Deaths from cardiovascular disease (CVD) are coming down, but CVD remains the primary cause of death among Americans, said a new report by the American Heart Association (AHA).

The report is published in the 17th December early online issue of Circulation, and is compiled by the AHA Statistics Committee and Stroke Statistics Subcommittee.

While CVD death rates coming down is good news, control of risk factors for CVD is still a challenge for many people said the report authors.

The report covers 2004, the most recent year from which final figures are available, and is a comprehensive national resource of statistics on cardiovascular diseases, risk factors, treatments, costs and quality of care.

The AHA did not conduct new research to glean the information but rather brought together a vast array of statistics from many sources, including government departments, policy makers, doctors, researcers, educators, and from the public.

CVD has been the number 1 killer in the US every year since 1900 (except in 1918 when the flu epidemic struck).

CVD includes heart disease, heart failure, stroke, high blood pressure, and other conditions such as cardiomyopathy (heart muscle deterioration), arrythmias such as atrial fibrillation (irregular heart beat), and peripheral arterial disease.

The report shows that:
  • The age-adjusted CVD death rate in the US for 2004 was 288.0 per 100,000 people.

  • This is down from 307.7 per 100,000 in 2003.

  • CVD was listed as the underlying cause of 869,724 deaths in 2004.

  • This compares with 911,163 deaths in 2003.

  • The second leading cause of death in the US was cancer, which claimed 553,888 lives in 2004.

  • Even when considered on its own (apart from CVD as a whole), heart disease is the number 1 killer in the US, claiming 451,326 lives in 2004.

  • When considered separately, stroke is the third leading cause of death in the US (150,074 deaths in 2004).

  • The fourth is accidents, which claimed 112,012 American lives in 2004.
Dr Donald Lloyd-Jones, associate professor in the Department of Preventive Medicine at Northwestern University's Feinberg School of Medicine in Chicago, chaired the AHA's Statistics Committee, which produced the report, along with the AHA's Stroke Statistics Subcomittee. He said that:

"These statistics make it clear that cardiovascular disease remains, by far, our greatest public health challenge."

Curiously, while deaths from CVD appear to be going down, the risk factors themselves are either staying steady or going up.

For example, overweight adults and children are on the increase in the US. That figure has been rising for decades. 66 per cent of US adults are now overweight, with nearly half of them being in the obese category, that is nearly one third of all Americans.

17 per cent of children and teenagers from 12 to 19 years of age are overweight, as are 17.5 of children from 6 to 11 years of age and 14 per cent of 2 to 5 year olds.

Lloyd-Jones said that although there has been significant progress in understanding what causes CVD, the report clearly shows there is still a long way to go in order to "capture people's attention and to implement the prevention and treatment programs we need".

The three biggest risk factors are overweight/obesity, smoking and diabetes.

The obesity crisis has come about because of changes in diet, with many Americans not sticking to national guidelines about the right foods to eat like fruit and vegetables.

The report gives examples from the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance Study that showed for 2005, only 21.4 per cent of male and 18.7 per cent of female high school students said they ate a minimum of 5 servings a day of fruits and vegetables.

Another CDC study called the 2005 Behavioral Risk Factor Surveillance Study showed that fewer than 1 in 3 American adults eats fruit two or more times a day, and less that one third eat vegetables three or more times a day.

Another big risk factor is smoking, which doubles or trebles the risk of death from coronary heart disease. More than 46 million Americans smoke every day, and every day, 4,000 American teenagers join those figures.

The latest report has more information on diabetes than previous issues. According to data from 1984-2004 National Health and Nutrition Examination Studies (NHNES), it is estimated that the proportion of the US population with diabetes will double from 2005 to 2050.

About one third of the 15.1 million people with the disease don't realize they have it, said the AHA authors, and nearly 60 million have prediabetes, a condition that increases the risk of getting full blown diabetes.

The report also contains information on the quality of care CVD patients receive in hospitals in the US, which appears to be improving, but the cost is projected to rise to 448.5 billion dollars in 2008, an increase of more than 16 billion dollars on the 2007 figure.

Lloyd-Jones said the updated report contains:

" A wealth of information that is useful for researchers, the media, policymakers, clinicians and the general public alike."

"We hope it will raise awareness that cardiovascular disease, the leading cause of disability and death in the United States, is highly preventable and very treatable; if people make themselves aware of their risks and the potential approaches," he added.

"Heart Disease and Stroke Statistics - 2008 Update. A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee."
Wayne Rosamond, Katherine Flegal, Karen Furie, Alan Go, Kurt Greenlund, Nancy Haase, Susan M. Hailpern, Michael Ho, Virginia Howard, Bret Kissela, Steven Kittner, Donald Lloyd-Jones, Mary McDermott, James Meigs, Claudia Moy, Graham Nichol, Christopher O'Donnell, Veronique Roger, Paul Sorlie, Julia Steinberger, Thomas Thom, Matt Wilson, Yuling Hong, and for the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
Circulation Published online before print December 17, 2007
doi: 10.1161/CIRCULATIONAHA.107.187998

Click here for Abstract.

Source: AHA news release.
Written by: Catharine Paddock