The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Cardiovascular Disease Figures

The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force

Cardiovascular Disease Figures


Heart Disease*17,09022%

Stroke*4,2815%

Other CVD*1,8612%

Chronic Lower Respiratory Disease

4,4906%

Other Unintentional Injuries*

2,7624%

All other causes30,10738%

Cancer18,01323%

Figure 1.1. CVD and Leading Causes of Death, N.C., 2010

Total Cardiovascular Diseases: 23,232 deaths, 29.6% of all deaths*

*Unintentional injuries other than motor-vehicles injuries.Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/data/lcd/lcd.cfm.

http://www.schs.state.nc.us/schs/data/lcd/lcd.cfm




Figure 1.2. Major Cardiovascular Disease Death Rates, 1979-2008

0

100

200

300

400

500

600

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e

North Carolina United States

Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

http://wonder.cdc.gov/mortSQL.html



Figure 1.3. Cardiovascular Disease Death Rates by Age and Gender, N.C., 2008

Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99; Q20-Q28. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

0

1,000

2,000

3,000

4,000

5,000

6,000

Death

Rate

per

100,0

00

Females

Males

Total

Females 11.5 78.8 162.5 430.1 1474.1 5531.6

Males 19.0 165.3 387.4 814.5 2076.8 5878.3

Total 15.3 120.8 269.5 604.9 1715.0 5633.0

<45 45-54 55-64 65-74 75-84 85+




Figure 1.4. Major Cardiovascular Disease Death Rates by Gender, N.C., 1979-2008

0

100

200

300

400

500

600

700

800

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-a

dju

ste

d D

ea

th R

ate Males

Females

Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 1.5. Major Cardiovascular Disease Death Rates by Race, N.C., 1979-2008

0

100

200

300

400

500

600

700

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-a

dju

ste

d D

ea

th R

ate African Americans

Whites

Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 1.6. Major Cardiovascular Disease Death Rates by Race and Gender, N.C., 1979-2008

0

100

200

300

400

500

600

700

800

900

1000

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e African-American MalesAfrican-American FemalesWhite MalesWhite Females

Major Cardiovascular Disease: 1999-2008: ICD-10 codes I00-I78; 1979-1998: ICD-9 codes 390-434, 436-448 multiplied by comparability ratio of 0.9981.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.


Figure 1.7. Percentage of Total CVD Deaths by Age Group, Race, and Gender, N.C., 2004-2008

10.424.825.9

43.2

0102030405060708090

100

African-American Males

White Males African-AmericanFemales

White Females

Pe

rce

nta

ge

of

CV

D D

ea

ths

<65 years 65+ years

Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 1.8. Cardiovascular Disease Death Rates by County of Residence, N.C., 2004-2008

Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99; Q20-Q28. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

N.C. overall: 275.0

U.S.: 265.7

Death Rate211.4 - 249.5

249.6 - 275.0

275.1 - 321.0

321.2 - 367.6

367.7- 436.6




Figure 1.9. Number and Percentage of Total CVD Hospital Discharges by Type of CVD, N.C., 2010

Other Heart Disease61,15137.7%

Coronary Heart Disease39,02224.0%

Stroke29,42918.1%

Other CVD24,88715.3%

Congestive Heart Failure7,8404.8%

All Cardiovascular Diseases: 162,329

ICD-9-CM codes: Cardiovascular Disease, excluding congenital malformations 390-459; Heart Disease 391-392.0, 393-398, 402, 404, 410-416, 420-429; Coronary Heart Disease 410-414; Congestive Heart Failure 428.0; Stroke 430-438. Principal diagnosis only; N.C. residents only.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 1.10. CVD Hospital Discharge Rates, N.C., 1995-2010

0

500

1,000

1,500

2,000

2,500

3,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Year

Ag

e-ad

just

ed D

isch

arg

e R

ate

Total

Males

Females

Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 1.11. CVD Hospital Discharge Rates by Age and Gender, N.C., 2010

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

Age Group

Dis

char

ge

Rat

e p

er 1

00,0

00

Females 44.2 202.3 513.4 1201.5 2193.5 4564.8 8584.5 13829.8

Males 45.7 210.4 717.4 1853.6 3655.0 6745.2 10716.9 14922.3

Total 45.0 206.3 613.9 1518.4 2886.9 5568.6 9453.5 14159.7

<25 25-34 35-44 45-54 55-64 65-74 75-84 85+

Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012.


Figure 1.12. Percentage of CVD Hospitalizations by Age Group, N.C., 2010

40.646.234.5

010

203040

50607080

90100

Female Male Total

Per

cen

tag

e o

f H

osp

ital

izat

ion

s

<65 years 65+ years

Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Provisional Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 1.13. Cardiovascular Disease Hospital Discharge Rates by County of Residence, N.C., 2006-2010

Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes: 390-459; Principal diagnosis only; N.C. residents only.Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.

N.C. overall: 1700.0

Hospital Discharge Rate

576.2 - 1121.1

1121.2 - 1700.0

1700.1 - 2060.4

2060.5 - 2552.2

2552.3 - 3124.4


Figure 1.14. Estimated Direct and Indirect Costs of CVD, United States, 2008

$179.2

$118.5

0

50

100

150

200

250

300

350

Total CVD

Bil

lio

ns

of

Do

llar

s

Indirect CostsDirect Costs

Total: $297.7 billion

Data Source: Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:e2–e220.


Figure 1.15. Cardiovascular Disease Hospital Charges, N.C., 1995-2010

$0

$1,000,000,000

$2,000,000,000

$3,000,000,000

$4,000,000,000

$5,000,000,000

$6,000,000,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Year

To

tal

Ho

spit

al C

har

ges

in

201

1 D

oll

ars

Total

Males

Females

Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 1.16. Cardiovascular Disease: Average Hospital Charges per Stay, N.C., 1995-2010

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

Ch

arg

es

pe

r S

tay

in

20

11

Do

lla

rs TotalMalesFemales

Total Cardiovascular Disease, excluding congenital malformations: ICD-9-CM codes 390-459; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Stroke Figures


Figure 2.1. Stroke and Leading Causes of Death, N.C., 2010


Heart Disease17,09022%

Stroke4,2815%

Other CVD1,8612%

Chronic Lower Respiratory

Disease4,4906%

Other Unintentional Injuries*2,7624%


Cancer18,01323%





46.6

38.9

0

10

20

30

40

50

60

N.C. U.S.

Ag

e-a

dju

ste

d S

tro

ke

De

ath

Ra

te

2020 Target (33.8) 2010 Target (50.0)

Healthy People 2020 Objective 12-07. Stroke: ICD-10 codes I60-I69.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012.

Figure 2.2. Stroke Death Rates & Healthy People 2020 Target, 2009

http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21






Figure 2.3. Stroke Death Rates, 1979-2008

0

20

40

60

80

100

120

140

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e


Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434, 436-438 multiplied by comparability ratio of 1.0588.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 2.4. Stroke Disease Deaths Rates by Age and Gender, N.C., 2008

Stroke: ICD-10 codes I60-I69. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

0

200

400

600

800

1,000

1,200

1,400

Age Group

Death

Rate

per

100,0

00

Females

Males

Total

Females 1.8 16.4 27.4 96.6 361.7 1294.1

Males 2.1 19.3 45.3 129.2 388.9 1122.0

Total 2.0 17.8 35.9 111.4 372.6 1243.8

<45 45-54 55-64 65-74 75-84 85+




Figure 2.5. Stroke Death Rates by Gender, N.C., 1979-2008

40

60

80

100

120

140

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e

Males

Females

Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434,436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 2.6. Stroke Death Rates by Race and Ethnicity & Healthy People 2020 Target, N.C., 2008

31.2

68.1

18.6

50.746.6

27.0

0102030405060708090

100A

me

rica

nIn

dia

n/A

lask

aN

ativ

e

Asi

an

/Pa

cific

Isla

nd

er

Afr

ica

nA

me

rica

n

Wh

ite

His

pa

nic

No

n-H

isp

an

ic

Ag

e-a

dju

ste

d S

tro

ke

De

ath

Ra

te

Stroke Death Rate 2020 Target (33.8) 2010 Target (50.0)

Healthy People 2020 Objective 12-07. Stroke: ICD-10 codes I60-I69.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012.




Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434, 436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

Figure 2.7. Stroke Death Rates by Race, N.C., 1979-2008

0

20

40

60

80

100

120

140

160

180

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e African Americans

Whites




Stroke: 1999-2008: ICD-10 codes I60-I69; 1979-1998: ICD-9 codes 430-434, 436-438 multiplied by comparability ratio of 1.0588. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

Figure 2.8. Stroke Death Rates by Race and Gender, N.C., 1979-2008

25

50

75

100

125

150

175

200

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat





Figure 2.9. Percentage of Total Stroke Deaths by Age Group, Race, and Gender, N.C., 2004-2008

38.8

16.2 22.67.80

102030405060708090

100

African-AmericanMales


White FemalesPer

cen

tag

e o

f S

tro

ke D

eath

s <65 years 65+ years

Stroke: 1999-2008: ICD-10 codes I60-I69. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 2.10. Stroke Death Rates by County of Residence, N.C., 2006-2010

Stroke: ICD-10 codes I60-I69.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.N.C. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Volume 2: Leading Causes of Death in North Carolina 2010, 2011. http://www.schs.state.nc.us/schs/deaths/lcd/2010/.U.S. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

N.C. overall: 47.8

U.S. (2004-2008): 44.5

Death Rate

Unreliable Rate (<50 Deaths)31.1 - 41.041.1 - 47.8

47.9 - 54.654.7 - 66.466.5 - 96.1

Unreliable Rate (<20 Deaths)

http://www.schs.state.nc.us/schs/deaths/lcd/2010/




Stroke29,42918.1%

Heart Disease108,01366.5%


Figure 2.11. Number and Percentage of Total CVD Hospital Discharges that were Due to Stroke, N.C., 2010



Figure 2.12. Stroke Hospital Discharge Rates, N.C., 1995-2010

250

270

290

310

330

350

370

390

410

430

450

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Year

Ag

e-a

dju

ste

d D

isc

ha

rge

Ra

te

Total

Males

Females

Stroke: ICD-9-CM Codes 430-438; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 2.13. Stroke Hospital Discharge Rates by Age and Gender, N.C., 2010

0

500

1,000

1,500

2,000

2,500

3,000

Age Group

Dis

char

ge

Rat

e p

er 1

00,0

00

Females 4.6 24.3 83.5 235.2 433.4 902.2 1,735.80 3,028.00

Males 5.2 19 82.8 264.2 607.1 1,165.80 1,971.60 2,749.90

Total 4.9 21.7 83.2 249.3 515.8 1,023.60 1,831.90 2,945.90

<25 25-34 35-44 45-54 55-64 65-74 75-84 85+

Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012.


Figure 2.14. Percentage of Stroke Hospitalizations by Age Group, N.C., 2010

36.841.732.4

010

2030

405060

7080

90100

Female Male Total

Pe

rce

nta

ge

of

Ho

sp

ita

liza

tio

ns

<65 years 65+ years

Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012.


Figure 2.15. Stroke History and Knowledge among N.C. Adults by Age Group, 2009

0.0

17

.7

82

.7

20

.0

0.2

19

.7

88

.2

21

.7

2.3

25

.4

88

.5

26

.0

4.5

25

.5

89

.5

25

.1

7.7

16

.3

88

.5

16

.2

13

.1

11

.0

83

.8

12

.5

26

.5

91

.6

25

.3

1.1

0

20

40

60

80

100

Had History ofStroke (2010)

Knew All StrokeSymptoms

Would Call 911 forStroke

Knew Symptoms& Would Call 911

Per

cen

t o

f P

op

ula

tio

n

18-24 25-34 35-44 45-54 55-64 65-74 75+

Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012.


3.0

25.5

88.3

23.4

3.8

11.2

88.9

9.9

0.2

14.3

12.8

2.7

11.6

80.6

9.3

2.6

10.8

84.6

10.4

93.9

0

20

40

60

80

100




Knew Symptoms &Would Call 911

Per

cen

t o

f P

op

ula

tio

n

WhiteAfrican American

AsianAmerican Indian

Other Race

Figure 2.16. Stroke History and Knowledge among N.C. Adults by Race, 2009

Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.*Knew Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012.


Figure 2.17. Stroke History and Knowledge among N.C. Adults by Education, 2009

5.4 8.2

80.6

6.4

3.1

14.5

88.1

12.9

3.3

23.3

88.9

21.0

1.8

32.3

90.7

30.0

0

20

40

60

80

100





Per

cen

t o

f P

op

ula

tio

n

< High School

High School or GED

Some Post-HS

College Grad



Figure 2.18. Stroke History and Knowledge among N.C. Adults by Household Income, 2009

5.9 9

.9

84

.4

11

.3

5.4

14

.0

87

.8

15

.3

3.2

16

.5

87

.0

17

.9

2.6

22

.2

86

.8

23

.8

2.4

26

.7

89

.5

29

.0

0.9

33

.1

90

.2

33

.2

0

20

40

60

80

100





Per

cen

t o

f P

op

ula

tio

n

<$15,000$15,000-24,999$25,000-34,999$35,000-49,999$50,000-74,999$75,000+



Figure 2.19. Stroke Hospital Discharge Rates by County of Residence, N.C., 2006-2010

Stroke: ICD-9-CM codes 430-438.; Principal diagnosis only; N.C. residents only.Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2006-2010. Produced by: State Center for Health Statistics, 06/08/2012.

N.C. overall: 298.4


106.4 - 169.8

169.9 - 265.9

266.0 - 298.4

298.5 - 385.7

385.8 - 550.0


Figure 2.20. Estimated Direct and Indirect Costs of CVD and Stroke, United States, 2008

$179.2

$18.8

$118.5

$15.5

020406080

100120140160180200220240260280300

Total CVD Stroke

Bil

lio

ns

of

Do

llar

s






Figure 2.21. Stroke Hospital Charges, N.C., 1995-2010

$0

$100,000,000

$200,000,000

$300,000,000

$400,000,000

$500,000,000

$600,000,000

$700,000,000

$800,000,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

To

tal H

osp

ital

Ch

arg

es in

201

1 D

olla

rs

Total

Males

Females

Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 2.22. Stroke Average Hospital Charges per Stay, N.C., 1995-2010

$15,000

$18,000

$21,000

$24,000

$27,000

$30,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

Ch

arg

es p

er S

tay

in 2

011

Do

llar

s

Total

Males

Females

Stroke: ICD-9-CM codes 430-438; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 2.23. Annual Medicaid Costs due to Stroke and Other CVD, N.C., 2011

Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Annual Medicaid Cost due to CVD, 2011. Produced by: State Center for Health Statistics, 09/19/2012.

$177,403,772$189,045,580

$231,402,818

$75,022,000

$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000

Heart Disease Heart Failure Hypertension Stroke

An

nu

al M

edic

aid

Co

sts


Figure 2.24. Stroke Awareness, N.C. Adults, 2001-2009

87.7

17.118.8

87.6

16.819.5

87.3

17.6

88.2

19.419.815.0

87.4

17.2 21.6

0102030405060708090

100


Would Call 911 for Stroke Knew All Symptoms &Would Call 911

Per

cen

t o

f P

op

ula

tio

n

2001 2003 2005 2007 2009

Adults = ages 18+ years. Data not available in 2002, 2004, 2006, 2008.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. *Knew All Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012.


