs. The United States In 2009, Tennessee had the… –8 th highest heart disease mortality rate –5 th highest stroke mortality rate Data source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final Data for National Vital Statistics Reports; vol. 58 no. 19. Hyattsville, MD: National Center for Health Statistics, 2010.

TN: 211/100,000 US: 180/100,000 Data source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final Data for National Vital Statistics Reports; vol. 58 no. 19. Hyattsville, MD: National Center for Health Statistics, 2010.

TN: 47/100,000 US: 39/100,000 Data source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final Data for National Vital Statistics Reports; vol. 58 no. 19. Hyattsville, MD: National Center for Health Statistics, 2010.

Tennessee vs. The United States In 2010, Tennessee had the… –14 th highest smoking prevalence –7 th highest obesity prevalence –4 th highest diabetes prevalence Data source: Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Prevalence and Trends Data. Accessed November 2010 at

Cardiovascular Disease Risk Factors

Risk FactorPrevalence (%)Change from Diabetes10.343%  Smoking22.014%  High Blood Pressure32.622%  High Cholesterol32.920%  Physical Inactivity64.0no change Overweight & Obesity69.016%  CVD Risk Factor Prevalence Tennessee, 2009 Data source: Tennessee Department of Health; Office of Health Statistics; Behavioral Risk Factor Surveillance System (BRFSS). Data are for adults 18+ years of age.

44% increase in obesity

Data source: Tennessee Department of Health; Office of Health Statistics; Behavioral Risk Factor Surveillance System (BRFSS). Data are for adults 18+ years of age.

Cardiovascular Disease Hospitalizations

CVD Hospitalizations CVD are the leading cause of inpatient hospitalizations and the 3 rd leading cause of emergency room visits in Tennessee In 2009, combined inpatient and outpatient hospital discharges for CVD totaled approximately 208,000 Combined inpatient and outpatient hospital charges for CVD totaled over $5 billion in 2009 – a 79% increase since 2000 Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).

Heart Disease Hospitalizations Heart disease is the most common cause of CVD hospital stays –72% of inpatient hospitalizations –62% of outpatient visits Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).

Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS). Charges are inflation adjusted to 2009 dollars.

Data source: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System (HDDS).

Cardiovascular Disease Mortality

Data source: CDC. Achievements in Public Health, : Decline in Deaths from Heart Disease and Stroke. MMWR 1999; 48(30):

Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS). Mortality rates prior to 1999 were compatibility adjusted to account for ICD revisions.

CVD Mortality In 2009, there were approximately 18,400 deaths due to CVD – about one death every 30 minutes Almost one-third of deaths in Tennessee are due to CVD –Heart disease is the 1 st leading cause of death –Stroke is the 5 th leading cause of death Data source: Tennessee Department of Health; Office of Health Statistics; Death Statistical System (DDS).

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