Health Reports & Data

Heart Disease and Stroke

Goal

Improve cardiovascular health and quality of life through prevention, detection, and treatment of risk factors for heart attack and stroke; early identification and treatment of heart attacks and strokes; and prevention of repeat cardiovascular events.

Overview

Heart disease is the leading cause of death in the United States.1 Stroke is the third leading cause of death in the United States. Together, heart disease and stroke are among the most widespread and costly health problems facing the Nation today, accounting for more than $500 billion in health care expenditures and related expenses in 2010 alone.2 Fortunately, they are also among the most preventable.

The leading modifiable (controllable) risk factors for heart disease and stroke are:

•    High blood pressure
•    High cholesterol
•    Cigarette smoking
•    Diabetes
•    Poor diet and physical inactivity
•    Overweight and obesity

Over time, these risk factors cause changes in the heart and blood vessels that can lead to heart attacks, heart failure, and strokes. It is critical to address risk factors early in life to prevent the potentially devastating complications of chronic cardiovascular disease.

Controlling risk factors for heart disease and stroke remains a challenge. High blood pressure and cholesterol are still major contributors to the national epidemic of cardiovascular disease. High blood pressure affects approximately 1 in 3 adults in the United States,3 and more than half of Americans with high blood pressure do not have it under control.3 High sodium intake is a known risk factor for high blood pressure and heart disease,4 yet about 90 percent of American adults exceed their recommendation for sodium intake.5

The risk of Americans developing and dying from cardiovascular disease would be substantially reduced if major improvements were made across the U.S. population in diet and physical activity, control of high blood pressure and cholesterol, smoking cessation, and appropriate aspirin use.6

Why is Heart Disease and Stroke Important?

Currently more than 1 in 3 adults (81.1 million) live with 1 or more types of cardiovascular disease.2 In addition to being the first and third leading causes of death, heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year.

The burden of cardiovascular disease is disproportionately distributed across the population. There are significant disparities in the following based on gender, age, race/ethnicity, geographic area, and socioeconomic status:7

•    Prevalence of risk factors
•    Access to treatment
•    Appropriate and timely treatment
•    Treatment outcomes
•    Mortality

Additional Resources

HP2020’s National Objectives for Heart Disease and Stroke
HHDW Reports on Heart Attack and Stroke
HHDW Reports on Hypertension and Blood Cholesterol

References

  1. Xu J, Kochanek KD, Murphy SL, et al. Deaths: Final data for 2007. Natl Vital Stat Rep. 2010;58(19).
  2. Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart disease and stroke statistics—2010 update: A report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation. 2010;121:e1-e170.
  3. Ostchega Y, Yoon SS, Hughes J, et al. Hypertension awareness, treatment, and control—continued disparities in adults: United States, 2005–2006. [NCHS Data Brief] Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health and Nutrition Examination Surveys; 2008. Available from: http://www.cdc.gov/nchs/data/databriefs/db03.pdf
  4. Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate, 1st ed. Washington, DC: National Academies Press; 2004.
  5. Centers for Disease Control and Prevention. Sodium intake among adults—United States, 2005–2006. MMWR. 2010;59:746-9.
  6. Agency for Healthcare Research and Quality (AHRQ), U.S. Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease [Internet]. AHRQ; 2009. Available from: http://www.ahrq.gov/clinic/USpstf/uspsasmi.htm
  7. Agency for Healthcare Research and Quality (AHRQ). 2008 National Healthcare Quality & Disparities Reports [Internet]. AHRQ; 2009. Available from: http://www.ahrq.gov/qual/qrdr08.htm
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OBJECTIVES AND SUB-OBJECTIVES

State Indicator Definition:
The number of coronary heart disease deaths (ICD-10 codes I11, I20-I25) per 100,000 population (age-adjusted to the 2000 U.S. Standard Population). The national indicator is defined in exactly the same way.