Figure 2.25. Knowledge of Each Stroke Symptom, N.C. Adults, 2001-2009

87

.8

68

.4

32

.9

70

.8

85

.3

68

.2

28

.9

87

.8 92

.6

70

.6

84

.6

63

.6

37

.4

89

.6

71

.9

85

.7

62

.8

39

.0

69

.5

90

.6

93

.39

0.5

86

.5

37

.7

62

.7

81

.9

68

.7

90

.8

85

.0 93

.5

0

20

40

60

80

100

Confusion,Trouble Speaking

Numbness,Weakness

Trouble Seeing Trouble Walking,Loss of Balance

SevereHeadache

Chest Pain Not aSymptom

Per

cen

t o

f P

op

ula

tio

n

2001 2003 2005 2007 2009

Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.Data not available in 2002, 2004, 2006, 2008.


Figure 2.26. Stroke Awareness by Hypertension Status, N.C. Adults, 2007

Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analysis conducted by: Heart Disease and Stroke Prevention Branch, 2010.

20.1

87.2

18.417.9

87.7

15.9

0

20

40

60

80

100



Per

cen

t o

f P

op

ula

tio

n No Diagnosed HypertensionDiagnosed Hypertension


Figure 2.27. Knowledge of Each Stroke Symptom by Hypertension Status, N.C. Adults, 2007


62.4

40.1

89.4

71.8

85.2

66.8

30.9

70.2

87.2 84.492.2 93.6

0102030405060708090

100

Confusion,Trouble

Speaking

Numbness,Weakness

TroubleSeeing

TroubleWalking,Loss ofBalance

SevereHeadache

Chest PainNot a

Symptom

Per

cen

t o

f P

op

ula

tio

n

No Diagnosed Hypertension Diagnosed Hypertension


Figure 2.28. Stroke Awareness by Stroke History Status, N.C. Adults, 2007


19.5

87.5

17.818.0

81.8

14.7

0

10

20

30

40

50

60

70

80

90

100



Per

cen

t o

f P

op

ula

tio

n

No History of StrokeHistory of Stroke


Figure 2.29. Knowledge of Each Stroke Symptom by Stroke History Status, N.C. Adults, 2007


87.792.5

70.6

84.6

63.6

37.5

88.7

70.7

83.5

62.5

36.1

93.2

0

20

40

60

80

100

Confusion,Trouble

Speaking

Numbness,Weakness

TroubleSeeing

TroubleWalking,Loss ofBalance

SevereHeadache

Chest PainNot a

Symptom

Per

cen

t o

f P

op

ula

tio

n

No History of Stroke History of Stroke


Heart Disease Figures



Figure 3.1. Heart Disease and Leading Causes of Death, N.C., 2010

Heart Disease17,09022%

Stroke4,2815%

Other CVD1,8612%

Chronic Lower Respiratory

Disease4,4906%

Other Unintentional Injuries*2,7624%


Cancer18,01323%





Figure 3.2. Heart Disease Death Rates, 1979-2008

0

50

100

150

200

250

300

350

400

450

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e


Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51; 1979-1998: ICD-9 codes 390-398, 402, 404, 410-429 multiplied by comparability ratio of 0.9858. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 3.3. Heart Disease Death Rates by Age and Gender, N.C., 2008

Heart Disease: ICD-10 codes I00-I09, I11, I13, I20-I51.Rates per 100,000 population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Death

Rate

per

100,0

00

Females

Males

Total

Females 7.1 55.9 122.7 301.3 997.5 3786.2

Males 13.9 137.8 318.9 629 1553.5 4413.5

Total 10.6 95.6 216 450.4 1219.7 3969.8

<45 45-54 55-64 65-74 75-84 85+




Figure 3.4. Heart Disease Death Rates by Gender, N.C., 1979-2008


0

100

200

300

400

500

600

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e

Males

Females




Figure 3.5. Heart Disease Death Rates by Race, N.C., 1979-2008


0

100

200

300

400

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e African Americans

Whites




Figure 3.6. Heart Disease Death Rates by Race and Gender, N.C., 1979-2008


100150

200250300350

400450500

550600

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-a

dju

ste

d D

ea

th R

ate

African-American Males African-American FemalesWhite Males White Females




Figure 3.7. Percentage of Total Heart Disease Deaths by Age Group, Race, and Gender, N.C., 2004-2008

Heart Disease: 1999-2008: ICD-10 codes I00-I09, I11, I13, I20-I51. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

10.925.827.7

44.3

0102030405060708090

100

African-AmericanMales


White Females

Pe

rce

nta

ge

of

He

art

Dis

ea

se

De

ath

s <65 years 65+ years




Figure 3.8. Heart Disease Death Rates by County of Residence, N.C., 2006-2010

Heart Disease: ICD-10 codes I00-I09, I11, I13, I20-I51.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.N.C. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Volume 2: Leading Causes of Death in North Carolina 2010, 2011. http://www.schs.state.nc.us/schs/deaths/lcd/2010/.U.S. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

N.C. overall: 184.9

U.S. (2004-2008): 200.8

Death Rate

141.5 - 172.6

172.7 - 184.9

185.0 - 206.0

206.1 - 238.0

238.1 - 346.2






Congestive Heart Failure*

7,8404.8%


Stroke29,42918.1%

Coronary Heart Disease*

39,02224.0%

Other Heart Disease*

61,15137.7%

Figure 3.9. Number and Percentage of Total CVD Hospital Discharges that were Due to Heart Disease, N.C., 2010

All Heart Diseases: 108,013, 66.5% of CVD Hospitalizations*



Figure 3.10. Heart Disease Hospital Discharge Rates, N.C., 1995-2010

750

900

1,050

1,200

1,350

1,500

1,650

1,800

1,950

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Year

Ag

e-ad

just

ed D

isch

arg

e R

ate

Total

Males

Females

Heart Disease: ICD-9-CM Codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 3.11. Heart Disease Hospital Discharge Rates by Age and Gender, N.C., 2010

0

2,000

4,000

6,000

8,000

10,000

Age Group

Dis

char

ge

Rat

e p

er 1

00,0

00

Females 22.9 110.7 288.6 716.7 1,391.50 3,016.80 5,738.90 9,188.50

Males 22.3 128.2 475.8 1,268.80 2,526.50 4,683.50 7,309.80 10,360.20

Total 22.6 119.4 380.9 985 1,930.00 3,784.20 6,379.10 9,540.80

<25 25-34 35-44 45-54 55-64 65-74 75-84 85+

Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012.


Figure 3.12. Percentage of Heart Disease Hospitalizations by Age Group, N.C., 2010

39.645.8

32.5

010

2030

405060

7080

90100

Female Male Total

Pe

rce

nta

ge

of

Ho

sp

ita

liza

tio

ns

<65 years 65+ years

Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012.


Figure 3.13. Heart Disease Hospital Discharge Rates by County of Residence, N.C., 2006-2010

Heart Disease: ICD-9-CM codes: 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only; N.C. residents only.Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.

N.C. overall: 1143.9


389.5- 713.7

713.8 - 1143.9

1144.0 - 1289.5

1289.6 - 1634.7

1634.8 - 2173.9


Figure 3.14. Estimated Direct and Indirect Costs of CVD and Heart Disease, United States, 2008

$179.2

$95.5

$118.5

$94.8

0

50

100

150

200

250

300

Total CVD Heart Disease

Bil

lio

ns

of

Do

llar

s


Data Source: Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012; 125:e2–e220.


