Cardiovascular Disease Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.1. CVD and Leading Causes of Death, N.C., 2010 Total Cardiovascular Diseases: 23,232 deaths, 29.6% of all deaths* Cancer 18,013 23% Heart Disease* 17,090 Stroke* 22% 4,281 5% Other CVD* 1,861 2% Chronic Lower Respiratory Disease 4,490 6% All other causes 30,107 38% Other Unintentional Injuries* 2,762 4% *Unintentional injuries other than motor-vehicles injuries. Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/data/lcd/lcd.cfm. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.2. Major Cardiovascular Disease Death Rates, 1979-2008 Age-adjusted Death Rate 600 500 400 300 200 100 North Carolina United States 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.3. Cardiovascular Disease Death Rates by Age and Gender, N.C., 2008 Death Rate per 100,000 6,000 5,000 Females Males Total 4,000 3,000 2,000 1,000 0 Females Males Total <45 45-54 55-64 65-74 75-84 85+ 11.5 19.0 15.3 78.8 165.3 120.8 162.5 387.4 269.5 430.1 814.5 604.9 1474.1 2076.8 1715.0 5531.6 5878.3 5633.0 Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99; Q20-Q28. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.4. Major Cardiovascular Disease Death Rates by Gender, N.C., 1979-2008 Age-adjusted Death Rate 800 700 Males Females 600 500 400 300 200 100 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.5. Major Cardiovascular Disease Death Rates by Race, N.C., 1979-2008 Age-adjusted Death Rate 700 African Americans Whites 600 500 400 300 200 100 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.6. Major Cardiovascular Disease Death Rates by Race and Gender, N.C., 1979-2008 Age-adjusted Death Rate 1000 African-American Males African-American Females White Males White Females 900 800 700 600 500 400 300 200 100 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.7. Percentage of Total CVD Deaths by Age Group, Race, and Gender, N.C., 2004-2008 Percentage of CVD Deaths <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 43.2 25.9 24.8 10.4 AfricanAmerican Males White Males AfricanAmerican Females White Females Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.8. Cardiovascular Disease Death Rates by County of Residence, N.C., 2004-2008 Death Rate 211.4 - 249.5 249.6 - 275.0 275.1 - 321.0 321.2 - 367.6 367.7- 436.6 N.C. overall: 275.0 U.S.: 265.7 Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99; Q20-Q28. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.9. Number and Percentage of Total CVD Hospital Discharges by Type of CVD, N.C., 2010 All Cardiovascular Diseases: 162,329 Other CVD 24,887 15.3% Coronary Heart Disease 39,022 24.0% Stroke 29,429 18.1% Congestive Heart Failure 7,840 4.8% Other Heart Disease 61,151 37.7% ICD-9-CM codes: Cardiovascular Disease, excluding congenital malformations 390-459; Heart Disease 391-392.0, 393-398, 402, 404, 410-416, 420-429; Coronary Heart Disease 410-414; Congestive Heart Failure 428.0; Stroke 430-438. Principal diagnosis only; N.C. residents only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.10. CVD Hospital Discharge Rates, N.C., 1995-2010 Age-adjusted Discharge Rate 3,000 2,500 2,000 1,500 1,000 Total Males Females 500 0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.11. CVD Hospital Discharge Rates by Age and Gender, N.C., 2010 Discharge Rate per 100,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 <25 25-34 35-44 45-54 55-64 65-74 75-84 85+ Females 44.2 202.3 513.4 1201.5 2193.5 4564.8 8584.5 13829.8 Males 45.7 210.4 717.4 1853.6 3655.0 6745.2 10716.9 14922.3 Total 45.0 206.3 613.9 1518.4 2886.9 5568.6 9453.5 14159.7 Age Group Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.12. Percentage of CVD Hospitalizations by Age Group, N.C., 2010 Percentage of Hospitalizations <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 46.2 40.6 Male Total 34.5 Female Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Provisional Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.13. Cardiovascular Disease Hospital Discharge Rates by County of Residence, N.C., 2006-2010 Hospital Discharge Rate 576.2 - 1121.1 1121.2 - 1700.0 1700.1 - 2060.4 N.C. overall: 1700.0 2060.5 - 2552.2 2552.3 - 3124.4 Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes: 390-459; Principal diagnosis only; N.C. residents only. Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 1.14. Estimated Direct and Indirect Costs of CVD, United States, 2008 350 Total: $297.7 billion Billions of Dollars 300 250 Indirect Costs Direct Costs $118.5 200 150 100 $179.2 50 0 Total CVD Data Source: Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:e2–e220. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Total Hospital Charges in 2011 Dollars Figure 1.15. Cardiovascular Disease Hospital Charges, N.C., 1995-2010 $6,000,000,000 $5,000,000,000 Total Males Females $4,000,000,000 $3,000,000,000 $2,000,000,000 $1,000,000,000 $0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Charges per Stay in 2011 Dollars Figure 1.16. Cardiovascular Disease: Average Hospital Charges per Stay, N.C., 1995-2010 $45,000 $40,000 $35,000 Total Males Females $30,000 $25,000 $20,000 $15,000 $10,000 $5,000 $0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Stroke Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.1. Stroke and Leading Causes of Death, N.C., 2010 Cancer 18,013 23% Heart Disease 17,090 22% Stroke 4,281 5% Other CVD 1,861 2% All other causes 30,107 38% Chronic Lower Respiratory Disease 4,490 6% Other Unintentional Injuries* 2,762 4% *Unintentional injuries other than motor-vehicles injuries. Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/data/lcd/lcd.cfm. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Stroke Death Rate Figure 2.2. Stroke Death Rates & Healthy People 2020 Target, 2009 60 50 46.6 38.9 40 30 20 10 0 N.C. 2020 Target (33.8) U.S. 2010 Target (50.0) Healthy People 2020 Objective 12-07. Stroke: ICD-10 codes I60-I69. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.3. Stroke Death Rates, 1979-2008 Age-adjusted Death Rate 140 120 100 80 60 40 20 North Carolina United States 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434, 436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.4. Stroke Disease Deaths Rates by Age and Gender, N.C., 2008 Death Rate per 100,000 1,400 1,200 Females Males Total 1,000 800 600 400 200 0 Females Males Total <45 45-54 55-64 65-74 75-84 85+ 1.8 2.1 2.0 16.4 19.3 17.8 27.4 45.3 35.9 96.6 129.2 111.4 361.7 388.9 372.6 1294.1 1122.0 1243.8 Age Group Stroke: ICD-10 codes I60-I69. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Death Rate Figure 2.5. Stroke Death Rates by Gender, N.C., 1979-2008 140 Males Females 120 100 80 60 40 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434,436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Stroke Death Rate 2020 Target (33.8) 2010 Target (50.0) 68.1 46.6 31.2 50.7 27.0 Non-Hispanic Hispanic White African American 18.6 Asian/Pacific Islander 100 90 80 70 60 50 40 30 20 10 0 American Indian/Alaska Native Age-adjusted Stroke Death Rate Figure 2.6. Stroke Death Rates by Race and Ethnicity & Healthy People 2020 Target, N.C., 2008 Healthy People 2020 Objective 12-07. Stroke: ICD-10 codes I60-I69. