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Prevalence of Coronary Heart Disease or Stroke Among Workers Aged <55 Years — United States, 2008–2012

August 20, 2014 Comments off

Prevalence of Coronary Heart Disease or Stroke Among Workers Aged <55 Years — United States, 2008–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Cardiovascular disease accounts for one in three deaths in the United States each year, and coronary heart disease and stroke account for most of those deaths (1). To try to prevent 1 million heart attacks and strokes by 2017, the U.S. Department of Health and Human Services launched the Million Hearts initiative, promoting proven and effective interventions in communities and clinical settings. In workplace settings, cardiovascular disease can be addressed through a Total Worker Health program, which integrates occupational safety and health protection with health promotion. To identify workers likely to benefit from such a program, CDC analyzed data from the National Health Interview Survey (NHIS) for the period 2008–2012 to estimate the prevalence of a history of coronary heart disease or stroke (CHD/stroke) among adults aged <55 years by selected characteristics, employment status, occupation category, and industry of employment. The results of that analysis showed that 1.9% of employed adults aged <55 years reported a history of CHD/stroke, compared with 2.5% of unemployed adults looking for work, and 6.3% of adults not in the labor force (e.g., unemployed adults who stopped looking for work, homemakers, students, retired persons, and disabled persons). Workers employed in service and blue collar occupations were more likely than those in white collar occupations to report a history of CHD/stroke. Two industry groups also had significantly higher adjusted prevalence ratios (aPRs) for CHD/stroke: Administrative and Support and Waste Management and Remediation Services* and Accommodation and Food Service.† Workers in these occupation and industry groups might especially benefit from a Total Worker Health approach to reducing the risk for CHD/stroke.

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Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010

May 12, 2014 Comments off

Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010
Source: Morbidity and Mortality Weekly Report (CDC)

In 2010, the top five causes of death in the United States were 1) diseases of the heart, 2) cancer, 3) chronic lower respiratory diseases, 4) cerebrovascular diseases (stroke), and 5) unintentional injuries (1). The rates of death from each cause vary greatly across the 50 states and the District of Columbia (2). An understanding of state differences in death rates for the leading causes might help state health officials establish disease prevention goals, priorities, and strategies. States with lower death rates can be used as benchmarks for setting achievable goals and calculating the number of deaths that might be prevented in states with higher rates. To determine the number of premature annual deaths for the five leading causes of death that potentially could be prevented (“potentially preventable deaths”), CDC analyzed National Vital Statistics System mortality data from 2008–2010. The number of annual potentially preventable deaths per state before age 80 years was determined by comparing the number of expected deaths (based on average death rates for the three states with the lowest rates for each cause) with the number of observed deaths. The results of this analysis indicate that, when considered separately, 91,757 deaths from diseases of the heart, 84,443 from cancer, 28,831 from chronic lower respiratory diseases, 16,973 from cerebrovascular diseases (stroke), and 36,836 from unintentional injuries potentially could be prevented each year. In addition, states in the Southeast had the highest number of potentially preventable deaths for each of the five leading causes. The findings provide disease-specific targets that states can use to measure their progress in preventing the leading causes of deaths in their populations.

Mortality from road crashes in 193 countries: a comparison with other leading causes of death

February 26, 2014 Comments off

Mortality from road crashes in 193 countries: a comparison with other leading causes of death
Source: Transportation Research Institute (University of Michigan)

This study compared, for each country of the world, the fatalities per population from road crashes with fatalities per population from three leading causes of death (malignant neoplasm, ischaemic heart disease, and cerebrovascular disease), and from all causes. The data, applicable to 2008, came from the World Health Organization. The main findings are as follows:
(1) For the world, there are 18 fatalities from road crashes per 100,000 population, as compared with 113 for malignant neoplasm, 108 for ischaemic heart disease, and 91 for cerebrovascular disease. The highest fatality rate from road crashes is in Namibia (45) and the lowest in the Maldives (2).
(2) For the world, fatalities from road crashes represent 2.1% of fatalities from all causes. The highest percentage is in the United Arab Emirates (15.9%) and the lowest in the Marshall Islands (0.3%).
(3) For the world, fatalities from road crashes represent 15.9% of fatalities from malignant neoplasm. The highest percentage is in Namibia (153.9%) and the lowest in the Maldives (1.7%).
(4) For the world, fatalities from road crashes represent 16.7% of fatalities from ischaemic heart disease. The highest percentage is in Qatar (123.9%) and the lowest in Malta (1.9%).
(5) For the world, fatalities from road crashes represent 19.6% of fatalities from cerebrovascular disease. The highest percentage is in Qatar (529.7%) and the lowest in the Marshall Islands (2.3%). The appendixes list the rates and percentages for each individual country.

AHA/ASA Guidelines for the Prevention of Stroke in Women

February 7, 2014 Comments off

AHA/ASA Guidelines for the Prevention of Stroke in Women
Source: Stroke

Purpose
The aim of this statement is to summarize data on stroke risk factors that are unique to and more common in women than men and to expand on the data provided in prior stroke guidelines and cardiovascular prevention guidelines for women. This guideline focuses on the risk factors unique to women, such as reproductive factors, and those that are more common in women, including migraine with aura, obesity, metabolic syndrome, and atrial fibrillation.

