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Heart Disease, Stroke Still Big Killers

Latest U.S. statistics suggest obesity, smoking are largely to blame

THURSDAY, Dec. 28, 2006 (HealthDay News) -- Rising obesity and poor nutrition are keeping heart disease at the top of the list of America's fatal illnesses, according to the 2007 edition of the American Heart Association's annual statistical round-up.

"Changes in lifestyle behaviors such as healthy diet and exercise could reduce the burden of cardiovascular disease," Wayne Rosamond, an epidemiologist at the University of North Carolina and chairman of the committee that drew up the report, said in a statement.

Instead, cardiovascular disease remains the nation's leading cause of death, accounting for 36.3 percent of all deaths, said the report, published in the journal Circulation. Heart disease topped the list of causes of death for Americans, with stroke third (behind cancer).

Stroke got special mention in this year's AHA report. Some 700,000 Americans experience a stroke each year, and the report concentrates on transient ischemic attacks (TIAs), often called "mini-strokes." These attacks are temporary arterial blockages that produce milder stroke-like symptoms that do not persist.

"People underestimate the importance of TIAs," Virginia Howard, assistant professor of epidemiology at the University of Alabama at Birmingham and chairwoman of the association's stroke statistics committee, said in a prepared statement. "About half of patients who have a TIA fail to report it to their health care provider, which is a terrible oversight considering the chance of a major stroke in the weeks or months following TIA."

On the more hopeful side, the report noted that the U.S. death rate from stroke had fallen by 20.4 percent from 1994 to 2004.

Surveying the risk factors for stroke and heart disease, the report found that nearly one in three adults have high blood pressure, and a third have readings close enough to high blood pressure to prompt clinical concern.

The nutrition news was also discouraging.

In 2005, more than three-quarters of adults reported eating fewer than five servings of fruits and vegetables daily. Only 30 percent of high school seniors said they ate green vegetables "nearly every day or more," down from 50 percent in 1980. Just 21.4 percent of boys and 18.7 percent of girls in grades 9 to 12 reported eating fruits and vegetables five times a day or more.

Nor was there much to cheer about on the obesity front. Nearly 14 percent of preschool children ages 2 to 5 were overweight in 2003-2004 -- up from 10.3 percent in 1999-2000. Overweight in children 6 to 11 rose from 4 percent in 1971-1974 to 17.5 percent in 2001-2004; the rate among those 12 to 19 increased from 6.1 percent to 17 percent during the same period.

And the ongoing Framingham Heart Study indicated that the incidence of diabetes -- a major risk factor for cardiovascular disease -- has doubled from the 1970s through the 1990s.

Progress has been made against smoking, regarded as the deadliest risk factor. Blood tests of cotinine, a measure of nicotine intake, showed that 59 percent of children were exposed to second-hand smoke in 1999-2002, down from 88 percent in 1988-1994. About 11 percent of homes with children had regular smokers in 2003, down from 29 percent in 1994.

Still, one of every five American adults smokes, the heart association said. Male smokers die 13.2 years earlier than nonsmokers, and women smokers die 14.5 years earlier.

Medical science is helping Americans who go to the hospital with cardiovascular disease. According to the AHA, the association's Get With the Guidelines program, instituted in 587 hospitals, is helping medical centers stick to evidence-based treatment guidelines. The hospitals reported an 86.3 percent adherence to coronary artery disease guidelines, 88 percent adherence to stroke guidelines and 82.5 percent adherence to a newer heart-failure guideline effort.

"These programs are showing positive indicators for improvement," Rosamond said. "Get With the Guidelines is a way to follow quality over time and identify areas of improvement. The heart failure program is a continuation of a successful effort, and overall composite indicators are quite good."

More information

You can get all the latest heart disease statistics from the American Heart Association.

SOURCE: Dec. 29, 2006, statement, American Heart Association, and Circulation
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