Figure 3.15. Heart Disease Hospital Charges, N.C., 1995-2010

$100,000,000

$600,000,000

$1,100,000,000

$1,600,000,000

$2,100,000,000

$2,600,000,000

$3,100,000,000

$3,600,000,000

$4,100,000,000

$4,600,000,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

To

tal H

osp

ital

Ch

arg

es in

201

1 D

olla

rs

Total

Males

Females

Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 3.16. Heart Disease: Average Hospital Charges per Stay, N.C., 1995-2010

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000

$50,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

Ch

arg

es p

er S

tay

in 2

011

Do

llar

s

TotalMalesFemales

Heart Disease: ICD-9-CM codes 391-392.0, 393-398, 402, 404, 410-416, 420-429; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 3.17. Annual Medicaid Costs due to Heart Disease and Other CVD, N.C., 2011


$177,403,772$189,045,580

$231,402,818

$75,022,000

$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000


An

nu

al M

edic

aid

Co

sts


Coronary Heart Disease Figures


Figure 4.1. Coronary Heart Disease, CVD, and Leading Causes of Death, N.C., 2010

Coronary Heart Disease 10507

13%Cancer18013 23%

All other causes30107 39%

Heart Failure16592%

Other Heart Disease 4924 6% Stroke

4281 5%

Other Unintentional Injuries27627%


4490 6%

Other CVD 18612%

*Unintentional injuries other than motor-vehicles injuries.Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/deaths/dms/2010/northcarolina.pdf.

http://www.schs.state.nc.us/schs/deaths/dms/2010/northcarolina.pdf



Figure 4.2. Coronary Heart Disease Death Rates, 1979-2008

0

50

100

150

200

250

300

350

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e


Coronary Heart Disease: 1999-2008: ICD-10 codes I20-I25; 1979-1998: ICD-9 codes 410-414, 429.2 multiplied by comparability ratio of 0.9990. Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 4.3. Coronary Heart Disease Death Rates & Healthy People 2020 Target, 2008

Healthy People 2010 Objective 12-1. Coronary Heart Disease: ICD-10 codes I11, I20-I25.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012.

126.0132.4

0

20

40

60

80

100

120

140

160

N.C. U.S.

Ag

e-a

dju

ste

d S

tro

ke

De

ath

Ra

te

2020 Target (100.8) 2010 Target (156.0)




Figure 4.4. Coronary Heart Disease Death Rates by Age and Gender, N.C., 2008

0

500

1,000

1,500

2,000

2,500

3,000

Death

Rate

per

100,0

00

Females

Males

Total

Females 2.8 31.3 74.9 191.2 625.4 2159.9

Males 6.8 95.3 238.2 457.1 1066.5 2816.9

Total 4.8 62.4 152.5 312.2 801.7 2352.1

<45 45-54 55-64 65-74 75-84 85+

Coronary Heart Disease: ICD-10 codes I20-I25. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 4.5. Coronary Heart Disease Death Rates by Gender, N.C., 1979-2008


50

100

150

200

250

300

350

400

450

500

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e

Males

Females




Figure 4.6. Death Rates by Race and Ethnicity & Healthy People 2020 Target, N.C., 2008

122.9

33.4

131.7119.7115.6

0

50

100

150

200

250

AmericanIndian/Alaska

Native

AfricanAmerican

White Hispanic Non-Hispanic

Ag

e-a

dju

ste

d C

oro

na

ry H

ea

rt D

ise

as

e

De

ath

Ra

te

Coronary Heart Disease Death Rate 2020 Target (100.8) 2010 Target (156.0)

Healthy People 2020 Objective 12-1. Coronary Heart Disease: ICD-10 codes I11, I20-I25.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2009. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html. Extracted by: Heart Disease and Stroke Prevention Branch, 8/28/2012.




Figure 4.7. Coronary Heart Disease Death Rates by Race, N.C., 1979-2008

75

125

175

225

275

325

375

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07Year

Ag

e-ad

just

ed D

eath

Rat

e African-Americans

Whites





Figure 4.8. Coronary Heart Disease Death Rates by Race and Gender, N.C., 1979-2008


25

75

125

175

225

275

325

375

425

475

525

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-ad

just

ed D

eath

Rat





Figure 4.9. Percentage of Total Coronary Heart Disease Deaths by Age Group, Race, and Gender, N.C., 2004-

2008

10.922.328.9

41.7

0102030405060708090

100

African-American Males


White Females

Pe

rce

nta

ge

of

CH

D D

ea

ths

<65 years 65+ years

Coronary Heart Disease: ICD-10 codes I20-I25.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.




Figure 4.10. Coronary Heart Disease Death Rates by County of Residence, N.C., 2004-2008

Coronary Heart Disease: ICD-10 codes I20-I25.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

N.C. overall: 129.6

U.S.: 135.3

Death Rate

88.1 - 108.3

108.4 - 129.6

129.7 - 149.6

149.7- 181.2

181.3 - 219.3




Figure 4.11. Number and Percentage of Total CVD Hospital Discharges that were Due to Coronary Heart

Disease, N.C., 2010




Stroke29,42918.1%


Congestive Heart Failure7,8404.8%


Figure 4.12. Coronary Heart Disease Hospital Discharge Rates, N.C., 1995-2010

200

300

400

500

600

700

800

900

1,000

1,100

1,200

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Year

Ag

e-ad

just

ed D

isch

arg

e R

ate

Total

Males

Females

Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 4.13. Coronary Heart Disease Hospital Discharge Rates by Age and Gender, N.C., 2010

Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012.

0

500

1,000

1,500

2,000

2,500

3,000

Age Group

Dis

char

ge

Rat

e p

er 1

00,0

00

Females 0.5 15.2 89.8 281.9 541.4 998.6 1460.3 1877.8

Males 0.9 28.4 198.5 647.2 1242.9 1996.6 2485.0 2634.7

Total 0.7 21.7 143.4 459.4 874.2 1458.1 1877.9 2105.6

<25 25-34 35-44 45-54 55-64 65-74 75-84 85+


Figure 4.14. Percentage of Coronary Heart Disease Hospitalizations by Age Group, N.C., 2010

47.352.139.6

010

2030

405060

7080

90100

Female Male Total

Per

cen

tag

e o

f H

osp

ital

izat

ion

s

<65 years 65+ years

Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/29/2012.


Figure 4.15. Coronary Heart Disease History and Knowledge among N.C. Adults by Age Group, 2009

0.0

9.6

82.7

8.1

0.8

10.6

88.2

9.5

2.0

14.1

13.1

6.0

17.7

88.5

15.5

12.9 18

.3

89.5

16.6

17.8

14.2

12.2

24.5

10.5

83.8

9.4

91.6

88.5

0102030405060708090

100

Had History of CHD(2010)

Knew All HeartAttack Symptoms

Would Call 911 forHeart Attack


Per

cen

t o

f P

op

ula

tio

n

18-24 25-34 35-44 45-54 55-64 65-74 75+



Figure 4.16. Coronary Heart Disease History and Knowledge among N.C. Adults by Race, 2009

7.6

17

.1

88

.3

15

.3

7.2

6.7

88

.9

6.0

2.7

9.1

93

.9

9.1

7.9

7.1

80

.6

6.0

4

84

.6

4.4

2.1

0

10

20

30

40

50

60

70

80

90

100

Had History ofCHD (2010)




Per

cen

t o

f P

op

ula

tio

n

WhiteAfrican AmericanAsianAmerican IndianOther Race



Figure 4.17. Coronary Heart Disease History and Knowledge among N.C. Adults by Education, 2009