Methods
Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council’s Scientific Statement Oversight Committee and the AHA’s Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through May 15, 2013. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA Stroke Council methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee.

Results
We provide current evidence, research gaps, and recommendations on risk of stroke related to preeclampsia, oral contraceptives, menopause, and hormone replacement, as well as those risk factors more common in women, such as obesity/metabolic syndrome, atrial fibrillation, and migraine with aura.

Conclusions
To more accurately reflect the risk of stroke in women across the lifespan, as well as the clear gaps in current risk scores, we believe a female-specific stroke risk score is warranted.

Sodium Intake in Populations: Assessment of Evidence

September 17, 2013 Comments off

Sodium Intake in Populations: Assessment of Evidence
Source: Institute of Medicine

Despite efforts over the past several decades to reduce sodium intake in the United States, adults still consume an average of 3,400 mg of sodium every day. A number of scientific bodies and professional health organizations, including the American Heart Association, the American Medical Association, and the American Public Health Association, support reducing dietary sodium intake. These organizations support a common goal to reduce daily sodium intake to less than 2,300 milligrams and further reduce intake to 1,500 mg among persons who are 51 years of age and older and those of any age who are African-American or have hypertension, diabetes, or chronic kidney disease.

A substantial body of evidence supports these efforts to reduce sodium intake. This evidence links excessive dietary sodium to high blood pressure, a surrogate marker for cardiovascular disease (CVD), stroke, and cardiac-related mortality. However, concerns have been raised that a low sodium intake may adversely affect certain risk factors, including blood lipids and insulin resistance, and thus potentially increase risk of heart disease and stroke. In fact, several recent reports have challenged sodium reduction in the population as a strategy to reduce this risk.

Sodium Intake in Populations recognizes the limitations of the available evidence, and explains that there is no consistent evidence to support an association between sodium intake and either a beneficial or adverse effect on most direct health outcomes other than some CVD outcomes (including stroke and CVD mortality) and all-cause mortality. Some evidence suggested that decreasing sodium intake could possibly reduce the risk of gastric cancer. However, the evidence was too limited to conclude the converse—that higher sodium intake could possibly increase the risk of gastric cancer. Interpreting these findings was particularly challenging because most studies were conducted outside the United States in populations consuming much higher levels of sodium than those consumed in this country. Sodium Intake in Populations is a summary of the findings and conclusions on evidence for associations between sodium intake and risk of CVD-related events and mortality.

Vital Signs: Avoidable Deaths from Heart Disease, Stroke, and Hypertensive Disease — United States, 2001–2010

September 9, 2013 Comments off

Vital Signs: Avoidable Deaths from Heart Disease, Stroke, and Hypertensive Disease — United States, 2001–2010
Source: Morbidity and Mortality Weekly Report (CDC)

Background: Deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, 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. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.

Methods: National Vital Statistics System mortality data for the period 2001–2010 were analyzed. Avoidable deaths were defined as those resulting from an underlying cause of heart disease (ischemic or chronic rheumatic), stroke, or hypertensive disease in decedents aged <75 years. Rates and trends by age, sex, race/ethnicity, and place were calculated.

Results: In 2010, an estimated 200,070 avoidable deaths from heart disease, stroke, and hypertensive disease occurred in the United States, 56% of which occurred among persons aged <65 years. The overall age-standardized death rate was 60.7 per 100,000. Rates were highest in the 65–74 years age group, among males, among non-Hispanic blacks, and in the South. During 2001–2010, the overall rate declined 29%, and rates of decline varied by age.

Conclusions: Nearly one fourth of all cardiovascular disease deaths are avoidable. These deaths disproportionately occurred among non-Hispanic blacks and residents of the South. Persons aged <65 years had lower rates than those aged 65–74 years but still accounted for a considerable share of avoidable deaths and demonstrated less improvement.

CDC Vital Signs — Preventable Deaths from Heart Disease & Stroke

September 4, 2013 Comments off

CDC Vital Signs — Preventable Deaths from Heart Disease & Stroke
Source: Centers for Disease Control and Prevention

Nearly 1 in 3 deaths in the US each year is caused by heart disease and stroke. At least 200,000 of these deaths could have been prevented through changes in health habits, such as stopping smoking, more physical activity, and less salt in the diet; community changes to create healthier living spaces, such as safe places to exercise and smoke-free areas; and managing high blood pressure, high cholesterol, and diabetes.

More people will have access to health care coverage and preventive care through the Affordable Care Act. Health care providers should talk with their patients about healthy habits at every visit and follow patients’ progress.

Health care systems and providers can also:

  • Use electronic health records to identify and support patients who need help quitting smoking or who have high blood pressure or high cholesterol.
  • Refer patients to community resources, such as smoking quitlines and blood pressure selfmanagement programs.
  • Track patient progress on the ABCS of heart health—Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation.
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