Cardiovascular Disease in Women Module I: Epidemiology

1
Cardiovascular Disease in WomenModule I
Epidemiology
2
Module I Epidemiology

• Statistics on Women and Cardiovascular Disease
• Comparisons to Men
• Age Differences Among Women
• Racial and Ethnic Group Differences

3
CVD and Other Major Causes of Death for Women in
the United States 2004
Source Adapted from American Heart Association
2008
4
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
5
Cardiovascular Disease Mortality U.S. Males and
Females 1980-2004
Source Adapted from American Heart Association
2008
6
Annual Numbers of U.S. Adults Diagnosed with
Myocardial Infarction and Fatal CHD by Age and
Sex Categories 1987-2004
Age in Years
Source Adapted from American Heart Association
2008
7
Acute MI Mortality by Age and Sex
Source Adapted from Vaccarino 1999
8
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
9
Major Causes of Death for White Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
10
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
11
Major Causes of Death for Black /African American
Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
12
Age-adjusted Death Rates for Leading Causes of
Death in White and Black/African American Women
U.S. 2004
Per 100,000 Population
Source Adapted from American Heart Association
2008
13
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
14
Major Causes of Death for Hispanic/Latina Women
U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
15
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
16
Major Causes of Death for Asian American and
Pacific Islander Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
17
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
18
Major Causes of Death for American Indian and
Alaska Native Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
19
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
20
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
21
Cardiovascular Disease in WomenModule I
Epidemiology
22
Module I Epidemiology

• Statistics on Women and Cardiovascular Disease
• Comparisons to Men
• Age Differences Among Women
• Racial and Ethnic Group Differences

23
CVD and Other Major Causes of Death for Women in
the United States 2004
Source Adapted from American Heart Association
2008
24
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
25
Cardiovascular Disease Mortality U.S. Males and
Females 1980-2004
Source Adapted from American Heart Association
2008
26
Annual Numbers of U.S. Adults Diagnosed with
Myocardial Infarction and Fatal CHD by Age and
Sex Categories 1987-2004
Age in Years
Source Adapted from American Heart Association
2008
27
Acute MI Mortality by Age and Sex
Source Adapted from Vaccarino 1999
28
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
29
Major Causes of Death for White Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
30
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
31
Major Causes of Death for Black /African American
Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
32
Age-adjusted Death Rates for Leading Causes of
Death in White and Black/African American Women
U.S. 2004
Per 100,000 Population
Source Adapted from American Heart Association
2008
33
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
34
Major Causes of Death for Hispanic/Latina Women
U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
35
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
36
Major Causes of Death for Asian American and
Pacific Islander Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
37
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
38
Major Causes of Death for American Indian and
Alaska Native Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
39
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
40
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
41
Cardiovascular Disease in WomenModule I
Epidemiology
42
Module I Epidemiology

• Statistics on Women and Cardiovascular Disease
• Comparisons to Men
• Age Differences Among Women
• Racial and Ethnic Group Differences

43
CVD and Other Major Causes of Death for Women in
the United States 2004
Source Adapted from American Heart Association
2008
44
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
45
Cardiovascular Disease Mortality U.S. Males and
Females 1980-2004
Source Adapted from American Heart Association
2008
46
Annual Numbers of U.S. Adults Diagnosed with
Myocardial Infarction and Fatal CHD by Age and
Sex Categories 1987-2004
Age in Years
Source Adapted from American Heart Association
2008
47
Acute MI Mortality by Age and Sex
Source Adapted from Vaccarino 1999
48
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
49
Major Causes of Death for White Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
50
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
51
Major Causes of Death for Black /African American
Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
52
Age-adjusted Death Rates for Leading Causes of
Death in White and Black/African American Women
U.S. 2004
Per 100,000 Population
Source Adapted from American Heart Association
2008
53
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
54
Major Causes of Death for Hispanic/Latina Women
U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
55
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
56
Major Causes of Death for Asian American and
Pacific Islander Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
57
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
58
Major Causes of Death for American Indian and
Alaska Native Women U.S. 2004
Percent of Total Deaths
Source Adapted from American Heart Association
2008
59
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
60
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