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.7. Stroke Death Rates by Race, N.C., 1979-2008 Age-adjusted Death Rate 180 African Americans Whites 160 140 120 100 80 60 40 20 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434, 436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.8. Stroke Death Rates by Race and Gender, N.C., 1979-2008 Age-adjusted Death Rate 200 African-American Males African-American Females White Males White Females 175 150 125 100 75 50 25 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434, 436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Stroke Deaths Figure 2.9. Percentage of Total Stroke Deaths by Age Group, Race, and Gender, N.C., 2004-2008 <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 38.8 African-American Males 16.2 22.6 White Males African-American Females 7.8 White Females Stroke: 1999-2008: ICD-10 codes I60-I69. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.10. Stroke Death Rates by County of Residence, N.C., 2006-2010 Death Rate Unreliable Rate (<20 Deaths) Unreliable Rate (<50 Deaths) 31.1 - 41.0 41.1 - 47.8 47.9 - 54.6 54.7 - 66.4 66.5 - 96.1 N.C. overall: 47.8 U.S. (2004-2008): 44.5 Stroke: ICD-10 codes I60-I69. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. N.C. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Volume 2: Leading Causes of Death in North Carolina 2010, 2011. http://www.schs.state.nc.us/schs/deaths/lcd/2010/. U.S. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.11. Number and Percentage of Total CVD Hospital Discharges that were Due to Stroke, N.C., 2010 Other CVD 24,887 15.3% Stroke 29,429 18.1% Heart Disease 108,013 66.5% ICD-9-CM codes: Cardiovascular Disease, excluding congenital malformations 390-459; Heart Disease 391-392.0, 393-398, 402, 404, 410416, 420-429; Coronary Heart Disease 410-414; Congestive Heart Failure 428.0; Stroke 430-438. Principal diagnosis only; N.C. residents only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.12. Stroke Hospital Discharge Rates, N.C., 1995-2010 450 Age-adjusted Discharge Rate 430 Total Males Females 410 390 370 350 330 310 290 270 250 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Stroke: ICD-9-CM Codes 430-438; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.13. Stroke Hospital Discharge Rates by Age and Gender, N.C., 2010 Discharge Rate per 100,000 3,000 2,500 2,000 1,500 1,000 500 0 <25 25-34 35-44 45-54 55-64 65-74 75-84 85+ Females 4.6 24.3 83.5 235.2 433.4 902.2 1,735.80 3,028.00 Males 5.2 19 82.8 264.2 607.1 1,165.80 1,971.60 2,749.90 Total 4.9 21.7 83.2 249.3 515.8 1,023.60 1,831.90 2,945.90 Age Group Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.14. Percentage of Stroke Hospitalizations by Age Group, N.C., 2010 Percentage of Hospitalizations <65 years 100 90 80 70 60 50 40 30 20 10 0 32.4 Female 65+ years 41.7 36.8 Male Total Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.15. Stroke History and Knowledge among N.C. Adults by Age Group, 2009 82.7 88.2 91.6 88.5 89.5 88.5 83.8 80 20 0 Had History of Stroke (2010) 18-24 17.7 19.7 25.3 25.4 25.5 16.3 11.0 40 20.0 21.7 26.5 26.0 25.1 16.2 12.5 60 0.0 0.2 1.1 2.3 4.5 7.7 13.1 Percent of Population 100 Knew All Stroke Would Call 911 for Knew Symptoms Symptoms Stroke & Would Call 911 25-34 35-44 45-54 55-64 65-74 75+ Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Had History of Stroke (2010) 84.6 80.6 93.9 Knew All Stroke Symptoms 10.4 9.3 12.8 23.4 10.8 11.6 2.6 2.7 0.2 0 3.8 20 14.3 11.2 25.5 40 9.9 60 3.0 Percent of Population 80 88.3 White African American Asian American Indian Other Race 100 88.9 Figure 2.16. Stroke History and Knowledge among N.C. Adults by Race, 2009 Would Call 911 for Knew Symptoms & Stroke Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force High School or GED 90.7 1.8 3.3 3.1 21.0 12.9 23.3 14.5 20 8.2 40 30.0 College Grad 6.4 60 Some Post-HS 32.3 80 88.9 80.6 < High School 5.4 Percent of Population 100 88.1 Figure 2.17. Stroke History and Knowledge among N.C. Adults by Education, 2009 0 Had History of Stroke (2010) Knew All Stroke Symptoms Would Call 911 for Knew Symptoms Stroke & Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force 17.9 15.3 33.2 29.0 23.8 90.2 89.5 86.8 87.0 11.3 22.2 16.5 9.9 0.9 2.4 2.6 3.2 5.4 20 14.0 40 33.1 60 26.7 80 84.4 <$15,000 $15,000-24,999 $25,000-34,999 $35,000-49,999 $50,000-74,999 $75,000+ 5.9 Percent of Population 100 87.8 Figure 2.18. Stroke History and Knowledge among N.C. Adults by Household Income, 2009 0 Had History of Stroke (2010) Knew All Stroke Symptoms Would Call 911 for Knew Symptoms & Stroke Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.19. Stroke Hospital Discharge Rates by County of Residence, N.C., 2006-2010 Hospital Discharge Rate 106.4 - 169.8 169.9 - 265.9 266.0 - 298.4 N.C. overall: 298.4 298.5 - 385.7 385.8 - 550.0 Stroke: ICD-9-CM codes 430-438.; Principal diagnosis only; N.C. residents only. Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2006-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Billions of Dollars Figure 2.20. Estimated Direct and Indirect Costs of CVD and Stroke, United States, 2008 300 280 260 240 220 200 180 160 140 120 100 80 60 40 20 0 Total: $297.7 billion Indirect Costs Direct Costs $118.5 $179.2 Total: $34.3 billion $15.5 $18.8 Total CVD Stroke Data Source: Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:e2–e220. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Total Hospital Charges in 2011 Dollars Figure 2.21. Stroke Hospital Charges, N.C., 1995-2010 $800,000,000 $700,000,000 Total Males Females $600,000,000 $500,000,000 $400,000,000 $300,000,000 $200,000,000 $100,000,000 $0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.22. Stroke Average Hospital Charges per Stay, N.C., 1995-2010 Charges per Stay in 2011 Dollars $30,000 $27,000 Total Males Females $24,000 $21,000 $18,000 $15,000 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 19952012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.23. Annual Medicaid Costs due to Stroke and Other CVD, N.C., 2011 Annual Medicaid Costs $250,000,000 $231,402,818 $189,045,580 $200,000,000 $177,403,772 $150,000,000 $100,000,000 $75,022,000 $50,000,000 $0 Heart Disease Heart Failure Hypertension Stroke Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Annual Medicaid Cost due to CVD, 2011. Produced by: State Center for Health Statistics, 09/19/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 2.24. Stroke Awareness, N.C. Adults, 2001-2009 100 90 80 70 60 50 40 30 20 10 0 87.7 87.4 87.6 87.3 88.2 19.8 17.2 18.8 19.5 Knew All Stroke Symptoms 21.6 17.1 15.0 16.8 17.6 19.4 Would Call 911 for Stroke 2001 2003 2005 2007 Knew All Symptoms & Would Call 911 2009 Adults = ages 18+ years. Data not available in 2002, 2004, 2006, 2008. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew All Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force 87.8 85.3 81.9 84.6 85.7 93.5 93.3 90.5 90.8 92.6 80 68.4 68.2 62.7 63.6 62.8 69.5 70.8 68.7 70.6 71.9 60 32.9 28.9 37.7 37.4 39.0 Percent of Population 100 90.6 86.5 85.0 87.8 89.6 Figure 2.25. Knowledge of Each Stroke Symptom, N.C. Adults, 2001-2009 40 20 0 Confusion, Trouble Speaking Numbness, Weakness 2001 Trouble Seeing 2003 2005 Trouble Walking, Loss of Balance 2007 Severe Headache Chest Pain Not a Symptom 2009 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available in 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.26. Stroke Awareness by Hypertension Status, N.C. Adults, 2007 100 Percent of Population 87.2 87.7 80 No Diagnosed Hypertension Diagnosed Hypertension 60 40 20 20.1 18.4 17.9 15.9 0 Knew All Stroke Symptoms Would Call 911 for Stroke Knew All Symptoms & Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analysis conducted by: Heart Disease and Stroke Prevention Branch, 2010. