The Impact of Cardiovascular Disease and Its Major Component Coronary Heart Disease on Human Health

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Cardiovascular disease is the most prevalent threat to life and health in the United States.1,2 It is the major cause of mortality, with 44% of deaths, and it is a major cause of morbidity.3 A major cardiovascular disease develops in 1/3 of men and 1/10 of women before the age of 60.4 The incidence of major cardiovascular events in men increases dramatically with age, from 7 events/1,000 people at age 35-44 to 68 events/1,000 people at age 85-94; comparable rates occur for women about 10 years later in life, but the difference narrows with age.5 In the United States, the cost of medical care is higher for cardiovascular disease than for any other diagnostic group.3 This diagnostic group includes the major forms of cardiovascular disease, which are coronary heart disease, stroke, congestive heart failure, pulmonary embolism, cardiac dysrhythmias, hypertensive disease, and peripheral artery disease. Together, these diseases are a massive burden on our health care system.

J.L. Holtzman (ed.), Atherosclerosis and Oxidant Stress: A New Perspective. © Springer 2007

Coronary heart disease accounts for approximately two-thirds of all cardiovascular disease and approximately 50% of the coronary heart disease patients have had myocardial infarctions.1,5 Coronary heart disease alone is the major cause of death in men over 40 years and women older than 64 years.6 It is the leading cause of death in adults over the age of 35 and accounts for greater than 25% of all deaths.6 In 1998 there were approximately one-half million deaths attributable to coronary heart diseases and a lower, but similar number of deaths has continued to occur in recent years.5 Approximately, 800,000 new cardiovascular events and 450,000 recurrent events occur each year.3 The lifetime risk of coronary heart disease, at age 40, is about 1 in 2 for men and 1 in 3 for women.7 The lifetime risk remains high with a 35% chance for men and a 25% chance for women at age 70. Coronary heart disease is the third most frequent cause of short stay hospitaliza-tions and ranks among the greatest cost per hospital admission and is also the leading cause of premature permanent disability.8 The cost of medical care for coronary heart disease has been estimated at $53 billion in direct costs plus 47 billion in indirect costs per year.1

The incidence of cardiovascular disease is disproportionate across gender and ethnic groups. The most pronounced difference is in the incidence of CHD in men vs. women. The mortality rate is 4.5 times greater in men than women aged 25-34 years old.2 This ratio declines to about 1.5 for the age group from 75 to 84 years. Regarding ethnic groups, the incidence of coronary heart disease is higher in African-Americans as compared to Caucasians;2 the lowest rates of these three groups occur in Hispanics.9

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