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Burden of Cardiovascular Disease in Mississippi

Burden of Cardiovascular Disease in Mississippi. Top Ten Leading Causes of Death in Mississippi, 2007 . Source: Mississippi Vital Statistics, 2007. CVD Age-Adjusted Mortality Rates, MS vs. US, 1999-2006. Source: CDC Wonder, 2006. MS Stroke Rates.

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Burden of Cardiovascular Disease in Mississippi

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  1. Burden of Cardiovascular Disease in Mississippi

  2. Top Ten Leading Causes of Death in Mississippi, 2007 Source: Mississippi Vital Statistics, 2007

  3. CVD Age-Adjusted Mortality Rates, MS vs. US, 1999-2006 Source: CDC Wonder, 2006

  4. MS Stroke Rates • 2005 MS age-adjusted stroke mortality was 19% higher than US • 2008 MS stroke rate was 54% higher than US Sources: Mississippi Vital Statistics, 2007 CDC Wonder 2005 MS BRFSS 2008

  5. Risk Factors of CVD, MS vs. US, 2007 Source: MS BRFSS, 2007

  6. Prevalence of Hypertension Adults, NHANES: 2005-2006

  7. JNC 7 Classification Chobanian et al. JAMA. 2003;289:2560-2572.

  8. Hypertension – Barriers to Control • _____________ NHANES: 2005-2006

  9. Hypertension* Obesity* Dyslipidemia* Diabetes mellitus* Microalbuminuria or est GFR <60 mL/min Cigarette smoking Physical inactivity Age > 55 for men > 65 for women Family hx of premature CVD < 55 for men < 65 for women *Components of metabolic syndrome. Chobanian et al. JAMA. 2003;289:2560-2572. NCEP ATP III. 2002. NIH Publication No. 02-5215 – uses earlier age cutpoints. CVD Risk Factors

  10. Relation Between Adiposity and Systolic BP 140 135 130 Systolic BP (mmHg) 125 120 115 14 16 18 20 22 24 26 28 30 32 2 ) Body Mass Index ( kg/m Jones et al. J Hypertension 12: 1433-1437,1994

  11. Epidemiological studies have shown a correlation between body weight and blood pressure 75% of hypertension in men and 65 % in women is associated with excess adiposity Garrison RJ. Prev Med. 16:1987

  12. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1999 1990 2008 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  13. Childhood Obesity Average weight gain of ~2 lbs/yr (~100 kcal/d surplus) Trends in Blood Pressure Among Children and Adolescents: JAMA;2004:291

  14. A Diet That Reduces Blood Pressure • DASH eating • Grains • Vegetables • Fruits • Low-fat dairy foods • Poultry, fish • Nuts, dry beans • Oils • Sweets

  15. Ambulatory Blood Pressure in High and Low Salt Diet

  16. Less Sodium - More Potassium Sodium: Less than 2300 mg/day (~ 1 tsp); with HTN < 1,500 mg/day Added at Table 10% Processed Foods 80% Cooking 10%

  17. Lifestyle Modifications *Dietary Approach to Stop Hypertension

  18. Evolution of SBP over the Life Course Green – Desirable BP trajectory Red, Orange – BP trajectories in individuals with multiple RFs

  19. Opportunity for Improving Blood Pressure Control Age Body Weight Dietary Choices Lifestyle Pharmocology Cultural forces Societal norms Commercial interests Food industry Public policy GeneticPredisposition

  20. A Bad Situation With the Potential to Get Worse Presents Great Opportunity! The Tide Is Rising! Egan. Hypertension. 2004;44:389.

  21. Hypertension • “Blood pressure that increases the risk for cardiovascular events (disease)” • “A level of BP above which treatment does more good than harm”

  22. Hypertension AssessmentAccurate and Reliable BP Readings

  23. 972 million people with HTN worldwide 73.6 million in US with HTN (33% of > 20 years) 53.6 million with preHTN) > 70% of pts with stroke, MI, CHF have antecedent HTN 1/5 deaths related to HTN Heart Disease is #1 cause of death in women in MS Stroke is #3 cause of death in women in MS

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