12.1

5.2

80.6

3.57.9 10.3 9.26.7

15.2

88.9

13.920.2 18.2

88.190.7

4.7

0

10

20

30

40

50

60

70

80

90

100





Per

cen

t o

f P

op

ula

tio

n

< High School

High School or GED

Some Post-HS

College Grad



Figure 4.18. Coronary Heart Disease History and Knowledge among N.C. Adults by Household Income,

20091

2.8

6.5

84

.4

5.8

12

.6

8.3

87

.8

7.17.7 1

1.7

87

.0

10

.7

6.7

14

.7

86

.8

12

.2

5.4

18

.7

17

.7

3.7

19

.6

90

.2

17

.8

89

.5

0

10

20

30

40

50

60

70

80

90

100





Pe

rce

nt

of

Po

pu

lati

on

<$15,000$15,000-24,999$25,000-34,999$35,000-49,999$50,000-74,999$75,000+



Figure 4.19. Coronary Heart Disease Hospital Discharge Rates by County of Residence, N.C., 2006-2010

Coronary Heart Disease: ICD-9-CM codes: 410-414; Principal diagnosis only; N.C. residents only.Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.

N.C. overall: 440.7


95.9 - 279.9

280.0- 440.7

440.8 - 495.4

495.5 - 710.7

710.8 - 973.2


Figure 4.20. Coronary Heart Disease Hospital Charges, N.C., 1995-2010

$0

$500,000,000

$1,000,000,000

$1,500,000,000

$2,000,000,000

$2,500,000,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

To

tal H

osp

ital

Ch

arg

es in

201

1 D

olla

rs

Total

Males

Females

Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


$25,000

$30,000

$35,000

$40,000

$45,000

$50,000

$55,000

$60,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

Ch

arg

es p

er S

tay

in 2

011

Do

llar

s

Total

Males

Females

Coronary Heart Disease: ICD-9-CM codes 410-414; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.

Figure 4.21. Coronary Heart Disease: Average Hospital Charges per Stay, N.C., 1995-2010


Figure 4.22. Heart Attack Awareness, N.C. Adults, 2001-2009

9.6

87.7

8.610.7

87.4

9.311.3

87.6

10

88.2

12.510.5

87.3

11.3 14.0

0102030405060708090

100

Knew All Heart AttackSymptoms

Would Call 911 for HeartAttack

Knew All Symptoms &Would Call 911

Per

cent

of P

opul

atio

n

2001 2003 2005 2007 2009

Adults = ages 18+ years. Data not available in 2002, 2004, 2006, 2008.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.*Knew All Symptoms & Would Call 911 produced by State Center for Health Statistics, 06/22/2012.


Figure 4.23. Knowledge of Each Heart Attack Symptom, N.C. Adults, 2001-2009

47

.8

67

.8

87

.4

89

.9

33

.8

51

.4

69

.2

92

.2

85

.7

86

.7

32

.2

46

.3

60

.5

90

.3

84

.0

84

.4

40

.4

55

.6 65

.0

85

.4

86

.5

39

.7

95

.6

85

.4

86

.0

39

.8

92

.7

63

.5

48

.0

93

.2

0102030405060708090

100

Pain in Jaw,Neck, Back

Feeling Weak,Lightheaded,

Faint

Chest Pain Pain in Arms,Shoulder

Shortness ofBreath

TroubleSeeing Not a

Symptom

Per

cen

t o

f P

op

ula

tio

n

2001 2003 2005 2007 2009Adults = ages 18+ years. Data not available in 2002, 2004, 2006, 2008.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.


Figure 4.24. Heart Attack Awareness by Coronary Heart Disease History, N.C. Adults, 2007

11.0

87.6

10.215.8

84.5

13.9

0102030405060708090

100

Knew All Heart AttackSymptoms

Would Call 911 for HeartAttack

Knew All Symptoms &Would Call 911

Per

cen

t o

f P

op

ula

tio

n No History of CHDHistory of CHD

Adults = ages 18+ years. CHD= Coronary Heart Disease.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analyzed by the Heart Disease and Stroke Prevention Branch, 2010.


Adults = ages 18+ years. CHD= Coronary Heart Disease.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2010. Analyzed by the Heart Disease and Stroke Prevention Branch, 2010.

Figure 4.25. Knowledge of Each Heart Attack Symptomby Coronary Heart Disease History, N.C. Adults, 2007

47.0

63.8

39.4

61.3

46.8

86.085.592.8

61.3

86.885.291.7

0102030405060708090

100

Pain in Jaw,Neck, Back

FeelingWeak,

Lightheaded,Faint

Chest Pain Pain in Arms,Shoulder

Shortness ofBreath

TroubleSeeing Not a

Symptom

Per

cen

t o

f P

op

ula

tio

n

No History of CHD

History of CHD


Heart Failure Figures


Coronary Heart Disease 1050713%Cancer

18013 23%

All other causes30107 39%

Heart Failure16592%

Other Heart Disease 4924 6% Stroke

4281 5%

Other Unintentional Injuries27627%


4490 6%

Other CVD 18612%

Figure 5.1. Heart Failure, CVD, and Leading Causes of Death, N.C., 2010

*Unintentional injuries other than motor-vehicles injuries.Total Cardiovascular Disease, including congenital malformations: ICD-10 codes I00-I99, Q20-Q28. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. Leading Causes of Death in North Carolina, 2010. SCHS Online Database, 2011. http://www.schs.state.nc.us/schs/deaths/dms/2010/northcarolina.pdf.




Figure 5.2. Heart Failure Death Rates, 1979-2008

Heart Failure: 1999-2008: ICD-10 codes I50; 1979-1998: ICD-9 codes 428 multiplied by comparability ratio of 1.0410.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

0

5

10

15

20

25

30

'79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07

Year

Ag

e-A

dju

sted

Dea

th R

ate





Figure 5.3. Heart Failure Death Rates by Age and Gender, N.C., 2008

Heart Failure: ICD-10 codes I50. Rates per 100,000 population. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

0

100

200

300

400

500

600

Death

Rate

per

100,0

00

Females

Males

Total

Females 1.5 22.5 97.6 580.1

Males 2.2 40.3 140.8 568.2

Total 1.8 30.6 114.9 576.6

<65 65-74 75-84 85+




Figure 5.4. Smoothed* Heart Failure Death Rates by Gender, N.C., 1998-2008

* 3-year moving averages (i.e., smoothed rate shown for 1999 is an average of the 1998, 1999, and 2000 rates).Heart Failure: 1999-2008: ICD-10 codes I50; 1979-1998: ICD-9 codes 428 multiplied by comparability ratio of 1.0410.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1979-1998 and 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

0

5

10

15

20

25

30

35

40

45

50

'98 '99 '00 '01 '02 '03 '04 '05 '06 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e

Males

Females




Figure 5.5. Smoothed* Heart Failure Death Rates by Race, N.C., 1998-2008


0

5

10

15

20

25

30

'98 '99 '00 '01 '02 '03 '04 '05 '06 '07

Year

Ag

e-ad

just

ed D

eath

Rat

e African Americans

Whites





Figure 5.6. Smoothed* Heart Failure Death Rates by Race and Gender, N.C., 1998-2008

151617

1819202122

232425

'98 '99 '00 '01 '02 '03 '04 '05 '06 '07

Year

Ag

e-a

dju

ste

d D

ea

th R

ate

African-American Males African-American Females White Males White Females




Figure 5.7. Percentage of Total Heart Failure Deaths by Age Group, Race, and Gender, N.C., 2004-2008

Heart Failure: ICD-10 codes I50.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

27.19.5 15.9

4.10

10

20

30

40

50

60

70

80

90

100

African-American

Males


White Females

Per

cen

tag

e o

f H

eart

Fai

lure

Dea

ths <65 years 65+ years




Figure 5.8. Heart Failure Death Rates by County of Residence, N.C., 2003-2008

Heart Failure: ICD-10 codes I50.Rates per 100,000 population, age-adjusted to the 2000 U.S. standard population.* Rates based on fewer than 20 deaths may be unreliable, should be interpreted with caution, and are not mapped.Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File, 1999-2008. CDC WONDER Online Database, 2011. http://wonder.cdc.gov/mortSQL.html.

