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Heart Disease Remains Top Killer in U.S.

Group also marks milestones for 2003

WEDNESDAY, Dec. 31, 2003 (HealthDayNews) -- Once again, cardiovascular disease retains its position as America's No. 1 killer.

In 2001, cardiovascular disease (CVD) killed 931,108 Americans. By comparison, that same year, cancer killed 553,768 Americans; accidents, 101,537, Alzheimer's disease, 53,852; and HIV/AIDS claimed 14,175 lives.

CVD is the umbrella term that includes high blood pressure, heart attack, angina, congestive heart failure, stroke, and congenital heart defects.

This is just one statistic appearing in the American Heart Association's (AHA's) Heart Disease and Stroke Statistics 2004 Update, released on Wednesday. The statistics are for 2001 or the most recent year for which data are available.

"Cardiovascular disease remains the leading killer of men and women," affirms Dr. Christopher O'Donnell, chairman of the AHA statistics committee and associate director of the Framingham Heart Study in Boston, Mass. "One item of good news is that potentially at least three major risk factors - obesity, cigarette smoking and hypertension -- are modifiable, although they remain very highly prevalent."

The update also shows that stroke was the third leading cause of death in the United States, with about 700,000 people experiencing a new or recurrent stroke.

"I'm very excited that this statistics group is paying more attention to stroke, and we have a new subcommittee that looks at stroke as a separate part," says Virginia Howard, chairwoman of the AHA's new stroke statistics subcommittee.

In terms of geography, Puerto Rico celebrated the lowest death rate for CVD in 2000, while Mississippi had the highest. Minnesota experienced the biggest decrease, with a 26.6 percent lower death rate in 2000 compared to a decade earlier.

South Carolina had the highest death rate from stroke in 2000, while New York had the lowest. The District of Columbia experienced the biggest decrease in stroke death rate in 2000, with a 26.6 percent decline from 1990. Alaska had the greatest increase, with a 7 percent higher rate in 2000 than 10 years earlier.

Also on Wednesday, the AHA released a list of the top 10 advances for 2003. Leading the list were new high blood pressure guidelines that incorporate a new classification -- "prehypertension" -- to identify people at risk for chronic high blood pressure. Other advances, appearing in order:

  • Ximelagatran, a new oral blood thinner to prevent blood clots, was approved as the first alternative in half a century to the old stalwart warfarin.
  • Research showed that automated external defibrillators (AEDs) in public places such as airports and shopping malls could double the chances that a heart attack victim will survive.
  • The U.S. Food and Drug Administration (FDA) approved eplerenone to treat congestive heart failure following a heart attack.
  • Studies showed that a patient's own transplanted bone marrow cells could regenerate heart muscle that had been damaged during a heart attack.
  • Drug-coated stents proved their mettle as a treatment for blocked arteries in the real world, and not just in clinical trials.
  • Researchers identified a genetic mutation that causes familial thoracic aortic aneurysm and dissection (TAAD), an inherited disorder in which the aorta enlarges until it bursts.
  • A substance extracted from the saliva of vampire bats appears to be an effective clot buster for people who have had ischemic stroke.
  • In studies, infusions of "good" cholesterol strip dangerous plaque from arteries.
  • And a new test that measures C-reactive protein, an inflammatory marker, may help identify people at risk for heart disease.

While all of this is good news, the bottom line for all Americans should be preventing the risk factors for heart disease, says Howard, an assistant professor of epidemiology at the University of Alabama at Birmingham.

"Don't develop diabetes or hypertension," she adds. "The message is probably not getting through yet, but we've made tremendous progress."

More information

New statistics will be available at the American Heart Association in January 2004. The AHA also has information on heart attacks.

SOURCES: Virginia Howard, M.S.P.H., chair, stroke statistics subcommittee, American Heart Association, and assistant professor of epidemiology, University of Alabama, Birmingham; Christopher O'Donnell, M.D., MPH, chair, AHA statistics committee, and associate director, Framingham Heart Study, Boston; Dec. 31, 2003, American Heart Association statistics
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