Missoula Measures - Heart Disease
Why this topic?
Heart disease is the leading cause of death in the United States. Stroke is the third leading cause of death in the United States. Together, heart disease and stroke are among the most widespread and costly health problems facing the Nation today, accounting for more than $500 billion in health care expenditures and related expenses in 2010 alone. Fortunately, they are also among the most preventable.
The leading modifiable (controllable) risk factors for heart disease and stroke are:
- High blood pressure
- High cholesterol
- Cigarette smoking
- Poor diet and physical inactivity
- Overweight and obesity
Over time, these risk factors cause changes in the heart and blood vessels that can lead to heart attacks, heart failure, and strokes. It is critical to address risk factors early in life to prevent the potentially devastating complications of chronic cardiovascular disease.
Controlling risk factors for heart disease and stroke remains a challenge. High blood pressure and cholesterol are still major contributors to the national epidemic of cardiovascular disease. High blood pressure affects approximately 1 in 3 adults in the United States, and more than half of Americans with high blood pressure do not have it under control.3 High sodium intake is a known risk factor for high blood pressure and heart disease, yet about 90 percent of American adults exceed their recommendation for sodium intake.
The risk of Americans developing and dying from cardiovascular disease would be substantially reduced if major improvements were made across the U.S. population in diet and physical activity, control of high blood pressure and cholesterol, smoking cessation, and appropriate aspirin use. Healthy People 2020
How are we doing?
In regard to Missoulians being aware of and treating hypertension, we think there is room for improvement. If we assume that we are similar to the nation (with a rate of 30% hypertension), then there are still many people who don’t know their status. We don’t know how many people have taken effective steps to reduce their high blood pressure once they became aware of their condition. Missoula's rates of death from heart disease or strokes are less than the state, and that is partially skewed by the influence of the realtively young UM population.
People with hypertension (high blood pressure) have three to four times the risk of developing coronary heart disease (heart attacks and angina), and as much as seven times the risk of stroke as do people with normal blood pressure. Hypertension, which usually has no symptoms or warning signs, is called "the silent killer;" about 35% of the people with high blood pressure are not aware of it.
Between 1999 and 2003, about 25% of Montanans reported that they had been told they had high blood pressure. Mt. BRFSS
Healthy People 2020 Targets
|Stroke death rate||42 /100,000||34 /100,000|
|Heart disease death rate||126 /100,000||108 /100,000|
|Percent of adults who had their cholesterol checked in past 5 years||75||82|
Smoking, obesity, high fat diet, lack of physical activity, high blood pressure, high cholesterol, family history. Other risk factor graphs
The causal relationship of high blood cholesterol to coronary heart disease also has been demonstrated. Coronary heart disease mortality and morbidity increase as blood cholesterol levels rise (HP 2000). Total cholesterol is defined as high at 240 and borderline high at 200.
Reducing dietary fat intake to an average of 30% of calories or less and average saturated fat intake to less than 10% of calories are dietary guidelines which can help reduce serum cholesterol levels. Other options include exercise programs and prescription medications.
Other Missoula heart disease data including Missoula/Montana Heart Disease/Stroke Mortality Rates.
Cardiovascular Disease (CVD) encompasses diseases of the heart and blood vessels. Chief among these are coronary heart disease and stroke. Coronary heart disease is a general term covering heart attacks and angina. Both of these conditions involve an insufficient supply of blood to the coronary arteries encircling the heart, and the consequent lack of oxygen to the heart muscle. CVD also includes atherosclerosis (degeneration and hardening of the arteries), rheumatic fever, and congenital defects.
Many factors influence not only whether a person will develop coronary heart disease but also how rapidly atherosclerosis progresses. Genetic predisposition, gender, and advancing age are recognized factors over which individuals have no control. Key modifiable factors include cigarette smoking, high blood cholesterol, high blood pressure, excessive body weight, and long-term physical inactivity (HP 2000).