Transcript Epidemiology CVD in Women Module

Cardiovascular Disease in Women
Module I: Epidemiology
Module I: Epidemiology
 Statistics on Women and Cardiovascular Disease
 Comparisons to Men
 Age Differences Among Women
 Racial and Ethnic Group Differences
CVD and Other Major Causes of Death
for Women in the United States: 2004
500,000
400,000
300,000
200,000
100,000
0
Total CVD
CHD
Cancer
Source: Adapted from American Heart Association 2008
Stroke
Asthma +
COPD
Congestive Heart Failure:
Gender Differences
 Compared to men, women with heart failure are:




Older
More likely to have hypertension
More likely to have diabetes
More likely to have diastolic dysfunction

 Knowledge of diastolic dysfunction prognosis
and treatment is limited
 Trials of congestive heart failure treatments have
included mainly men
Source: Stromberg 2003
Cardiovascular Disease Mortality:
U.S. Males and Females 1980-2004
550,000
500,000
Men
Women
450,000
400,000
1980
1985
1990
Source: Adapted from American Heart Association 2008
1995
2000
2004
Annual Numbers of U.S. Adults Diagnosed
with Myocardial Infarction and Fatal CHD
by Age and Sex Categories: 1987-2004
300,000
200,000
Men
Women
100,000
0
35-44
45-64
65-74
Age in Years
Source: Adapted from American Heart Association 2008
75+
Acute MI Mortality by Age and Sex
30
25
Men
20
Women
Death During
Hospitalization
15
(%)
10
5
0
<50
50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89
Age
Source: Adapted from Vaccarino 1999
Racial and Ethnic Groups
 Cardiovascular disease is the leading cause of death
for African Americans, Latinos, Asian Americans,
Pacific Islanders, and American Indians
 African American women are at the highest risk for
death from heart disease among all racial, ethnic,
and gender groups
Source: American Heart Association 2004
Major Causes of Death for
White Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Asthma +
COPD
Alzheimer's
Disease
African Americans
 African American women are at highest risk for death
from heart disease among all race, ethnic, and gender
groups
 African Americans with established CHD are at high
risk for cardiac death
 The risk of death and morbidity from CHD attributable
to HTN is higher in African Americans
Sources: American Heart Association 2004, Mosca 2004, ATP III 2002, American Heart Association 2008
Major Causes of Death for Black /African
American Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Kidney
Disease
Age-adjusted Death Rates for Leading
Causes of Death in White and Black/African
American Women: U.S. 2004
150
Per
100,000
100
Population
Black/African
American Women
White Women
50
0
CHD
Stroke
Lung
Cancer
Source: Adapted from American Heart Association 2008
Breast
Cancer
Latinas
 Latinas have higher rates of many risk factors for heart
disease, including obesity, physical inactivity, metabolic
syndrome, diabetes, and hypertension, than white women
 It is estimated that over 50% of Latinas born in the year
2000 will develop diabetes. CHD is the leading cause of
death in diabetics.
Sources: American Heart Association 2004, Narayan 2003
Major Causes of Death for
Hispanic/Latina Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Accidents
Asian Americans and Pacific Islanders
 There is limited information on the prevention and treatment
of heart disease in Asian Americans and Pacific Islanders
 The risk of heart disease varies between different
ethnic groups within the Asian American community
 South Asians have been reported to have a high prevalence
of heart disease at young ages, in part because of a high
prevalence of metabolic syndrome
Source: ATP III 2002
Major Causes of Death for Asian American
and Pacific Islander Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Accidents
American Indians
 Cardiovascular disease rates vary among
American Indian communities
 Unlike other ethnic groups, the incidence of
CHD is increasing among American Indians
Source: ATP III 2002
Major Causes of Death for American Indian
and Alaska Native Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Accidents
Diabetes
Mellitus
Summary
 Among U.S. women, cardiovascular disease
is the leading cause of death
 Among U.S. women, cardiovascular disease
is the leading cause of death for whites,
African Americans, Latinas, Asian
Americans, Pacific Islanders, and American
Indians
Source: American Heart Association 2008
Summary
 Mortality from CVD has decreased more for men
in the past 20 years than for women
 Over 10,000 women under age 45 suffer an acute
myocardial infarction every year
Source: American Heart Association 2008
Cardiovascular Disease in Women
Module I: Epidemiology
Module I: Epidemiology
 Statistics on Women and Cardiovascular Disease
 Comparisons to Men
 Age Differences Among Women
 Racial and Ethnic Group Differences
CVD and Other Major Causes of Death for
Women in the United States: 2004
500,000
400,000
300,000
200,000
100,000
0
Total CVD
CHD
Cancer
Source: Adapted from American Heart Association 2008
Stroke
Asthma +
COPD
Congestive Heart Failure:
Gender Differences
 Compared to men, women with heart failure are:




Older
More likely to have hypertension
More likely to have diabetes
More likely to have diastolic dysfunction

 Knowledge of diastolic dysfunction prognosis
and treatment is limited
 Trials of congestive heart failure treatments have
included mainly men
Source: Stromberg 2003
Cardiovascular Disease Mortality:
U.S. Males and Females 1980-2004
550,000
500,000
Men
Women
450,000
400,000
1980
1985
1990
Source: Adapted from American Heart Association 2008
1995
2000
2004
Annual Numbers of U.S. Adults Diagnosed
with Myocardial Infarction and Fatal CHD
by Age and Sex Categories: 1987-2004
300,000
200,000
Men
Women
100,000
0
35-44
65-74
45-64
Age in Years
Source: Adapted from American Heart Association 2008
75+
Acute MI Mortality by Age and Sex
30
25
Men
20
Women
Death During
Hospitalization
15
(%)
10
5
0
<50
50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89
Age
Source: Adapted from Vaccarino 1999
Racial and Ethnic Groups
 Cardiovascular disease is the leading cause of death
for African Americans, Latinos, Asian Americans,
Pacific Islanders, and American Indians
 African American women are at the highest risk for
death from heart disease among all racial, ethnic,
and gender groups
Source: American Heart Association 2004
Major Causes of Death for White Women:
U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Asthma +
COPD
Alzheimer's
Disease
African Americans
 African American women are at highest risk for death
from heart disease among all race, ethnic, and gender
groups
 African Americans with established CHD are at high
risk for cardiac death
 The risk of death and morbidity from CHD attributable
to HTN is higher in African Americans
Sources: American Heart Association 2004, Mosca 2004, ATP III 2002, American Heart Association 2008
Major Causes of Death for Black /African
American Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Kidney
Disease
Age-adjusted Death Rates for Leading Causes
of Death in White and Black/African
American Women: U.S. 2004
150
100
Per
100,000
Population 50
Black/African
American Women
White Women
0
CHD
Stroke
Lung
Cancer
Source: Adapted from American Heart Association 2008
Breast
Cancer
Latinas
 Latinas have higher rates of many risk factors for heart
disease, including obesity, physical inactivity, metabolic
syndrome, diabetes, and hypertension, than white women
 It is estimated that over 50% of Latinas born in the year
2000 will develop diabetes. CHD is the leading cause of
death in diabetics.
Sources: American Heart Association 2004, Narayan 2003
Major Causes of Death for Hispanic/Latina
Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Accidents
Asian Americans and Pacific Islanders
 There is limited information on the prevention and
treatment of heart disease in Asian Americans and
Pacific Islanders
 The risk of heart disease varies between different ethnic
groups within the Asian American community
 South Asians have been reported to have a high
prevalence of heart disease at young ages, in part
because of a high prevalence of metabolic syndrome
Source: ATP III 2002
Major Causes of Death for Asian American
and Pacific Islander Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Accidents
American Indians
 Cardiovascular disease rates vary among
American Indian communities
 Unlike other ethnic groups, the incidence of
CHD is increasing among American Indians
Source: ATP III 2002
Major Causes of Death for American Indian
and Alaska Native Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Accidents
Diabetes
Mellitus
Summary
 Among U.S. women, cardiovascular disease
is the leading cause of death
 Among U.S. women, cardiovascular disease
is the leading cause of death for whites,
African Americans, Latinas, Asian
Americans, Pacific Islanders , and American
Indians
Source: American Heart Association 2008
Summary
 Mortality from CVD has decreased more for men
in the past 20 years than for women
 Over 10,000 women under age 45 suffer an acute
myocardial infarction every year
Source: American Heart Association 2008
Cardiovascular Disease in Women
Module I: Epidemiology
Module I: Epidemiology
 Statistics on Women and Cardiovascular Disease
 Comparisons to Men
 Age Differences Among Women
 Racial and Ethnic Group Differences
CVD and Other Major Causes of Death for
Women in the United States: 2004
500,000
400,000
300,000
200,000
100,000
0
Total CVD
CHD
Cancer
Source: Adapted from American Heart Association 2008
Stroke
Asthma +
COPD
Congestive Heart Failure:
Gender Differences
 Compared to men, women with heart failure are:




Older
More likely to have hypertension
More likely to have diabetes
More likely to have diastolic dysfunction

 Knowledge of diastolic dysfunction prognosis
and treatment is limited
 Trials of congestive heart failure treatments have
included mainly men
Source: Stromberg 2003
Cardiovascular Disease Mortality:
U.S. Males and Females 1980-2004
550,000
500,000
Men
Women
450,000
400,000
1980
1985
1990
Source: Adapted from American Heart Association 2008
1995
2000
2004
Annual Numbers of U.S. Adults Diagnosed
with Myocardial Infarction and Fatal CHD
by Age and Sex Categories: 1987-2004
300,000
200,000
Men
Women
100,000
0
35-44
65-74
45-64
Age in Years
Source: Adapted from American Heart Association 2008
75+
Acute MI Mortality by Age and Sex
30
25
Men
20
Women
Death During
Hospitalization
15
(%)
10
5
0
<50
50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89
Age
Source: Adapted from Vaccarino 1999
Racial and Ethnic Groups
 Cardiovascular disease is the leading cause of death
for African Americans, Latinos, Asian Americans,
Pacific Islanders, and American Indians
 African American women are at the highest risk for
death from heart disease among all racial, ethnic,
and gender groups
Source: American Heart Association 2004
Major Causes of Death for White Women:
U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Asthma +
COPD
Alzheimer's
Disease
African Americans
 African American women are at highest risk for death
from heart disease among all race, ethnic, and gender
groups
 African Americans with established CHD are at high
risk for cardiac death
 The risk of death and morbidity from CHD attributable
to HTN is higher in African Americans
Sources: American Heart Association 2004, Mosca 2004, ATP III 2002, American Heart Association 2008
Major Causes of Death for Black /African
American Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Kidney
Disease
Age-adjusted Death Rates for Leading Causes
of Death in White and Black/African
American Women: U.S. 2004
150
100
Per
100,000
Population 50
Black/African
American Women
White Women
0
CHD
Stroke
Lung
Cancer
Source: Adapted from American Heart Association 2008
Breast
Cancer
Latinas
 Latinas have higher rates of many risk factors for heart
disease, including obesity, physical inactivity, metabolic
syndrome, diabetes, and hypertension, than white women
 It is estimated that over 50% of Latinas born in the year
2000 will develop diabetes. CHD is the leading cause of
death in diabetics.
Sources: American Heart Association 2004, Narayan 2003
Major Causes of Death for Hispanic/Latina
Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Accidents
Asian Americans and Pacific Islanders
 There is limited information on the prevention and
treatment of heart disease in Asian Americans and
Pacific Islanders
 The risk of heart disease varies between different ethnic
groups within the Asian American community
 South Asians have been reported to have a high
prevalence of heart disease at young ages, in part
because of a high prevalence of metabolic syndrome
Source: ATP III 2002
Major Causes of Death for Asian American
and Pacific Islander Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Diabetes
Mellitus
Accidents
American Indians
 Cardiovascular disease rates vary among
American Indian communities
 Unlike other ethnic groups, the incidence of
CHD is increasing among American Indians
Source: ATP III 2002
Major Causes of Death for American Indian
and Alaska Native Women: U.S. 2004
40.0
Percent
of Total
Deaths
30.0
20.0
10.0
0.0
Diseases of
the Heart and
Stroke
Cancer
Source: Adapted from American Heart Association 2008
Accidents
Diabetes
Mellitus
Summary
 Among U.S. women, cardiovascular
disease is the leading cause of death
 Among U.S. women, cardiovascular disease
is the leading cause of death for whites,
African Americans, Latinas, Asian Americans,
Pacific Islanders , and American Indians
Source: American Heart Association 2008
Summary
 Mortality from CVD has decreased more for men
in the past 20 years than for women
 Over 10,000 women under age 45 suffer an acute
myocardial infarction or die of CHD every year
Source: American Heart Association 2008