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Heart disease and stroke—the principal components of cardiovascular
disease—are the first and third leading causes of death for both men
and women in the United States, accounting for nearly 40% of all
deaths. Over 930,000 Americans die of cardiovascular disease each
year, which amounts to one death every 34 seconds. Although these
largely preventable conditions are more common among people ages 65
years and older, the number of sudden deaths from heart disease
among people ages 15–34 has increased.
Deaths are only part of the picture. Over 64 million Americans (almost one-fourth of the population) live with cardiovascular disease. Coronary heart disease is a leading cause of premature, permanent disability in the U.S. workforce. Stroke alone accounts for disability among more than 1 million Americans. Over 6 million hospitalizations each year are due to cardiovascular disease. The economic impact of cardiovascular disease on the U.S. health care system continues to grow as the population ages. The cost of heart disease and stroke in the United States is projected to be $368 billion in 2004, including health care expenditures and lost productivity from death and disability. Risk Factors Must Be AddressedTwo of the major independent risk factors for cardiovascular disease are high blood pressure and high blood cholesterol. About 90% of middle-aged Americans will develop high blood pressure in their lifetime, and over 70% of people with high blood pressure do not have it under control. A 12–13 point reduction in blood pressure can reduce heart attacks by 21%, strokes by 37%, and all deaths from cardiovascular disease by 25%. Over 80% of those who have high blood cholesterol do not have it under control. A 10% decrease in total blood cholesterol levels may reduce the incidence of coronary heart disease by as much as 30%. A key strategy for addressing these risk factors is to educate the public and health care practitioners about the importance of prevention. Current guidelines recommend that all adults have their blood pressure checked regularly and their blood cholesterol levels checked every 5 years. Systems changes are also needed to help practitioners adhere to guidelines for treating patients with or at risk for heart disease and stroke, such as prescribing beta-blockers and aspirin. Preventive actions can help people at any level of blood pressure or cholesterol to reduce their risk. People also need to be educated about the signs and symptoms of heart attacks and stroke and the importance of calling 911 quickly. Forty-seven percent of heart attack victims and about the same percentage of stroke victims die before emergency medical personnel arrive. Other important risk factors for heart disease and stroke—such as diabetes, tobacco use, physical inactivity, poor nutrition, and overweight and obesity—need to be addressed through lifestyle changes and appropriate use of medications.
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