N.C. Overall: 18.5

U.S.: 18.3

Death Rate

0.0 - 12.9

13.0 - 18.5

18.6 - 21.1

21.2 - 26.2

26.3 - 38.9

<20 deaths*




Figure 5.9. Number and Percentage of Total CVD Hospital Discharges that were Due to Congestive

Heart Failure, N.C., 2010




Stroke29,42918.1%


Congestive Heart Failure

7,8404.8%


Figure 5.10. Congestive Heart Failure Hospitalization Rates & Healthy People 2010 Targets

2.6

5.2

10.7

19.7

6.5

13.5

26.5

32.9

8.5

0

5

10

15

20

25

30

35

65-74 years 75-84 years 85+years

Ho

sp

itali

zati

on

Rate

North Carolina

United States

2010 Target

Healthy People 2010 Objective 12-06. Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis. Age-specific rates per 1,000 population.Data Source: Healthy People 2020, Online Database, 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=21, and North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.




Figure 5.11. Congestive Heart Failure Hospital Discharge Rates, N.C., 1995-2010

Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Discharge rates per 100,000 population, age-adjusted to the U.S. 2000 standard population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012.

0

50

100

150

200

250

300

350

400

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Year

Ag

e-ad

just

ed D

isch

arg

e R

ate

Total

Males

Females


Figure 5.12. Congestive Heart Failure Hospital Discharge Rates by Age and Gender, N.C., 2010

0

200

400

600

800

1,000

1,200

1,400

Age Group

Dis

char

ge

Rat

e p

er 1

00,0

00

Females 1.0 9.2 19.3 46.5 92.2 219.7 471.6 1005.8

Males 1.6 6.7 20.9 62.8 132.9 308.0 591.6 1217.9

Total 1.3 7.9 20.1 54.4 111.5 260.3 520.5 1069.4

<25 25-34 35-44 45-54 55-64 65-74 75-84 85+

Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Discharge rates per 100,000 population. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 5.13. Percentage of Congestive Heart Failure Hospitalizations by Age Group, N.C., 2010

30.935.226.8

010

203040

50607080

90100

Female Male Total

Pe

rce

nta

ge

of

Ho

sp

ita

liza

tio

ns

<65 years 65+ years

Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Provisional Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012.


Figure 5.14. Congestive Heart Failure Hospital Discharge Rates by County of Residence, N.C., 2006-2010

Congestive Heart Failure: ICD-9-CM codes: 428.0; Principal diagnosis only; N.C. residents only.Discharge rates per 100,000 population age-adjusted to the U.S. 2000 standard population.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 2006-2010. Produced by: State Center for Health Statistics, 06/08/2012.

N.C. overall: 169.8


53.9 - 123.2

123.3 - 169.8

169.9 - 232.9

233.0 - 336.9

337.0 - 464.7


Figure 5.15. Congestive Heart Failure Hospital Charges, N.C., 1995-2010

$0

$100,000,000

$200,000,000

$300,000,000

$400,000,000

$500,000,000

$600,000,000

$700,000,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

To

tal

Ho

spit

al C

har

ges

in

201

1 D

oll

ars

Total

Males

Females

Congestive Heart Failure: ICD-9-CM codes 428.0; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 5.16. Congestive Heart Failure: Average Hospital Charges per Stay, N.C., 1995-2010

$10,000

$15,000

$20,000

$25,000

$30,000

'95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10Year

Ch

arg

es p

er S

tay

in 2

011

Do

llar

s TotalMalesFemales

Congestive Heart Failure: ICD-9-CM Codes 428.0; Principal diagnosis only. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Inpatient Hospital Discharges, 1995-2010. Produced by: State Center for Health Statistics, 06/08/2012. Charges adjusted to 2011 dollars using the Bureau of Labor Statistics Consumer Price Index tables for Medical Care for years 1995-2012, U.S. city average, not seasonally adjusted.


Figure 5.17. Annual Medicaid Costs due to Congestive Heart Failure and Other CVD, N.C., 2011


$177,403,772

$189,045,580

$231,402,818

$75,022,000

$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000


An

nu

al M

edic

aid

Co

sts


High Blood Pressure Figures


Figure 6.1. Blood Pressure Checked within Past 2 Years, 1991-2009

50

55

60

65

70

75

80

85

90

95

100

'91 '92 '93 '95 '97 '99 '01 '05 '09

Year

Per

cen

tag

e o

f A

du

lts


Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.US Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention.Data not available for N.C. in 1994, 1996, 1998, 2000, 2002-2004, 2006-2008; data not available for U.S. in 1991, 1992, 1994, 1996, 1998, 2000-2009.


Figure 6.2. Blood Pressure-related Measures among N.C. Adults by Age Group, 2009

22.6

11.4

41.7

60.3

81.2

7.0

93.4 92.0

20.4

94.496.1

34.4

90.8

97.5

50.4

99.1 94.6

62.0

99.096.2

65.7

0

10

20

30

40

50

60

70

80

90

100

Blood Pressure Checked within thePast 2 Years

Have High Blood Pressure Taking Medication for High BloodPressure

Per

cen

t o

f P

op

ula

tio

n

18-24 25-34 35-44 45-54 55-64 65-74 75+

Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.


Figure 6.3. Blood Pressure Checked within Past 2 Years, by Gender, N.C., 1991-2009

50

55

60

65

70

75

80

85

90

95

100

'91 '92 '93 '95 '97 '99 '01 '05 '09

Year

Per

cen

tag

e o

f A

du

lts

Males

Females

Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002-2004, 2006-2008.


Figure 6.4. Blood Pressure-related Measures among N.C. Adults by Race and Gender, 2009

39.4 42.3

80.4

97.0

79.1

33.0

94.5 89.697.4

85.0

29.4

97.8

0102030405060708090

100

Blood Pressure Checkedwithin the Past 2 Years

Have High BloodPressure

Taking Medication forHigh Blood Pressure*

Per

cen

t o

f P

op

ula

tio

n

African American Men White Men African American Women White Women

* Among those who have high blood pressure.Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.Blood pressure screening data is from 2005, all other data are from 2009.


* Among those who have high blood pressure.Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.

31.1

82.1

97.2

41.0

14.0

75.3

92.6

38.1

61.1

82.1

12.6

96.3

85.7

96.0

56.1

0102030405060708090

100




Per

cen

t o

f P

op

ula

tio

n

White African American Asian American Indian Other Race

Figure 6.5. Blood Pressure-related Measures among N.C. Adults by Race, 2009


Figure 6.6. Blood Pressure Checked within Past 2 Years, by Race, N.C., 1991-2009

80

85

90

95

100

'91 '92 '93 '95 '97 '99 '01 '05 '09

Year

Per

cen

tag

e o

f A

du

lts

African-Americans

Whites

Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002-2004, 2006-2008.


