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CHD remains leading cause of death in Americans, despite recent decline
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Although self-reports of coronary heart disease have declined from 2006 to 2010, CVD remains the leading cause of death in the US, with rates varying from state to state and by race and ethnicity, according to recent data published in the CDC’s Morbidity and Mortality Weekly Report.
“We’re all at risk for heart disease and stroke,” Jing Fang, MD, epidemiologist in the CDC’s Division of Heart Disease and Stroke Prevention, said in a press release. “People of all ages, genders, races and ethnicities are affected. However, certain groups, including American Indians/Alaska natives, African Americans and older adults, are at higher risk than others.”
CDC researchers analyzed data from Behavioral Risk Factor Surveillance System surveys conducted between 2006 and 2010, a state-based, random digit-dialed telephone survey of the US civilian, noninstitutionalized population aged 18 years or older. Administered in all 50 states, the District of Columbia, and the US territories of Guam, Puerto Rico and the US Virgin Islands, the survey estimates state-specific CHD prevalence and recent trends by age, sex, race/ethnicity and education.
Overall, the number of participants who reported being told they have CHD by a health care professional declined from 6.7% to 6%. By 2010, participants aged 65 years and older had a higher CHD prevalence (19.8%) vs. participants aged 45 to 64 years (7.1%) and 18 to 44 years (1.2%). CHD prevalence was also greater in participants with less than a high school education (9.2%) vs. high school graduates (6.7%), participants with some college education (6.2%) and participants with a college degree (4.6%).
Among the states, age-adjusted CHD prevalence from 2006 to 2010 showed the greatest declines in West Virginia (23.1%; from 10.4% to 8%) and Missouri (22.1%; from 7.7% to 6%). By 2010, CHD prevalence by state varied widely, from 3.7% in Hawaii and 3.8% in Washington, D.C. to 8% in West Virginia and 8.2% in Kentucky. Researchers generally observed the greatest regional prevalences in the South.
Declines among racial/ethnic populations from 2006 to 2010 were observed among whites (6.4% to 5.8%) and Hispanics (6.9% to 6.1%). CHD prevalence was greatest among American Indians/Alaska natives (11.6%), followed by blacks (6.5%), Hispanics (6.1%), whites (5.8%), and Asians or native Hawaiians/ Pacific Islanders (3.9%). Analysis of race and sex revealed that in 2010 American Indian/Alaska natives (14.3%) and whites (7.7%) had the greatest CHD prevalence among men, while American Indian/Alaska natives (8.4%) and blacks (5.9%) had the greatest CHD prevalence among women.
Fang J. MMWR. 2011;60:1377-1381.
Disclosures: The researchers report no relevant financial disclosures.
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The decline in mortality for CHD is dramatic and reflects the effect of prevention from modifying known risk factors and improved treatment of the disease. Improving compliance must be our first goal. There is, however, a fresh feature on the scene from genetics. There are 36 genetic risk variants discovered and, to the world's surprise, 23 of them do not act through any of the known risk factors. Comprehensive prevention will in the future have the opportunity to incorporate these new factors.
– Robert Roberts, MD, FRCPC, MACC
Cardiology Today Editorial Board member
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