State Baseline:
70.4 deaths per 100,000 population (2010)

Most Recent State Value:
73.6 deaths per 100,000 population (2015)

HP2020 Target:
National: 103.4 deaths per 100,000 population

National Data Source:
National Vital Statistics System

State Data Source:
Hawaii Vital Statistics System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
The number of stroke deaths (ICD-10 codes: I60-I69) per 100,000 population (age adjusted to the U.S. 2000 Standard Population). The national indicator is defined in exactly the same way.

State Baseline:
34.6 deaths per 100,000 population (2010)

Most Recent State Value:
37.4 deaths per 100,000 population (2015)

HP2020 Target:
National: 33.8 deaths per 100,000 population

National Data Source:
National Vital Statistics System

State Data Source:
Hawaii Vital Statistics System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

HDS-5
Reduce the proportion of persons in the population with hypertension
State Indicator Definition:
Percentage of adults aged 18 years and over who have been told by a doctor, nurse, or other health professional that they have hypertension. The national indicator excludes pregnant women.

State Baseline:
28.7% (2011)

Most Recent State Value:
32.0% (2015)

HP2020 Target:
National: 26.9%

National Data Source:
National Health and Nutrition Examination Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults aged 18 years and older who have had their blood cholesterol checked within the preceding 5 years. The national indicator is defined in exactly the same way.

State Baseline:
73.9% (2011)

Most Recent State Value:
75.8% (2013)

HP2020 Target:
National: 82.1%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults 18 years and older who reported that they had their blood cholesterol checked and were told by a doctor, nurse, or other health care professional that it was high.The national indicator is based on total serum cholesterol level measurements, and defined as the percentage of persons aged 20 years and older with total blood cholesterol of 240 mg/dL or greater. Therefore, individuals who take medication to lower their serum cholesterol levels and whose measured total serum cholesterol levels are below the cut-offs for high cholesterol, are not defined as having high cholesterol.

State Baseline:
36.9% (2011)

Most Recent State Value:
36.3% (2015)

HP2020 Target:
National: 13.5%

National Data Source:
National Health and Nutrition Examination Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults aged 18 years and older with high blood pressure/hypertension who are taking medicines for their high blood pressure. The national indicator is defined differently as the percentage of adults aged 20 years and older who take prescribed medications to lower their blood pressure, whereas the state data does not specify that the medication taken must be prescribed.

State Baseline:
80.3% (2011)

Most Recent State Value:
74.5% (2015)

HP2020 Target:
National: 69.5%

National Data Source:
National Health and Nutrition Examination Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults with hypertension whose mean systolic blood pressure is less than 140 mm Hg and mean diastolic blood pressure is less than 90 mm Hg.  The indicator excludes pregnant women. The national indicator is defined in exactly the same way.

State Baseline:
57.4% (2010)

Most Recent State Value:
63.5% (2015)

HP2020 Target:
National: 61.2%

National Data Source:
Uniform Data System

State Data Source:
Uniform Data System

Data Reports:
HHM Report
DHHS Health Indicators Warehouse

HDS-15
Increase aspirin use as recommended among adults with no history of cardiovascular disease
State Indicator Definition:
Percentage of women aged 55 to 79 years with no history of cardiovascular disease who take aspirin every day or every other day. The national indicator is developmental; the definition and target have yet to be established.

State Baseline:
25.7% (2013)

HP2020 Target:
National: 24.8%

National Data Source:
National Hospital Ambulatory Medical Care Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report

State Indicator Definition:
Percentage of men aged 45 to 79 years with no history of cardiovascular disease who take aspirin every day or every other day. The national indicator is developmental; the definition and target have yet to be established.

State Baseline:
25.8% (2013)

HP2020 Target:
National: 19.3%

National Data Source:
National Hospital Ambulatory Medical Care Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report

HDS-16
Increase the proportion of adults aged 20 years and older who are aware of the symptoms of and how to respond to a heart attack
State Indicator Definition:
Percentage of adults 18 years and older who were able to identify all five symptoms of a heart attack (Pain or discomfort in the jaw, neck or back; Feeling weak, lightheaded or faint; Chest pain or discomfort; Pain or discomfort in the arms or shoulder; Shortness of breath) correctly and stated that calling 9-1-1 is the FIRST thing they would do if someone was having a heart attack or stroke. The national indicator is defined differently as adults aged 20 years and older who can identify all five symptoms of a heart attack correctly and stated that calling 9-1-1 or another emergency number is the BEST thing to do right away if someone was having a heart attack.

