Summary

Death rates from CVD have declined, yet the burden of disease remains high.

• The 2004 overall death rate from CVD (International Classification of Diseases 10, I00–I99) was 288.0 per 100 000. The rates were 335.1 per 100 000 for white males, 454.0 per 100 000 for black males, 238.0 per 100 000 for white females, and 333.6 per 100 000 for black females. From 1994 to 2004, death rates from CVD (International Classification of Diseases 10, I00–I99) declined 24.7%. Preliminary mortality data from 2005 show that CVD (I00–I99; Q20–Q28) accounted for 35.2% (861 826) of all 2 447 910 deaths in 2005, or 1 of every 2.8 deaths in the United States.
  
• Nearly 2400 Americans die of CVD each day—an average of 1 death every 37 seconds. The 2005 overall preliminary death rate from CVD was 279.2. More than 148 000 Americans killed by CVD (I00–I99) in 2004 were <65 years of age. In 2004, 32% of deaths from CVD occurred before the age of 75 years, which is well before the average life expectancy of 77.9 years.
  
• Coronary heart disease caused 1 of every 5 deaths in the United States in 2004. Coronary heart disease mortality was 451 326. In 2008, an estimated 770 000 Americans will have a new coronary attack, and about 430 000 will have a recurrent attack. It is estimated that an additional 175 000 silent first myocardial infarctions occur each year. About every 26 seconds, an American will have a coronary event, and about every minute someone will die from one.
  
• Each year, about 780 000 people experience a new or recurrent stroke. About 600 000 of these are first attacks, and 180 000 are recurrent attacks. Preliminary data from 2005 indicate that stroke accounted for about 1 of every 17 deaths in the United States. On average, every 40 seconds someone in the United States has a stroke. From 1994 to 2004, the stroke death rate fell 24.2%, and the actual number of stroke deaths declined 6.8%.
  
• In 2004, 1 in 8 death certificates (284 365 deaths) in the United States mentions heart failure.
  

Control of risk factors remains an issue for many Americans.

• The age-adjusted prevalence of high low-density lipoprotein cholesterol in US adults was 26.6% in 1988–1994 and 25.3% in 1999–2004. Between 1988–1994 and 1999–2004, awareness increased from 39.2% to 63.0%, and use of pharmacological lipid-lowering treatment increased from 11.7% to 40.8%. Low-density lipoprotein cholesterol control increased from 4.0% to 25.1% among those with high low-density lipoprotein cholesterol.
  
• Overall, 62.0% of adults 18 years of age engaged in at least some vigorous and/or light-moderate leisure-time physical activity lasting 10 minutes per session. In 2002–2004, 40.2% of people 75 years of age (age adjusted) engaged in at least some regular leisure-time physical activity. Men were more likely (64.0%) to exercise than were women (60.2%).
  
• More than 9 million children and adolescents between 6 and 19 years of age are considered overweight on the basis of being in the 95th percentile or higher of body mass index values in the 2000 Centers for Disease Control and Prevention growth chart.
  
• On the basis of data from the National Health and Nutrition Examination Survey, the prevalence of overweight in children between 6 and 11 years of age increased from 4.0% in 1971–1974 to 17.5% in 2001–2004. The prevalence of overweight in adolescents between 12 and 19 years of age increased from 6.1% to 17.0%. In 2003–2004, 36% of women 65 to 74 years of age and 24% of women 75 years of age were obese. This is an increase from 1988–1994, when 27% of women 65 to 74 years of age and 19% of women 75 years of age were obese. For men, from 1988–1994, 24% of those 65 to 74 years of age and 13% of those 75 years of age were obese, compared with 33% of those 65 to 74 years of age and 23% of those 75 years of age in 2003–2004.
  
• One and a half million new cases of diabetes were diagnosed in people 20 years of age in 2005.
  

The 2008 Update expands data coverage of CVD-related kidney disease.

• End-stage renal disease and chronic kidney disease are conditions that are most commonly associated with diabetes and/or high blood pressure and occur when the kidneys can no longer function normally on their own.
  
• The incidence of reported end-stage renal disease has almost doubled in the past 10 years. In 2004, 104 364 new cases of end-stage renal disease were reported.
  
• The number of persons treated for end-stage renal disease increased from 68 757 in 1994 to 102 356 in 2004; this translates to 261.3 per million in 1994 to 348.6 per million in 2004.
  
• The US Renal Data System estimates that by 2010, 650 000 Americans will require treatment for kidney failure, which represents a 60% increase over the number who received such treatment in 2001.
  
• The prevalence of chronic kidney disease (stages I–V) is 16.8%. This represents an increase over the 14.5% prevalence estimate from the National Health and Nutrition Examination Survey 1988–1994.
  
• The prevalence of chronic kidney disease was greater among those with diabetes (40.2%), hypertension (24.6%), and CVD (28.2%) than among those without these chronic conditions.
  

Improvements in medical care are being made.

• Over a 3-year period from 2002 through 2004, among 159 168 patients admitted with heart failure at 285 hospitals, inotrope use decreased, and improvements were made in providing discharge instructions, smoking counseling, left ventricular assessment, and β-blocker prescription.
  
• During this same period of time, clinical outcomes improved, including the need for mechanical ventilation (5.3% to 3.4%), length of stay (mean, 6.3 days to 5.5 days), and in-hospital death rate (4.5% to 3.2%).
  

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current data available in the Statistics Update. The 2005 preliminary mortality data have been released, and although not included in this year’s Update, more information can be found at the National Center for Health Statistics Web site, http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimdeaths05/prelimdeaths05.htm.

1. About These Statistics

The surveys used are:

Behavioral Risk Factor Surveillance Survey (BRFSS)—ongoing telephone health survey system

Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS)—stroke incidence rates and outcome within a biracial population

Medical Expenditure Panel Survey (MEPS)—data on specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for

National Health and Nutrition Examination Survey (NHANES)—disease and risk factor prevalence and nutrition statistics

National Health Interview Survey (NHIS)—disease and risk factor prevalence

National Hospital Discharge Survey (NHDS)—hospital inpatient discharges (discharged alive, dead, or status unknown)

National Ambulatory Medical Care Survey (NAMCS)—physician office visits

National Hospital Ambulatory Medical Care Survey (NHAMCS)—hospital outpatient and emergency department visits

National Inpatient Sample (NIS) of the Agency for Health Research and Quality—hospital inpatient discharges and charges

National Institute of Neurological Disorders and Stroke (NINDS)—brain and nervous system disorders

National Nursing Home Survey (NNHS)—nursing home visits

National Vital Statistics—national and state mortality data

World Health Organization (WHO)—country mortality

Youth Risk Behavior Surveillance (YRBS)—trends for 6 categories of priority health-risk behaviors in youth and young adults