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.27. Knowledge of Each Stroke Symptom by Hypertension Status, N.C. Adults, 2007 Percent of Population No Diagnosed Hypertension 100 90 80 70 60 50 40 30 20 10 0 87.2 89.4 92.2 93.6 Diagnosed Hypertension 84.4 85.2 70.2 71.8 62.4 66.8 40.1 30.9 Confusion, Trouble Speaking Numbness, Weakness Trouble Seeing Trouble Walking, Loss of Balance Severe Headache Chest Pain Not a Symptom Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analysis conducted by: Heart Disease and Stroke Prevention Branch, 2010. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.28. Stroke Awareness by Stroke History Status, N.C. Adults, 2007 100 87.5 Percent of Population 90 81.8 80 No History of Stroke History of Stroke 70 60 50 40 30 20 19.5 18.0 17.8 14.7 10 0 Knew All Stroke Symptoms Would Call 911 for Stroke Knew All Symptoms & Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analysis conducted by: Heart Disease and Stroke Prevention Branch, 2010. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 2.29. Knowledge of Each Stroke Symptom by Stroke History Status, N.C. Adults, 2007 Percent of Population No History of Stroke 100 87.7 88.7 History of Stroke 92.5 93.2 84.6 83.5 80 70.6 70.7 63.6 62.5 60 37.5 36.1 40 20 0 Confusion, Trouble Speaking Numbness, Weakness Trouble Seeing Trouble Walking, Loss of Balance Severe Headache Chest Pain Not a Symptom Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analysis conducted by: Heart Disease and Stroke Prevention Branch, 2010. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Heart Disease Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.1. Heart Disease and Leading Causes of Death, N.C., 2010 Cancer 18,013 23% Heart Disease 17,090 Stroke 22% 4,281 5% Other CVD 1,861 2% All other causes 30,107 38% Chronic Lower Respiratory Disease 4,490 6% Other Unintentional Injuries* 2,762 4% *Unintentional injuries other than motor-vehicles injuries. Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/data/lcd/lcd.cfm. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.2. Heart Disease Death Rates, 1979-2008 Age-adjusted Death Rate 450 400 350 300 250 200 150 100 50 North Carolina United States 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51; 1979-1998: ICD-9 codes 390-398, 402, 404, 410-429 multiplied by comparability ratio of 0.9858. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.3. Heart Disease Death Rates by Age and Gender, N.C., 2008 4,500 Death Rate per 100,000 4,000 3,500 Females Males Total 3,000 2,500 2,000 1,500 1,000 500 0 Females Males Total <45 45-54 55-64 65-74 75-84 85+ 7.1 13.9 10.6 55.9 137.8 95.6 122.7 318.9 216 301.3 629 450.4 997.5 1553.5 1219.7 3786.2 4413.5 3969.8 Heart Disease: ICD-10 codes I00-I09, I11, I13, I20-I51. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.4. Heart Disease Death Rates by Gender, N.C., 1979-2008 Age-adjusted Death Rate 600 Males Females 500 400 300 200 100 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51; 1979-1998: ICD-9 codes 390-398, 402, 404, 410-429 multiplied by comparability ratio of 0.9858. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Death Rate Figure 3.5. Heart Disease Death Rates by Race, N.C., 1979-2008 African Americans Whites 400 300 200 100 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51; 1979-1998: ICD-9 codes 390-398, 402, 404, 410-429 multiplied by comparability ratio of 0.9858. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Death Rate Figure 3.6. Heart Disease Death Rates by Race and Gender, N.C., 1979-2008 600 550 500 450 400 350 300 250 200 150 100 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year African-American Males White Males African-American Females White Females Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51; 1979-1998: ICD-9 codes 390-398, 402, 404, 410-429 multiplied by comparability ratio of 0.9858. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Heart Disease Deaths Figure 3.7. Percentage of Total Heart Disease Deaths by Age Group, Race, and Gender, N.C., 2004-2008 <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 44.3 27.7 25.8 10.9 African-American Males White Males African-American Females White Females Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.8. Heart Disease Death Rates by County of Residence, N.C., 2006-2010 Death Rate 141.5 - 172.6 172.7 - 184.9 185.0 - 206.0 N.C. overall: 184.9 206.1 - 238.0 U.S. (2004-2008): 200.8 238.1 - 346.2 Heart Disease: ICD-10 codes I00-I09, I11, I13, I20-I51. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. N.C. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Volume 2: Leading Causes of Death in North Carolina 2010, 2011. http://www.schs.state.nc.us/schs/deaths/lcd/2010/. U.S. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.9. Number and Percentage of Total CVD Hospital Discharges that were Due to Heart Disease, N.C., 2010 All Heart Diseases: 108,013, 66.5% of CVD Hospitalizations* Other CVD 24,887 15.3% Stroke 29,429 18.1% Coronary Heart Disease* 39,022 24.0% Congestive Heart Failure* 7,840 4.8% Other Heart Disease* 61,151 37.7% ICD-9-CM codes: Cardiovascular Disease, excluding congenital malformations 390-459; Heart Disease 391-392.0, 393-398, 402, 404, 410416, 420-429; Coronary Heart Disease 410-414; Congestive Heart Failure 428.0; Stroke 430-438. Principal diagnosis only; N.C. residents only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.10. Heart Disease Hospital Discharge Rates, N.C., 1995-2010 Age-adjusted Discharge Rate 1,950 Total Males Females 1,800 1,650 1,500 1,350 1,200 1,050 900 750 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Heart Disease: ICD-9-CM Codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Discharge Rate per 100,000 Figure 3.11. Heart Disease Hospital Discharge Rates by Age and Gender, N.C., 2010 10,000 8,000 6,000 4,000 2,000 0 <25 25-34 35-44 45-54 55-64 65-74 75-84 85+ Females 22.9 110.7 288.6 716.7 1,391.50 3,016.80 5,738.90 9,188.50 Males 22.3 128.2 475.8 1,268.80 2,526.50 4,683.50 7,309.80 10,360.20 Total 22.6 119.4 380.9 985 1,930.00 3,784.20 6,379.10 9,540.80 Age Group Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.12. Percentage of Heart Disease Hospitalizations by Age Group, N.C., 2010 Percentage of Hospitalizations <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 45.8 32.5 Female Male 39.6 Total Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.13. Heart Disease Hospital Discharge Rates by County of Residence, N.C., 2006-2010 Hospital Discharge Rate 389.5- 713.7 713.8 - 1143.9 N.C. overall: 1143.9 1144.0 - 1289.5 1289.6 - 1634.7 1634.8 - 2173.9 Heart Disease: ICD-9-CM codes: 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only; N.C. residents only. Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.14. Estimated Direct and Indirect Costs of CVD and Heart Disease, United States, 2008 300 Indirect Costs Direct Costs Billions of Dollars 250 $118.5 200 150 $94.8 100 $179.2 50 $95.5 0 Total CVD Heart Disease Data Source: Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012; 125:e2–e220. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Total Hospital Charges in 2011 Dollars Figure 3.15. Heart Disease Hospital Charges, N.C., 1995-2010 $4,600,000,000 $4,100,000,000 Total Males Females $3,600,000,000 $3,100,000,000 $2,600,000,000 $2,100,000,000 $1,600,000,000 $1,100,000,000 $600,000,000 $100,000,000 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.16. Heart Disease: Average Hospital Charges per Stay, N.C., 1995-2010 Charges per Stay in 2011 Dollars $50,000 $45,000 $40,000 Total Males Females $35,000 $30,000 $25,000 $20,000 $15,000 $10,000 $5,000 $0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 3.17. Annual Medicaid Costs due to Heart Disease and Other CVD, N.C., 2011 Annual Medicaid Costs $250,000,000 $231,402,818 $189,045,580 $200,000,000 $177,403,772 $150,000,000 $100,000,000 $75,022,000 $50,000,000 $0 Heart Disease Heart Failure Hypertension Stroke Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Annual Medicaid Cost due to CVD, 2011. Produced by: State Center for Health Statistics, 09/19/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Coronary Heart Disease Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.1. Coronary Heart Disease, CVD, and Leading Causes of Death, N.C., 2010 Cancer 18013 23% Coronary Heart Disease 10507 13% Heart Failure 1659 2% Other Heart Disease 4924 6% Stroke 4281 5% Other CVD 1861 2% All other causes 30107 39% Chronic Lower Respiratory Disease 4490 6% Other Unintentional Injuries 2762 *Unintentional injuries other than motor-vehicles injuries. 7% Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/deaths/dms/2010/northcarolina.pdf. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.2. Coronary Heart Disease Death Rates, 19792008 Age-adjusted Death Rate 350 300 250 200 150 100 50 United States North Carolina 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Coronary Heart Disease: 1999-2008: ICD-10 codes I20-I25; 1979-1998: ICD-9 codes 410-414, 429.2 multiplied by comparability ratio of 0.9990. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Stroke Death Rate Figure 4.3. Coronary Heart Disease Death Rates & Healthy People 2020 Target, 2008 160 140 126.0 132.4 120 100 80 60 40 20 0 N.C. 2020 Target (100.8) U.S. 2010 Target (156.0) Healthy People 2010 Objective 12-1. Coronary Heart Disease: ICD-10 codes I11, I20-I25. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.4. Coronary Heart Disease Death Rates by Age and Gender, N.C., 2008 Death Rate per 100,000 3,000 2,500 Females Males Total 2,000 1,500 1,000 500 0 Females Males Total <45 45-54 55-64 65-74 75-84 85+ 2.8 6.8 4.8 31.3 95.3 62.4 74.9 238.2 152.5 191.2 457.1 312.2 625.4 1066.5 801.7 2159.9 2816.9 2352.1 Coronary Heart Disease: ICD-10 codes I20-I25. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.5. Coronary Heart Disease Death Rates by Gender, N.C., 1979-2008 Age-adjusted Death Rate 500 450 Males Females 400 350 300 250 200 150 100 50 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Coronary Heart Disease: 1999-2008: ICD-10 codes I20-I25; 1979-1998: ICD-9 codes 410-414, 429.2 multiplied by comparability ratio of 0.9990. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Coronary Heart Disease Death Rate Figure 4.6. Death Rates by Race and Ethnicity & Healthy People 2020 Target, N.C., 2008 250 Coronary Heart Disease Death Rate 2020 Target (100.8) 2010 Target (156.0) 200 150 122.9 131.7 115.6 119.7 100 50 33.4 0 American Indian/Alaska Native African American White Hispanic Non-Hispanic Healthy People 2020 Objective 12-1. Coronary Heart Disease: ICD-10 codes I11, I20-I25. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.7. Coronary Heart Disease Death Rates by Race, N.C., 1979-2008 Age-adjusted Death Rate 375 African-Americans 325 Whites 275 225 175 125 75 '79 '81 '83 '85 '87 '89 '91 '93 '95 Year '97 '99 '01 '03 '05 '07 Coronary Heart Disease: 1999-2008: ICD-10 codes I20-I25; 1979-1998: ICD-9 codes 410-414, 429.2 multiplied by comparability ratio of 0.9990. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.8. Coronary Heart Disease Death Rates by Race and Gender, N.C., 1979-2008 Age-adjusted Death Rate 525 African-American Males African-American Females White Males White Females 475 425 375 325 275 225 175 125 75 25 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Coronary Heart Disease: 1999-2008: ICD-10 codes I20-I25; 1979-1998: ICD-9 codes 410-414, 429.2 multiplied by comparability ratio of 0.9990. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.9. Percentage of Total Coronary Heart Disease Deaths by Age Group, Race, and Gender, N.C., 20042008 Percentage of CHD Deaths <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 41.7 28.9 AfricanAmerican Males White Males 22.3 AfricanAmerican Females 10.9 White Females Coronary Heart Disease: ICD-10 codes I20-I25. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 19992008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.10. Coronary Heart Disease Death Rates by County of Residence, N.C., 2004-2008 Death Rate 88.1 - 108.3 108.4 - 129.6 N.C. overall: 129.6 129.7 - 149.6 U.S.: 135.3 149.7- 181.2 181.3 - 219.3 Coronary Heart Disease: ICD-10 codes I20-I25. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.11. Number and Percentage of Total CVD Hospital Discharges that were Due to Coronary Heart Disease, N.C., 2010 Other CVD 24,887 15.3% Coronary Heart Disease 39,022 24.0% Stroke 29,429 18.1% Congestive Heart Failure 7,840 4.8% Other Heart Disease 61,151 37.7% ICD-9-CM codes: Cardiovascular Disease, excluding congenital malformations 390-459; Heart Disease 391-392.0, 393-398, 402, 404, 410416, 420-429; Coronary Heart Disease 410-414; Congestive Heart Failure 428.0; Stroke 430-438. Principal diagnosis only; N.C. residents only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.12. Coronary Heart Disease Hospital Discharge Rates, N.C., 1995-2010 1,200 Age-adjusted Discharge Rate 1,100 Total Males Females 1,000 900 800 700 600 500 400 300 200 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.13. Coronary Heart Disease Hospital Discharge Rates by Age and Gender, N.C., 2010 Discharge Rate per 100,000 3,000 2,500 2,000 1,500 1,000 500 0 Females Males Total <25 25-34 35-44 45-54 55-64 65-74 75-84 85+ 0.5 0.9 0.7 15.2 28.4 21.7 89.8 198.5 143.4 281.9 647.2 459.4 541.4 1242.9 874.2 998.6 1996.6 1458.1 1460.3 2485.0 1877.9 1877.8 2634.7 2105.6 Age Group Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.14. Percentage of Coronary Heart Disease Hospitalizations by Age Group, N.C., 2010 Percentage of Hospitalizations <65 years 100 90 80 70 60 50 40 30 20 10 0 65+ years 52.1 47.3 Male Total 39.6 Female Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force 82.7 88.2 91.6 88.5 89.5 88.5 83.8 Had History of CHD Knew All Heart (2010) Attack Symptoms 18-24 25-34 35-44 8.1 9.5 13.1 15.5 16.6 12.2 9.4 9.6 10.6 14.1 17.7 18.3 14.2 10.5 100 90 80 70 60 50 40 30 20 10 0 0.0 0.8 2.0 6.0 12.9 17.8 24.5 Percent of Population Figure 4.15. Coronary Heart Disease History and Knowledge among N.C. Adults by Age Group, 2009 Would Call 911 for Knew Symptoms & Heart Attack