State Baseline:
28.0% (2009)

HP2020 Target:
National: 40.9%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults 18 years and older who were able to identify all five symptoms of a heart attack (Pain or discomfort in the jaw, neck or back; Feeling weak, lightheaded or faint; Chest pain or discomfort; Pain or discomfort in the arms or shoulder; Shortness of breath) correctly. The national indicator is limited to adults aged 20 years and older.

State Baseline:
30.6% (2009)

HP2020 Target:
National: 43.6%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults 18 years and older who stated that calling 9-1-1 is the FIRST thing they would do if someone was having a heart attack or stroke. The national indicator is defined differently as adults aged 20 years and older who stated that calling 9-1-1 or another emergency number is the BEST thing to do right away if someone was having a heart attack.

State Baseline:
89.7% (2009)

HP2020 Target:
National: 93.8%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

HDS-17
Increase the proportion of adults aged 20 years and older who are aware of the symptoms of and how to respond to a stroke
State Indicator Definition:
Percentage of adults 18 years and older who were able to identify all five symptoms of a stroke (Sudden confusion or trouble speaking; Sudden numbness or weakness of face, arm, or leg, especially on one side; Sudden trouble seeing in one or both eyes; Sudden trouble walking, dizziness, or loss of balance; Severe headache with no known cause) correctly and stated that calling 9-1-1 is the FIRST thing they would do if someone was having a heart attack or stroke. The national indicator is defined differently as adults aged 20 years and older who can identify all five symptoms of a heart attack correctly and stated that calling 9-1-1 or another emergency number is the BEST thing to do right away if someone was having a heart attack.

State Baseline:
37.7% (2009)

HP2020 Target:
National: 56.4%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults 18 years and older who were able to identify all five symptoms of a stroke (Sudden confusion or trouble speaking; Sudden numbness or weakness of face, arm, or leg, especially on one side; Sudden trouble seeing in one or both eyes; Sudden trouble walking, dizziness, or loss of balance; Severe headache with no known cause) correctly. The national indicator is defined in exactly the same way.

State Baseline:
41.9% (2009)

HP2020 Target:
National: 59.3%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
Percentage of adults 18 years and older who stated that calling 9-1-1 is the FIRST thing they would do if someone was having a heart attack or stroke. The national indicator is limited to adults aged 20 years and older who stated that calling 9-1-1 or another emergency number is the BEST thing to do right away if someone was having a stroke.

State Baseline:
90.0% (2009)

HP2020 Target:
National: 94.7%

National Data Source:
National Health Interview Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report
DHHS Health Indicator Warehouse

State Indicator Definition:
percentage of adults aged 18 years and older with a history of cardiovascular disease who report taking aspirin daily or every other day to reduce the chance of having a heart attack or stroke.

State Baseline:
59.6% (2013)

HP2020 Target:
National: 52.1%

National Data Source:
National Ambulatory Medical Care Survey

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report

State Indicator Definition:
Percentage of adults aged 18 years and over who suffered a heart attack and, subsequently, went to any kind of outpatient rehabilitation. The national indicator is developmental; the definition and target have yet to be established.

State Baseline:
18.1% (2012)

Most Recent State Value:
19.1% (2013)

HP2020 Target:
National: 84.8%

National Data Source:
Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report

State Indicator Definition:
Percentage of adults aged 18 years and over who suffered a stroke and, subsequently, went to any kind of outpatient rehabilitation. The national indicator is developmental; the definition and target have yet to be established.

State Baseline:
29.2% (2012)

Most Recent State Value:
23.5% (2013)

HP2020 Target:
National: This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.

National Data Source:
Get with the Guidelines- Stroke

State Data Source:
Hawaii Behavioral Risk Factor Surveillance System

Data Reports:
HHDW Report
HHM Report