Figure 6.7. Blood Pressure-related Measures among N.C. Adults by Education, 2009


89.3

38.4

85.4 82.2

30.5

79.0

97.7

25.1

80.7

36.2

95.4 95.8

0

20

40

60

80

100




Pe

rce

nt

of

Po

pu

lati

on

< High School High School or GED Some Post-HS College Grad


93.9

40.5

86.8

40.7

96.9

31.0

83.3

98.0

78.081.4

35.6

90.2

79.2

94.9

75.3

29.8

98.1

24.3

0

20

40

60

80

100




Per

cen

t o

f P

op

ula

tio

n

<$15,000 $15,000-24,999 $25,000-34,999

$35,000-49,999 $50,000-74,999 $75,000+

Figure 6.8. Blood Pressure-related Measures among N.C. Adults by Household Income, 2009



Figure 6.9. Estimated Direct and Indirect Costs of CVD and Hypertensive Disease, United States, 2008

$179.2

$47.3

$118.5

$3.3

0

100

200

300

400

500

600

Total CVD Hypertensive Disease

Bil

lio

ns

of

Do

llar

s




Figure 6.10. Hypertension Prevalence, 1990-2009

Adults = ages 18+ years.1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive.NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012 . US Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention.Data not available for U.S. in 1990-1993; data not available for N.C. or U.S. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.

0

5

10

15

20

25

30

35

40

45

50

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts



Figure 6.11. Annual Medicaid Costs due to Hypertension and Other CVD, N.C., 2011


$177,403,772$189,045,580

$231,402,818

$75,022,000

$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000


An

nu

al M

edic

aid

Co

sts


0

5

10

15

20

25

30

35

40

45

50

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

Males

Females

Figure 6.12. Hypertension Prevalence, by Gender, N.C., 1990-2009

Adults = ages 18+ years.1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive.NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.


0

20

40

60

80

100

Age Group

Per

cen

tag

e o

f A

du

lts

Whites

African Americans

Total

Whites 5.9 10.5 19.8 29.7 47.7 59.9

African Americans 8.6 18.1 30.4 52.6 65.4 82.6

Total 7.0 11.4 20.4 34.4 50.4 63.9

18-24 25-34 35-44 45-54 55-64 65+

Figure 6.13. Hypertension Prevalence by Age and Race, N.C., 2009

Adults = ages 18+ years.Race specific data combines 65-74 & 75+ categories.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.


Figure 6.14. Hypertension Prevalence, by Race, N.C., 1990-2009

0

5

10

15

20

25

30

35

40

45

50

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

African-Americans

Whites

Adults = ages 18+ years.1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive.NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.


Figure 6.15. Percentage of People with Diagnosed Hypertension who are Taking Anti-Hypertensive

Medication, N.C. Adults, 2001-20097

4.9

68

.9

79

.7

74

.6

74

.8

76

.0

73

.7 78

.0

75

.5

77

.5

77

.4

73

.8 80

.6

78

.9

78

.882

.3

78

.8 85

.4

82

.1

84

.1

81

.6

77

.3 85

.7

85

.7

82

.1

0102030405060708090

100

NC Overall Men Women AfricanAmericans

Whites

Per

cen

t o

f P

eop

le w

ith

Hyp

erte

nsi

on

2001 2003 2005 2007 20091990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive. Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.Data not available for N.C. in 2002, 2004, 2006, 2008.


Figure 6.16. Use of Anti-Hypertensive Medication by Race and Gender, N.C. Adults, 2001-2009

74

.9

67

.6

78

.9

80

.0

76

.0

69

.6 75

.0 79

.8

79

.8

77

.4

74

.2

75

.7 82

.4

81

.6

82

.3

75

.8 81

.8 86

.9

86

.3

80

.4

79

.1 85

.0

68

.8

89

.6

81

.6

010

2030

4050

607080

90100

NC Overall African-American Men

White Men African-AmericanWomen

White Women

Per

cen

t o

f P

eop

le w

ith

Hyp

erte

nsi

on

2001 2003 2005 2007 2009

1990-2001 included women diagnosed with high blood pressure only while pregnant as hypertensive, while 2003 and later years data do not consider them to be hypertensive.Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.Data not available for N.C. in 2002, 2004, 2006, 2008.


High Blood Cholesterol Figures


Figure 7.1. Cholesterol Checked within Past 5 Years, 1990-2009

50

55

60

65

70

75

80

85

90

95

100

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts


Adults = ages 18+ years.North Carolina Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.U.S. Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention.Data not available for U.S. in 1990-1992; data not available for N.C. or U.S. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.


Figure 7.2. Cholesterol-related Measures among N.C. Adults by Age Group, 2009

* Among those who have ever had their blood cholesterol checked.Adults = ages 18+ years. Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.

38.1

13.2

61.7

19.0

79.5

31.4

88.2

42.9

93.1

53.558.0

52.4

96.3 96.0

0102030405060708090

100

Blood Cholesterol Checked withinthe Past 5 Years

Diagnosed with High Cholesterol*

Per

cen

t o

f P

op

ula

tio

n

18-24 25-34 35-44 45-54 55-64 65-74 75+


50

55

60

65

70

75

80

85

90

95

100

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

Males

Females

Figure 7.3. Cholesterol Checked within Past 5 Years, by Gender, N.C., 1990-2009

Adults = ages 18+ years.NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012 . Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.


Figure 7.4. Cholesterol-related Measures among N.C. Adults by Race and Gender, 2009


75.7

40.3

80.8 79.3

37.2 39.342.9

83.3

0102030405060708090

100

Blood Cholesterol Checked within Past5 Years


Pe

rce

nt

of

Po

pu

lati

on

African American Men White Men African American Women White Women



Figure 7.5. Cholesterol-related Measures among N.C. Adults by Race, 2009

82.1

41.0

77.7

38.5

79.3

31.9

66.2

35.6

44.6

32.4

0102030405060708090

100

Blood Cholesterol Checked within Past5 Years


Per

cen

t o

f P

op

ula

tio

n

White African American Asian American Indian Other Race


Figure 7.6. Cholesterol Checked within Past 5 Years, by Race, N.C., 1990-2009

Adults = ages 18+ years. NC Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012. Data not available for N.C. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.

50

55

60

65

70

75

80

85

90

95

100

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

African-Americans

Whites


Figure 7.7. Cholesterol Checked within Past 5 Years, by Race and Gender, N.C., 1990-2009


45

50

55

60

65

70

75

80

85

90

95

100

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

African-American MalesAfrican-American FemalesWhite MalesWhite Females


Figure 7.8. Cholesterol-related Measures among N.C. Adults by Education, 2009

* Among those who have ever had their blood cholesterol checked.Adults = ages 18+ years.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.

60.0

49.1

74.2

45.0

79.0

38.7

89.2

34.3

0102030405060708090

100

Blood Cholesterol Checked withinPast 5 Years


Per

cen

t o

f P

op

ula

tio

n

< High School High School or GED Some Post-HS College Grad


Figure 7.9. Cholesterol-related Measures among N.C. Adults by Household Income, 2009


62.9

48.0

71.1

47.6

76.6

44.6

83.0

36.2

85.3

40.3

88.5

33.4

0

20

40

60

80

100

Blood Cholesterol Checked withinPast 5 Years


Pe

rce

nt

of

Po

pu

lati

on

<$15,000 $15,000-24,999 $25,000-34,999

$35,000-49,999 $50,000-74,999 $75,000+


Figure 7.10. High Cholesterol Prevalence, 1990-2009

Adults = ages 18+ years.North Carolina Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 06/2012.U.S. Data Source: National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention.Data not available for U.S. in 1990-1993; data not available for N.C. or U.S. in 1994, 1996, 1998, 2000, 2002, 2004, 2006, 2008.

