Stroke

The overall age-adjusted mortality rate (AAMR) for stroke in Texas declined from 66.3 per 100,000 in 1999 to 52.1 per 100,000 in 2005. The decrease was statistically significant. Females have significantly higher risk of dying from stroke than males. Among the race/ethnicity groups, African Americans have significantly higher stroke mortality rates compared to Whites, Hispanics and other races. AAMR for Whites showed a significant decrease from a high of 65.7 per 100,000 in 2001 to 50.7 per 100,000 in 2005.

Cardiovascular disease (CVD) refers to any of the disorders that affect the circulatory system, including coronary heart disease, congestive heart failure and stroke. One in three American adults, or an estimated 80.7 million people, has one or more types of cardiovascular disease. In 2007, about 1.5 million Texas adults had been diagnosed with CVD or stroke. The American Heart Association has estimated the direct and indirect cost of CVD in the US for 2008 will be $448.5 billion.

B. Mortality

Cardiovascular disease is a grouping of vascular diseases that affects the heart and circulatory system. Heart disease and stroke—the two most common forms of cardiovascular disease (CVD)—are the first and third leading causes of death in the United States and in Texas. CVD causes more deaths among both genders and all racial and ethnic groups than any other disease.

Ischemic Heart DiseaseThe overall age-adjusted mortality rate (AAMR) for ischemic heart disease (IHD) declined from 202.4 per 100,000 in 1999 to 151.8 per 100,000 in 2005. The decrease was statistically significant. AAMR for males and females and for Whites and African Americans also showed significant decline during the same period. AAMR for Hispanics, however, stayed relatively level through 2002, and then showed a significant decline after 2005. In addition, among the race/ethnicity groups, African Americans have a higher risk of dying from IHD than Whites, Hispanics and other races.

C. Financial Burden

The total hospital charges for CVD diagnoses have increased each year from 2001 to 2006. Among the specific CVD diseases, total hospital charges were highest for ischemic heart disease, followed by congestive heart failure, ischemic stroke, and hemorrhagic stroke.

Prevalence of Stroke by Gender & Race, Adults 18+— Texas 2007

Data source:: BRFSS, Center for Health Statistics, DSHS, 2007

Current Toll on Texas TODAY

Prevalence of Heart Disease by Gender & Race, Adults 18+— Texas 2007

Data source: Texas Vital Statistics Unit, Center for Health Statistics, DSHS, 1999-2005

Data Source: Texas Vital Statistics Unit, Center for Health Statistics, DSHS, 1999-2005

5 Year Average Age-Adjusted Mortality Rates forStroke, Texas, 2001—2005

Data Source: Texas Health Care Information Collection (THCIC), DSHS, 2001-2006

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

Nationwide Texas Males Females Whites AfricanAmericans

Hispanics

Prev

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e (pe

rcent

with 9

5% C

I)

-1.0%

1.0%

3.0%

5.0%

7.0%

9.0%

Pre

vale

nce

( p

erc

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t with

95

% C

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Ischemic Heart Disease (ICD 9 I20-I25), Seven Year Mortality Rates by Gender & Race, Texas, 1999-2005

0

50

100

150

200

250

300

1999 2000 2001 2002 2003 2004 2005

Ag

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sted

Mo

rtal

ity

Rat

e P

er 1

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00

Total

Females

Males

African Americans

Hispanics

Whites

Other

A. Prevalence

The Burden of Cardiovascular Disease in TEXAS

Standard Source of Primary Payment for Cardiovascular Disease in Texas, 2006

Medicaid5%

Commercial27%Self Pay

8%

Other2%

Medicare58%

Total Hospital Charges for Selected CVD Diagnoses Texas 2001-2006

$0

$1

$2

$3

$4

$5

$6

$7

$8

2001 2002 2003 2004 2005 2006

Am

ou

nt

in B

illi

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s o

f D

oll

ars

Congestive Heart Failure Ischemic Stroke

Hemorrhagic Stroke Ischemic Heart Disease

5 Year Average Age-Adjusted Mortality Rates forIschemic Heart Disease, Texas, 2001—2005

 Weihua Li, MD, MPH, MS, Jane Osmond, MPH, RRT, Cardiovascular Health & Wellness Program; Tracy Haywood, Strategic Preparedness Branch, Texas Department of State Health Services

Age-Adjusted Mortality Rate Per 100,000Average State Rate 58.8 (58.3-59.4) Per 100,000

Stroke (ICD 10 I60-I69), Seven Year Mortality by Gender & Race, Texas, 1999-2005

0

20

40

60

80

100

Total Males Females Whites Blacks Hispanics Other

Age-a

djus

ted R

ates

Per

100,0

00

1999

2000

2001

2002

2003

2004

2005

Acknowledgement: Support provided by Jennifer Smith, Adult Health and Chronic Disease Group, Texas Department of State Health Services.

Age-Adjusted MortalityRate Per 100,000Average State Rate 166.7(165.9-167.6) Per 100,000