Cardiovascular Diseases

Cardiovascular Diseases in California

California

Cardiovascular disease refers to a number of conditions resulting from plaque building up in arteries, including coronary artery disease, chest pain, heart attacks and strokes. Heart disease was the leading cause of death in the United States in 2020. Stroke, the fifth-leading cause of death in the U.S. in 2020, may lead to disabilities including paralysis, speech difficulties and emotional problems. Heart failure may result in fatigue, depression and difficulty engaging in physical activities. 

Risk factors for cardiovascular disease include high blood pressure, high cholesterol, obesity, physical inactivity, unhealthy diet, diabetes, smoking, excessive alcohol consumption, high levels of stress and family history of heart disease or stroke.

The direct and indirect costs of cardiovascular disease for the 2017-2018 fiscal year totaled approximately $378.0 billion, around 12% of all U.S. health expenditures.

The prevalence of cardiovascular disease is higher among:

• Men compared with women.  
• Adults ages 65 and older compared with those ages 18-44.
• American Indian/Alaska Native adults compared with all other racial and ethnic groups except for adults who identify their race as other; Asian adults have the lowest prevalence of cardiovascular disease.
• Adults with less than a high school education compared with college graduates; the prevalence is significantly lower with each increase in education level.
• Adults with an annual household income less than $25,000 compared with adults with higher incomes; the prevalence is significantly lower with each increase in income level. 
• Adults living in non-metropolitan areas compared with adults in metropolitan areas.

Many of the risk factors for cardiovascular disease may be successfully reduced through lifestyle changes, medication or medical procedures. Between 1980 and 2000, the death rate from coronary heart disease halved; 47% of this decrease was due to medical interventions like coronary artery bypass and statin therapy. Another 44% of the decline was attributable to increases in physical activity, reductions in smoking prevalence and lowering of cholesterol and blood pressure. Interventions that reduce risk factors such as high cholesterol, smoking and physical inactivity could prevent 80% of heart attacks and strokes. 

The American Heart Association created Life’s Simple 7, a tool to help individuals measure and manage their heart health.

The Million Hearts initiative is a national effort to improve access and quality of care to reduce the incidence of heart disease and stroke; it aims to prevent 1 million heart attacks and strokes by 2027 through promotion of community and clinical prevention programs. Healthy People 2030 has numerous objectives to improve cardiac health and reduce heart disease and stroke mortality, including improving overall cardiovascular health in adults, reducing coronary heart disease and stroke deaths and increasing treatment and management of high blood pressure and high cholesterol.

Ford, Earl S., Umed A. Ajani, Janet B. Croft, Julia A. Critchley, Darwin R. Labarthe, Thomas E. Kottke, Wayne H. Giles, and Simon Capewell. 2007. “Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980–2000.” New England Journal of Medicine 356 (23): 2388–98. https://doi.org/10.1056/NEJMsa053935.

Heo, Seongkum, Terry A. Lennie, Chizimuzo Okoli, and Debra K. Moser. 2009. “Quality of Life in Patients with Heart Failure: Ask the Patients.” Heart & Lung 38 (2): 100–108. https://doi.org/10.1016/j.hrtlng.2008.04.002.

Tsao, Connie W., Aaron W. Aday, Zaid I. Almarzooq, Alvaro Alonso, Andrea Z. Beaton, Marcio S. Bittencourt, Amelia K. Boehme, et al. 2022. “Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association.” Circulation 145 (8). https://doi.org/10.1161/CIR.0000000000001052.