0

5

10

15

20

25

30

35

40

45

50

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts



Figure 7.11. High Cholesterol Prevalence, by Gender, N.C., 1990-2009


0

5

10

15

20

25

30

35

40

45

50

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

Males

Females


Figure 7.12. High Cholesterol Prevalence, by Race, N.C., 1990-2009


0

5

10

15

20

25

30

35

40

45

50

'90 '91 '92 '93 '95 '97 '99 '01 '03 '05 '07 '09

Year

Per

cen

tag

e o

f A

du

lts

African-Americans

Whites


Other Risk Factors Figures


Figure 8.1. Prevalence of Physical Activity-related Measures among Adults

Adults = ages 18+ years.*During the past month, did you participate in any physical activities?** Engaging in at least 30 minutes of moderate activity per day on 5 or more days of the week, or at least 20 minutes of vigorous activity per day on 3 or more days of the week.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Branch, 08/2012.

25.7

46.4

24.0

50.6

0

10

20

30

40

50

60

70

80

90

100

No Exercise* (2010) Recommended Physical Activity**(2009)

Per

cen

t o

f P

op

ula

tio

n



Figure 8.2. Prevalence of Physical Activity-related Measures among High School Students, 2011

47.6

34.7

49.5

32.4

0

10

20

30

40

50

60

70

80

90

100

Meet Recommended Levels ofPhysical Activity*

Watch 3+ Hours of TV on AverageSchool Day

Per

cen

t o

f P

op

ula

tio

n


* Physically active for a total of 60 minutes or more per day on 5 or more of the past 7 days.Data Source: Centers for Disease Control and Prevention. 2011 Youth Risk Behavior Survey. Available at: www.cdc.gov/yrbs. Accessed on 8/17/2012.

http://www.cdc.gov/healthyyouth/yrbs/index.htm


Figure 8.3. Prevalence of Daily Consumption of 5+ Fruits and Vegetables among Adults, 2009

20.6 23.5

0

10

20

30

40

50

60

70

80

90

100


Per

cen

t o

f P

op

ula

tio

n

Adults = ages 18+ years.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Branch, 08/2012.


Figure 8.4. Prevalence of Daily Consumption of 5+ Fruits and Vegetables among High School Students, 2011

19.4 21.4

0

10

20

30

40

50

60

70

80

90

100

North Carolina United States (2007)

Per

cen

t o

f P

op

ula

tio

n

N.C. Data Source: North Carolina Department of Public Instruction. 2011 Youth Risk Behavior Survey. Available at: http://www.nchealthyschools.org/docs/data/yrbs/2011/statewide/high-school.pdf Accessed on 8/17/2012.U.S. Data Source: Centers for Disease Control and Prevention. 2007 Youth Risk Behavior Survey. www.cdc.gov/yrbs.

http://www.cdc.gov/yrbs


Figure 8.5. Prevalence of Tobacco Use-related Measures among Adults, 2010

19.8

60.5

17.3

52.4

0

10

20

30

40

50

60

70

80

90

100

Current Cigarette Smoking Tried to Quit Smoking in Past Year

Per

cen

t o

f P

op

ula

tio

n


Adults = ages 18+ years.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011. Extracted by: Heart Disease and Stroke Prevention Branch, 08/2012 and National Centers for Disease Control and Prevention, 2011. Quitting Smoking Among Adults--- United States, 2001--2010 . MMWR 2011; 60 (No. 44): 1514.


Figure 8.6. Prevalence of Tobacco Use-related Measures among Students

4.27.45.2

8.215.5

22.517.2

23.9

0

10

20

30

40

50

60

70

80

90

100

Current Cigarette Smoking Any Current Tobacco Use

Per

cen

t o

f P

op

ula

tio

n

NC Middle School (2011) US Middle School (2009)

NC High School (2011) US High School (2009)

N.C. Data Source: 2011 North Carolina Youth Tobacco Survey. http://www.tobaccopreventionandcontrol.ncdhhs.gov/data/yts/yts11/NC-YTS-SummaryTablesStatewide-2011-051512FINAL.pdf.U.S. Data Source: Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students --- United States, 2000--2009. MMWR 2010; 59(No. 33): 1064. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a2.htm.


Figure 8.7. Prevalence of Overweight and Obesity among Adults, 2010

36.7

28.6

65.3

36.2

27.6

63.8

0

10

20

30

40

50

60

70

80

90

100

Overweight Obese Overweight or Obese

Per

cen

t o

f P

op

ula

tio

n


Overweight: BMI >= 25.0 and <30.0; Obese: BMI >= 30.0; Overweight or Obese: BMI >= 25.0.Adults = ages 18+ years.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Prevention Branch, 08/2012.


Figure 8.8. Prevalence of Overweight and Obesity among High School Students, 2011

15.912.915.2 13.0

0

10

20

30

40

50

60

70

80

90

100

Overweight Obese

Per

cen

t o

f P

op

ula

tio

n


Overweight: BMI >= 85th and <95th Percentile; Obese: BMI >= 95th Percentile.Data Source: Centers for Disease Control and Prevention. 2011 Youth Risk Behavior Survey. Available at: www.cdc.gov/yrbs. Accessed on 8/17/2012.

http://www.cdc.gov/healthyyouth/yrbs/index.htm


15.625.8 28

16.1

17.1 18.1

0

10

20

30

40

50

60

70

80

90

100

2-4 Years (2010) 5-11 Years 12-18 Years

Per

cen

t o

f P

op

ula

tio

n

Overweight

Obese

Overweight: BMI >= 85th and <95th Percentile; Obese: BMI >= 95th Percentile; Overweight or At-risk for Overweight: BMI >= 85th Percentile.Data from age group 2-4 years are from 2010, all other age groups are from 2009 data.Data Source: N.C. Nutrition and Physical Activity Surveillance System data. http://www.nutritionnc.com/nutrsurv.htm

Figure 8.9. Prevalence of Overweight and Obesity among Children seen in N.C. Public Health Clinics by Age Group


Figure 8.10. Prevalence of Diagnosed Diabetes among Adults, 2010

9.8 8.7

0

10

20

30

40

50

60

70

80

90

100


Per

cen

t o

f P

op

ula

tio

n

Adults = ages 18+ years.Data Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, SCHS Online Database, 2011 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Prevention Branch, 08/2012.


Figure 8.11. Estimated Number of Adults with Chronic High Blood Glucose Levels, N.C., 2010

711,000 **711,000 **

223,000++

2,442,000+

461,000 *

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

NC BRFSS National

Nu

mb

er o

f A

du

lts Pre-Diabetes

Undiagnosed DiabetesDiagnosed Diabetes

*Estimate is based on self-report of diagnosed pre-diabetes in the 2010 NC BRFSS survey.**Estimate is based on self-report of diagnosed diabetes in the 2010 NC BRFSS survey.+Estimate is obtained by applying the estimated national prevalence of pre-diabetes among adults 20 years or older of 35 percent (National Diabetes fact sheet, 2011) to the 2010 NC population of the same age group.++Estimate is obtained by applying the estimated national prevalence of undiagnosed diabetes among adults 20 years or older of 3.2 percent (National Diabetes fact sheet, 2011) to the 2010 NC population of the same age group.N.C. Source: North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System, 2012 and National Behavioral Risk Factor Surveillance System Data, Center for Disease Control & Prevention. Extracted by: Heart Disease and Stroke Branch: 08/2012.U.S. Source: Center for Disease Control and Prevention. National diabetes facts sheet: national estimates and general information on diabetes and pre-diabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.

Documents

The Burden of CVD in N.C. – September, 2012 N.C. Justus-Warren Heart Disease & Stroke Prevention Task Force Cardiovascular Disease Figures