More than 200,000 preventable deaths from heart disease and stroke occurred in the United States in 2010, according to a new report from the CDC. More than half of these deaths happened to people younger than 65 years of age. The overall rate of preventable deaths from heart disease and stroke went down nearly 30 percent between 2001 and 2010, but the declines varied by age. Lack of access to preventive screenings and early treatment for high blood pressure and high cholesterol could explain the differences among age groups.
Cardiovascular disease is the leading cause of U.S. deaths and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons under 75 years old) are potentially avoidable.
Cardiovascular diseases, including heart disease and stroke, kill nearly 800,000 Americans each year or one in three deaths. However, the report notes that most cardiovascular disease can be managed or prevented in the first place by addressing risk factors.
Death rates in 2010 were highest among adults aged 65-74 years (401.5 per 100,000 population). But preventable deaths have declined faster in those aged 65-74 years compared to those under age 65. Men are more than twice as likely as women — and blacks twice as likely as whites — to die from preventable heart disease and stroke.
“Despite progress against heart disease and stroke, hundreds of thousands of Americans die each year from these preventable causes of death,” said CDC Director Tom Frieden, M.D., M.P.H. “Many of the heart attacks and strokes that will kill people in the coming year could be prevented by reducing blood pressure and cholesterol and stopping smoking.”
The report looked at preventable deaths from heart disease and stroke defined as those that occurred in people under age 75 that could have been prevented by more effective public health measures, lifestyle changes, or medical care. Deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. Avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States.
Blacks are twice as likely—and Hispanics are slightly less likely—as whites to die from preventable heart disease and stroke. Black men have the highest risk. Hispanic men are twice as likely as Hispanic women to die from preventable heart disease and stroke.
By state, avoidable deaths from cardiovascular disease ranged from a rate of 36.3 deaths per 100,000 population in Minnesota to 99.6 deaths per 100,000 in the District of Columbia. By county, the highest avoidable death rates in 2010 were concentrated primarily in the southern Appalachian region and much of Tennessee, Arkansas, Mississippi, Louisiana, and Oklahoma. The lowest rates were in the West, Midwest, and Northeast regions.
To save more lives from these preventable deaths, doctors, nurses, and other health care providers can encourage healthy habits at every patient visit, including not smoking, increasing physical activity, eating a healthy diet, maintaining a healthy weight, and taking medicines as directed. Providers should track patient progress on the ABC’S of heart health — Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation. Hypertension is the single most important risk factor for stroke, and its control is essential to reducing death from stroke.
Health care systems can adopt and use electronic health records to identify patients who smoke or who have high blood pressure or high cholesterol and help providers follow and support patient progress. Through the Affordable Care Act, more Americans will have access to health coverage and preventive care, including young people and other medically underserved groups.
Communities and health departments can help by promoting healthier living spaces, including tobacco-free areas and safe walking areas. By promoting community design that increases access to sidewalks and bike lanes, improving the local food environment (access to fresh fruits and vegetables and lower sodium options), enhancing worksite wellness programs, improving insurance coverage, and improving access to quality health care, local communities can support health and wellness.
Nearly one fourth of all cardiovascular disease deaths are avoidable. These deaths disproportionately occurred among non-Hispanic blacks and residents of the South. Persons under age 65 had lower rates than those aged 65–74, years but still accounted for a considerable share of avoidable deaths and demonstrated less improvement. The finding of a slower decline in avoidable deaths in younger age groups in this report highlights the importance of improving prevention, diagnosis, and treatment efforts in younger adults.
See the CDC Report
Also see the CDC Announcement
See also Medical Law Perspectives, February 2012 Report: The New Oral Contraceptives: Stroke and Other Adverse Event Liability