Would Call 911 45-54 55-64 65-74 75+ Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Had History of CHD (2010) 4 6.0 6.0 9.1 84.6 80.6 93.9 88.9 15.3 4.4 7.1 9.1 6.7 2.1 7.9 2.7 17.1 88.3 White African American Asian American Indian Other Race 7.2 100 90 80 70 60 50 40 30 20 10 0 7.6 Percent of Population Figure 4.16. Coronary Heart Disease History and Knowledge among N.C. Adults by Race, 2009 Knew All Heart Would Call 911 for Knew Symptoms Attack Symptoms Heart Attack & Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.17. Coronary Heart Disease History and Knowledge among N.C. Adults by Education, 2009 Percent of Population 100 90 < High School 80 High School or GED 70 Some Post-HS College Grad 60 88.1 88.9 90.7 80.6 50 40 30 20 10 20.2 12.1 18.2 15.2 7.9 6.7 4.7 13.9 10.3 5.2 9.2 3.5 0 Had History of CHD (2010) Knew All Heart Would Call 911 for Knew Symptoms Attack Symptoms Heart Attack & Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Had History of CHD (2010) 17.8 12.2 17.7 7.1 5.8 10.7 90.2 89.5 86.8 87.0 87.8 84.4 19.6 14.7 18.7 11.7 8.3 6.5 10 0 3.7 30 20 5.4 50 40 6.7 70 60 7.7 <$15,000 $15,000-24,999 $25,000-34,999 $35,000-49,999 $50,000-74,999 $75,000+ 12.6 100 90 80 12.8 Percent of Population Figure 4.18. Coronary Heart Disease History and Knowledge among N.C. Adults by Household Income, 2009 Knew All Heart Would Call 911 for Knew Symptoms Attack Symptoms Heart Attack & Would Call 911 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.19. Coronary Heart Disease Hospital Discharge Rates by County of Residence, N.C., 2006-2010 Hospital Discharge Rate 95.9 - 279.9 280.0- 440.7 440.8 - 495.4 N.C. overall: 440.7 495.5 - 710.7 710.8 - 973.2 Coronary Heart Disease: ICD-9-CM codes: 410-414; Principal diagnosis only; N.C. residents only. Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Total Hospital Charges in 2011 Dollars Figure 4.20. Coronary Heart Disease Hospital Charges, N.C., 1995-2010 $2,500,000,000 $2,000,000,000 Total Males Females $1,500,000,000 $1,000,000,000 $500,000,000 $0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 4.21. Coronary Heart Disease: Average Hospital Charges per Stay, N.C., 1995-2010 Charges per Stay in 2011 Dollars $60,000 $55,000 Total Males Females $50,000 $45,000 $40,000 $35,000 $30,000 $25,000 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 19952012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 4.22. Heart Attack Awareness, N.C. Adults, 2001-2009 100 90 80 70 60 50 40 30 20 10 0 87.7 87.4 87.6 87.3 88.2 9.6 10.7 11.3 11.3 14.0 8.6 Would Call 911 for Heart Attack Knew All Heart Attack Symptoms 2001 2003 2005 2007 9.3 10 10.5 12.5 Knew All Symptoms & Would Call 911 2009 Adults = ages 18+ years. Data not available in 2002, 2004, 2006, 2008. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew All Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force 87.4 85.7 84.0 85.4 85.4 89.9 86.7 84.4 86.0 86.5 95.6 92.2 90.3 92.7 93.2 Pain in Jaw, Neck, Back Pain in Arms, Shoulder Shortness of Breath 33.8 32.2 40.4 39.8 39.7 67.8 69.2 60.5 63.5 65.0 100 90 80 70 60 50 40 30 20 10 0 47.8 51.4 46.3 48.0 55.6 Percent of Population Figure 4.23. Knowledge of Each Heart Attack Symptom, N.C. Adults, 2001-2009 Feeling Weak, Lightheaded, Faint 2001 Chest Pain 2003 2005 2007 Trouble Seeing Not a Symptom 2009 Adults = ages 18+ years. Data not available in 2002, 2004, 2006, 2008. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 4.24. Heart Attack Awareness by Coronary Heart Disease History, N.C. Adults, 2007 100 90 80 70 60 50 40 30 20 10 0 87.6 11.0 84.5 15.8 Knew All Heart Attack Symptoms No History of CHD History of CHD 10.2 Would Call 911 for Heart Attack 13.9 Knew All Symptoms & Would Call 911 Adults = ages 18+ years. CHD= Coronary Heart Disease. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analyzed by the Heart Disease and Stroke Prevention Branch, 2010. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 4.25. Knowledge of Each Heart Attack Symptom by Coronary Heart Disease History, N.C. Adults, 2007 100 90 80 70 60 50 40 30 20 10 0 No History of CHD History of CHD 61.3 63.8 92.8 91.7 85.5 85.2 86.0 86.8 61.3 47.0 46.8 39.4 Pain in Jaw, Neck, Back Feeling Chest Pain Pain in Arms, Shortness of Trouble Weak, Shoulder Breath Seeing Not a Lightheaded, Symptom Faint Adults = ages 18+ years. CHD= Coronary Heart Disease. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analyzed by the Heart Disease and Stroke Prevention Branch, 2010. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Heart Failure Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.1. Heart Failure, CVD, and Leading Causes of Death, N.C., 2010 Cancer 18013 23% Coronary Heart Disease 10507 13% Heart Failure 1659 2% Other Heart Disease 4924 Stroke 6% 4281 5% Other CVD 1861 2% All other causes 30107 39% Chronic Lower Respiratory Disease 4490 6% Other Unintentional Injuries 2762 7% *Unintentional injuries other than motor-vehicles injuries. Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/deaths/dms/2010/northcarolina.pdf. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.2. Heart Failure Death Rates, 1979-2008 Age-Adjusted Death Rate 30 25 20 15 10 5 North Carolina United States 0 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 Year Heart Failure: 1999-2008: ICD-10 codes I50; 1979-1998: ICD-9 codes 428 multiplied by comparability ratio of 1.0410. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.3. Heart Failure Death Rates by Age and Gender, N.C., 2008 Death Rate per 100,000 600 500 Females Males Total 400 300 200 100 0 Females Males Total <65 65-74 75-84 85+ 1.5 2.2 1.8 22.5 40.3 30.6 97.6 140.8 114.9 580.1 568.2 576.6 Heart Failure: ICD-10 codes I50. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.4. Smoothed* Heart Failure Death Rates by Gender, N.C., 1998-2008 Age-adjusted Death Rate 50 45 Males Females 40 35 30 25 20 15 10 5 0 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 Year * 3-year moving averages (i.e., smoothed rate shown for 1999 is an average of the 1998, 1999, and 2000 rates). Heart Failure: 1999-2008: ICD-10 codes I50; 1979-1998: ICD-9 codes 428 multiplied by comparability ratio of 1.0410. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.5. Smoothed* Heart Failure Death Rates by Race, N.C., 1998-2008 Age-adjusted Death Rate 30 African Americans Whites 25 20 15 10 5 0 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 Year * 3-year moving averages (i.e., smoothed rate shown for 1999 is an average of the 1998, 1999, and 2000 rates). Heart Failure: 1999-2008: ICD-10 codes I50; 1979-1998: ICD-9 codes 428 multiplied by comparability ratio of 1.0410. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Age-adjusted Death Rate Figure 5.6. Smoothed* Heart Failure Death Rates by Race and Gender, N.C., 1998-2008 25 24 23 22 21 20 19 18 17 16 15 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 Year African-American Males African-American Females White Males White Females * 3-year moving averages (i.e., smoothed rate shown for 1999 is an average of the 1998, 1999, and 2000 rates). Heart Failure: 1999-2008: ICD-10 codes I50; 1979-1998: ICD-9 codes 428 multiplied by comparability ratio of 1.0410. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Heart Failure Deaths Figure 5.7. Percentage of Total Heart Failure Deaths by Age Group, Race, and Gender, N.C., 2004-2008 <65 years 100 90 80 70 60 50 40 30 20 10 0 27.1 AfricanAmerican Males 65+ years 9.5 15.9 White Males AfricanAmerican Females 4.1 White Females Heart Failure: ICD-10 codes I50. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.8. Heart Failure Death Rates by County of Residence, N.C., 2003-2008 Death Rate 0.0 - 12.9 13.0 - 18.5 N.C. Overall: 18.5 18.6 - 21.1 21.2 - 26.2 U.S.: 18.3 26.3 - 38.9 <20 deaths* Heart Failure: ICD-10 codes I50. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. * Rates based on fewer than 20 deaths may be unreliable, should be interpreted with caution, and are not mapped. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.9. Number and Percentage of Total CVD Hospital Discharges that were Due to Congestive Heart Failure, N.C., 2010 Other CVD 24,887 15.3% Coronary Heart Disease 39,022 24.0% Stroke 29,429 18.1% Congestive Heart Failure 7,840 4.8% Other Heart Disease 61,151 37.7% ICD-9-CM codes: Cardiovascular Disease, excluding congenital malformations 390-459; Heart Disease 391-392.0, 393-398, 402, 404, 410416, 420-429; Coronary Heart Disease 410-414; Congestive Heart Failure 428.0; Stroke 430-438. Principal diagnosis only; N.C. residents only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.10. Congestive Heart Failure Hospitalization Rates & Healthy People 2010 Targets 35 Hospitalization Rate 30 25 32.9 North Carolina United States 2010 Target 26.5 19.7 20 13.5 15 10.7 10 5 8.5 6.5 5.2 2.6 0 65-74 years 75-84 years 85+years Healthy People 2010 Objective 12-06. Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis. Age-specific rates per 1,000 population. Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.11. Congestive Heart Failure Hospital Discharge Rates, N.C., 1995-2010 Age-adjusted Discharge Rate 400 350 300 250 200 Total Males Females 150 100 50 0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.12. Congestive Heart Failure Hospital Discharge Rates by Age and Gender, N.C., 2010 Discharge Rate per 100,000 1,400 1,200 1,000 800 600 400 200 0 <25 25-34 35-44 45-54 55-64 65-74 75-84 85+ Females 1.0 9.2 19.3 46.5 92.2 219.7 471.6 1005.8 Males 1.6 6.7 20.9 62.8 132.9 308.0 591.6 1217.9 Total 1.3 7.9 20.1 54.4 111.5 260.3 520.5 1069.4 Age Group Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.13. Percentage of Congestive Heart Failure Hospitalizations by Age Group, N.C., 2010 Percentage of Hospitalizations <65 years 100 90 80 70 60 50 40 30 20 10 0 26.8 Female 65+ years 35.2 30.9 Male Total Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.14. Congestive Heart Failure Hospital Discharge Rates by County of Residence, N.C., 2006-2010 Hospital Discharge Rate 53.9 - 123.2 123.3 - 169.8 169.9 - 232.9 N.C. overall: 169.8 233.0 - 336.9 337.0 - 464.7 Congestive Heart Failure: ICD-9-CM codes: 428.0; Principal diagnosis only; N.C. residents only. Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2006-2010. Produced by: State Center for Health Statistics, 06/08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.15. Congestive Heart Failure Hospital Charges, N.C., 1995-2010 Total Hospital Charges in 2011 Dollars $700,000,000 $600,000,000 Total Males Females $500,000,000 $400,000,000 $300,000,000 $200,000,000 $100,000,000 $0 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.16. Congestive Heart Failure: Average Hospital Charges per Stay, N.C., 1995-2010 Charges per Stay in 2011 Dollars $30,000 Total Males Females $25,000 $20,000 $15,000 $10,000 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 Year Congestive Heart Failure: ICD-9-CM Codes 428.0; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 19952012, U.S. city average, not seasonally adjusted. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 5.17. Annual Medicaid Costs due to Congestive Heart Failure and Other CVD, N.C., 2011 $250,000,000 $231,402,818 Annual Medicaid Costs $189,045,580 $200,000,000 $177,403,772 $150,000,000 $100,000,000 $75,022,000 $50,000,000 $0 Heart Disease Heart Failure Hypertension Stroke Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Annual Medicaid Cost due to CVD, 2011. Produced by: State Center for Health Statistics, 09/19/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force High Blood Pressure Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Adults Figure 6.1. Blood Pressure Checked within Past 2 Years, 1991-2009 100 95 90 85 80 75 70 65 60 55 50 North Carolina '91 '92 '93 '95 United States '97 '99 '01 '05 '09 Year Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. US Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002-2004, 2006-2008; data not available for U.S. in 1991, 1992, 1994, 1996, 1998, 2000-2009. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.2. Blood Pressure-related Measures among N.C. Adults by Age Group, 2009 100 93.4 92.0 94.4 96.1 97.5 99.1 99.0 94.6 96.2 90.8 Percent of Population 90 81.2 80 65.7 70 60.3 62.0 60 50.4 50 41.7 40 34.4 30 22.6 20.4 20 11.4 7.0 10 0 Blood Pressure Checked within the Past 2 Years 18-24 25-34 35-44 Have High Blood Pressure 45-54 55-64 Taking Medication for High Blood Pressure 65-74 75+ Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.3. Blood Pressure Checked within Past 2 Years, by Gender, N.C., 1991-2009 Percentage of Adults 100 95 90 85 80 75 70 65 60 Males Females 55 50 '91 '92 '93 '95 '97 '99 '01 '05 '09 Year Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002-2004, 2006-2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 6.4. Blood Pressure-related Measures among N.C. Adults by Race and Gender, 2009 100 90 80 70 60 50 40 30 20 10 0 97.4 97.0 94.5 89.6 97.8 80.4 79.1 42.3 39.4 33.0 Blood Pressure Checked within the Past 2 Years African American Men 29.4 Have High Blood Pressure White Men 85.0 Taking Medication for High Blood Pressure* African American Women White Women * Among those who have high blood pressure. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Blood pressure screening data is from 2005, all other data are from 2009. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 6.5. Blood Pressure-related Measures among N.C. Adults by Race, 2009 100 90 80 70 60 50 40 30 20 10 0 96.3 97.2 96.0 92.6 82.1 82.1 85.7 75.3 61.1 41.0 56.1 38.1 31.1 14.0 Blood Pressure Checked within the Past 2 Years White African American 12.6 Have High Blood Pressure Asian Taking Medication for High Blood Pressure* American Indian Other Race * Among those who have high blood pressure. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.6. Blood Pressure Checked within Past 2 Years, by Race, N.C., 1991-2009 Percentage of Adults 100 95 90 85 African-Americans Whites 80 '91 '92 '93 '95 '97 '99 '01 '05 '09 Year Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002-2004, 2006-2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 6.7. Blood Pressure-related Measures among N.C. Adults by Education, 2009 100 95.4 95.8 97.7 89.3 85.4 80 82.2 79.0 80.7 60 38.4 40 36.2 30.5 25.1 20 0 Blood Pressure Checked within the Past 2 Years < High School Have High Blood Pressure High School or GED Some Post-HS Taking Medication for High Blood Pressure* College Grad * Among those who have high blood pressure. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.8. Blood Pressure-related Measures among N.C. Adults by Household Income, 2009 Percent of Population 100 93.9 90.2 94.9 96.9 98.1 98.0 86.8 81.4 80 83.3 79.2 75.3 78.0 60 40.7 40.5 35.6 40 31.0 29.8 24.3 20 0 Blood Pressure Checked within the Past 2 Years <$15,000 $35,000-49,999 Have High Blood Pressure $15,000-24,999 $50,000-74,999 Taking Medication for High Blood Pressure* $25,000-34,999 $75,000+ * Among those who have high blood pressure. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.9. Estimated Direct and Indirect Costs of CVD and Hypertensive Disease, United States, 2008 600 Indirect Costs Direct Costs Billions of Dollars 500 400 300 $118.5 200 $179.2 100 $3.3 $47.3 0 Total CVD Hypertensive Disease Data Source: Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:e2–e220. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Adults Figure 6.10. Hypertension Prevalence, 1990-2009 50 45 40 35 30 25 20 15 10 5 0 North Carolina '90 '91 '92 '93 '95 '97 United States '99 '01 '03 '05 '07 '09 Adults = ages 18+ years. Year 1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. US Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Data not available for U.S. in 1990-1993; data not available for N.C. or U.S. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.11. Annual Medicaid Costs due to Hypertension and Other CVD, N.C., 2011 Annual Medicaid Costs $250,000,000 $231,402,818 $189,045,580 $200,000,000 $177,403,772 $150,000,000 $100,000,000 $75,022,000 $50,000,000 $0 Heart Disease Heart Failure Hypertension Stroke Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Annual Medicaid Cost due to CVD, 2011. Produced by: State Center for Health Statistics, 09/19/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.12. Hypertension Prevalence, by Gender, N.C., 1990-2009 Percentage of Adults 50 Males Females 45 40 35 30 25 20 15 10 5 0 '90 '91 '92 '93 '95 '97 '99 Year '01 '03 '05 '07 '09 Adults = ages 18+ years. 1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Adults Figure 6.13. Hypertension Prevalence by Age and Race, N.C., 2009 100 80 Whites African Americans Total 60 40 20 0 18-24 25-34 35-44 45-54 55-64 65+ Whites 5.9 10.5 19.8 29.7 47.7 59.9 African Americans 8.6 18.1 30.4 52.6 65.4 82.6 Total 7.0 11.4 20.4 34.4 50.4 63.9 Age Group Adults = ages 18+ years. Race specific data combines 65-74 & 75+ categories. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 6.14. Hypertension Prevalence, by Race, N.C., 1990-2009 Percentage of Adults 50 45 African-Americans 40 Whites 35 30 25 20 15 10 5 0 '90 '91 '92 '93 '95 '97 '99 Year '01 '03 '05 '07 '09 Adults = ages 18+ years. 1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force NC Overall Men 2001 2003 Women 2005 2007 African Americans 2009 82.1 84.1 78.8 77.5 74.8 85.7 82.1 78.9 75.5 74.6 85.7 85.4 80.6 78.0 79.7 77.3 78.8 73.8 73.7 68.9 81.6 82.3 77.4 76.0 100 90 80 70 60 50 40 30 20 10 0 74.9 Percent of People with Hypertension Figure 6.15. Percentage of People with Diagnosed Hypertension who are Taking Anti-Hypertensive Medication, N.C. Adults, 2001-2009 Whites 1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive. Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force NC Overall AfricanAmerican Men White Men AfricanAmerican Women 85.0 86.3 81.6 79.8 80.0 89.6 86.9 82.4 79.8 2009 78.9 79.1 81.8 2007 75.7 68.8 75.0 2005 80.4 75.8 2003 74.2 69.6 67.6 81.6 82.3 77.4 2001 76.0 100 90 80 70 60 50 40 30 20 10 0 74.9 Percent of People with Hypertension Figure 6.16. Use of Anti-Hypertensive Medication by Race and Gender, N.C. Adults, 2001-2009 White Women 1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive. Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force High Blood Cholesterol Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Adults Figure 7.1. Cholesterol Checked within Past 5 Years, 1990-2009 100 95 90 85 80 75 70 65 60 55 50 North Carolina '90 '91 '92 '93 '95 United States '97 '99 '01 '03 '05 '07 '09 Year Adults = ages 18+ years. North Carolina Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. U.S. Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Data not available for U.S. in 1990-1992; data not available for N.C. or U.S. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 7.2. Cholesterol-related Measures among N.C. Adults by Age Group, 2009 100 90 80 70 60 50 40 30 20 10 0 88.2 93.1 96.3 96.0 79.5 61.7 53.5 58.0 52.4 42.9 38.1 31.4 19.0 13.2 Blood Cholesterol Checked within the Past 5 Years 18-24 25-34 35-44 Diagnosed with High Cholesterol* 45-54 55-64 65-74 75+ * Among those who have ever had their blood cholesterol checked. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 7.3. Cholesterol Checked within Past 5 Years, by Gender, N.C., 1990-2009 Percentage of Adults 100 Males Females 95 90 85 80 75 70 65 60 55 50 '90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09 Year Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 7.4. Cholesterol-related Measures among N.C. Adults by Race and Gender, 2009 100 90 80 70 60 50 40 30 20 10 0 75.7 80.8 79.3 83.3 40.3 Blood Cholesterol Checked within Past 5 Years African American Men White Men 42.9 37.2 39.3 Diagnosed with High Cholesterol* African American Women White Women * Among those who have ever had their blood cholesterol checked. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 7.5. Cholesterol-related Measures among N.C. Adults by Race, 2009 100 90 80 70 60 50 40 30 20 10 0 82.1 77.7 79.3 66.2 44.6 41.0 38.5 31.9 Blood Cholesterol Checked within Past 5 Years White African American Asian 35.6 32.4 Diagnosed with High Cholesterol* American Indian Other Race * Among those who have ever had their blood cholesterol checked. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 7.6. Cholesterol Checked within Past 5 Years, by Race, N.C., 1990-2009 Percentage of Adults 100 95 African-Americans 90 Whites 85 80 75 70 65 60 55 50 '90 '91 '92 '93 '95 '97 '99 Year '01 '03 '05 '07 '09 Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 7.7. Cholesterol Checked within Past 5 Years, by Race and Gender, N.C., 1990-2009 100 African-American Males African-American Females White Males White Females Percentage of Adults 95 90 85 80 75 70 65 60 55 50 45 '90 '91 '92 '93 '95 '97 '99 Year '01 '03 '05 '07 '09 Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 7.8. Cholesterol-related Measures among N.C. Adults by Education, 2009 100 90 80 70 60 50 40 30 20 10 0 89.2 74.2 79.0 60.0 49.1 45.0 38.7 Blood Cholesterol Checked within Past 5 Years < High School High School or GED 34.3 Diagnosed with High Cholesterol* Some Post-HS College Grad * Among those who have ever had their blood cholesterol checked. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percent of Population Figure 7.9. Cholesterol-related Measures among N.C. Adults by Household Income, 2009 100 83.0 80 71.1 85.3 88.5 76.6 62.9 60 48.0 47.6 44.6 36.2 40 40.3 33.4 20 0 Blood Cholesterol Checked within Past 5 Years <$15,000 $35,000-49,999 Diagnosed with High Cholesterol* $15,000-24,999 $50,000-74,999 $25,000-34,999 $75,000+ * Among those who have ever had their blood cholesterol checked. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Percentage of Adults Figure 7.10. High Cholesterol Prevalence, 19902009 50 45 40 35 30 25 20 15 10 5 0 North Carolina '90 '91 '92 '93 '95 United States '97 '99 '01 '03 '05 '07 '09 Year Adults = ages 18+ years. North Carolina Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. U.S. Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Data not available for U.S. in 1990-1993; data not available for N.C. or U.S. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 7.11. High Cholesterol Prevalence, by Gender, N.C., 1990-2009 Percentage of Adults 50 Males Females 45 40 35 30 25 20 15 10 5 0 '90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09 Year Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 7.12. High Cholesterol Prevalence, by Race, N.C., 1990-2009 Percentage of Adults 50 45 African-Americans 40 Whites 35 30 25 20 15 10 5 0 '90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09 Year Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Other Risk Factors Figures The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.1. Prevalence of Physical Activity-related Measures among Adults Percent of Population 100 North Carolina 90 United States 80 70 60 46.4 50 50.6 40 30 25.7 24.0 20 10 0 No Exercise* (2010) Recommended Physical Activity** (2009) Adults = ages 18+ years. *During the past month, did you participate in any physical activities? ** Engaging in at least 30 minutes of moderate activity per day on 5 or more days of the week, or at least 20 minutes of vigorous activity per day on 3 or more days of the week. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Branch, 08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.2. Prevalence of Physical Activity-related Measures among High School Students, 2011 Percent of Population 100 North Carolina 90 United States 80 70 60 50 47.6 49.5 34.7 40 32.4 30 20 10 0 Meet Recommended Levels of Physical Activity* Watch 3+ Hours of TV on Average School Day * Physically active for a total of 60 minutes or more per day on 5 or more of the past 7 days. Data Source: Centers for Disease Control and Prevention. 2011 Youth Risk Behavior Survey. Available at: www.cdc.gov/yrbs. Accessed on 8/17/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.3. Prevalence of Daily Consumption of 5+ Fruits and Vegetables among Adults, 2009 100 Percent of Population 90 80 70 60 50 40 30 20.6 23.5 20 10 0 North Carolina United States Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Branch, 08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.4. Prevalence of Daily Consumption of 5+ Fruits and Vegetables among High School Students, 2011 100 Percent of Population 90 80 70 60 50 40 30 20 19.4 21.4 North Carolina United States (2007) 10 0 N.C. Data Source: North Carolina Department of Public Instruction. 2011 Youth Risk Behavior Survey. Available at: http://www.nchealthyschools.org/docs/data/yrbs/2011/statewide/high-school.pdf Accessed on 8/17/2012. U.S. Data Source: Centers for Disease Control and Prevention. 2007 Youth Risk Behavior Survey. www.cdc.gov/yrbs. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.5. Prevalence of Tobacco Use-related Measures among Adults, 2010 100 North Carolina Percent of Population 90 United States 80 70 60.5 60 52.4 50 40 30 20 19.8 17.3 10 0 Current Cigarette Smoking Tried to Quit Smoking in Past Year Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 08/2012 and National Centers for Disease Control and Prevention, 2011. Quitting Smoking Among Adults--- United States, 2001--2010. MMWR 2011; 60 (No. 44): 1514. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.6. Prevalence of Tobacco Use-related Measures among Students 100 Percent of Population 90 NC Middle School (2011) US Middle School (2009) NC High School (2011) US High School (2009) 80 70 60 50 40 30 22.5 15.5 20 10 4.2 23.9 17.2 5.2 7.4 8.2 0 Current Cigarette Smoking Any Current Tobacco Use N.C. Data Source: 2011 North Carolina Youth Tobacco Survey. http://www.tobaccopreventionandcontrol.ncdhhs.gov/data/yts/yts11/NCYTS-SummaryTablesStatewide-2011-051512FINAL.pdf. U.S. Data Source: Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students --- United States, 2000--2009. MMWR 2010; 59(No. 33): 1064. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a2.htm. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.7. Prevalence of Overweight and Obesity among Adults, 2010 100 North Carolina Percent of Population 90 United States 80 65.3 70 63.8 60 50 40 36.7 36.2 28.6 30 27.6 20 10 0 Overweight Obese Overweight or Obese Overweight: BMI >= 25.0 and <30.0; Obese: BMI >= 30.0; Overweight or Obese: BMI >= 25.0. Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Prevention Branch, 08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.8. Prevalence of Overweight and Obesity among High School Students, 2011 100 North Carolina Percent of Population 90 United States 80 70 60 50 40 30 20 15.9 15.2 13.0 12.9 10 0 Overweight Obese Overweight: BMI >= 85th and <95th Percentile; Obese: BMI >= 95th Percentile. Data Source: Centers for Disease Control and Prevention. 2011 Youth Risk Behavior Survey. Available at: www.cdc.gov/yrbs. Accessed on 8/17/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.9. Prevalence of Overweight and Obesity among Children seen in N.C. Public Health Clinics by Age Group 100 Percent of Population 90 Overweight Obese 80 70 60 50 40 17.1 30 20 10 18.1 16.1 25.8 28 5-11 Years 12-18 Years 15.6 0 2-4 Years (2010) Overweight: BMI >= 85th and <95th Percentile; Obese: BMI >= 95th Percentile; Overweight or At-risk for Overweight: BMI >= 85th Percentile. Data from age group 2-4 years are from 2010, all other age groups are from 2009 data. Data Source: N.C. Nutrition and Physical Activity Surveillance System data. http://www.nutritionnc.com/nutrsurv.htm The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.10. Prevalence of Diagnosed Diabetes among Adults, 2010 100 Percent of Population 90 80 70 60 50 40 30 20 10 9.8 8.7 North Carolina United States 0 Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Prevention Branch, 08/2012. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Figure 8.11. Estimated Number of Adults with Chronic High Blood Glucose Levels, N.C., 2010 Number of Adults 3,500,000 3,000,000 2,500,000 Pre-Diabetes Undiagnosed Diabetes Diagnosed Diabetes 2,442,000+ 2,000,000 1,500,000 1,000,000 500,000 461,000 * 223,000++ 711,000 ** 711,000 ** NC BRFSS National 0 *Estimate is based on self-report of diagnosed pre-diabetes in the 2010 NC BRFSS survey. **Estimate is based on self-report of diagnosed diabetes in the 2010 NC BRFSS survey. +Estimate is obtained by applying the estimated national prevalence of pre-diabetes among adults 20 years or older of 35 percent (National Diabetes fact sheet, 2011) to the 2010 NC population of the same age group. ++Estimate is obtained by applying the estimated national prevalence of undiagnosed diabetes among adults 20 years or older of 3.2 percent (National Diabetes fact sheet, 2011) to the 2010 NC population of the same age group. N.C. Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, 2012 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Branch: 08/2012. U.S. Source: Center for Disease Control and Prevention. National diabetes facts sheet: national estimates and general information on diabetes and pre-diabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011. The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force