Cardiovascular Diseases

Alabama’s #8 Health Indicator

Cardiovascular Diseases (CVDs) are identified as the eighth most prominent health indicator in AL. It refers to a group of serious health conditions that can result in death and disability (CDC Heart Disease). CVD was the leading cause of death in AL for 2019 (America Health Rankings).

CVDs are caused by plaque buildup in an individual’s arteries. This causes the arteries to narrow over time, partially or totally blocking the blood flow. The four most common CVDs are coronary artery disease, heart failure, heart attacks, and stroke (CDC Heart Disease). While the other three conditions affect the heart, a stroke affects the brain and occurs when there is a lack of blood flow to an area of the brain. Stroke was the fourth leading cause of death in AL in 2019 (America Health Rankings).

Another common CVD condition that affects many American adults is hypertension (also called high blood pressure). According to CDC, an individual can be considered to have pre-hypertension based on the following: family history, weight, level of physical activity, diet, smoking, and having other co-existing diseases, such as diabetes (CDC Heart Disease). Many people in AL have hypertension or high cholesterol but are not aware of their condition. Unfortunately for many individuals, chest pain is the first reason for visiting the doctor.

Disproportionately Affected Populations

CVDs are considered an aging disease, which means your risk of receiving the diagnosis increases with age. White males have the highest risk of developing CVDs, followed by AA/black males, AA/black females, and Asian males (CDC Heart Disease). Individuals who live in food deserts (i.e., places with limited access to healthy and affordable food choices) and low-income neighborhoods with little green space have higher rates of CVD morbidity (American Heart Association).

Geographic Variation

AL is within the CDC-designated “Stroke Belt,” which includes most of the Southeast U.S. (i.e., Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia). These states had an age-adjusted stroke mortality rate that exceeded the national rate by 34 percent in 2018 (CDC Heart Disease).

Alabama Cardiovascular Diseases Highlights

Indicator data are collected from Blue Cross Blue Shield of AL (BCBS) Claims, Centers for Medicare and Medicaid Services, AL Medicaid Agency, BRFSS, and the ADPH Center for Health Statistics Mortality Files.

• AL’s stroke mortality rate was 64.0 deaths per 100,000 persons in 2019.
• Shelby County, located in the Northeastern Public Health District, had the highest stroke rate with 142.1 deaths per 100,000 persons.
• According to BRFSS data, the diagnosis of hypertension is higher in populations with low income and low educational attainment.

Resources

• Agency for Health Care Research and Quality (Essential Hypertension Guideline Summary)
• American Heart Association
• American Heart Association (Atherosclerosis)
• American Heart Association (Go Red for Females)
• American Heart Association (Heart Failure)
• American Heart Association (Heart Hub)
• American Heart Association (High Blood Pressure)
• American Heart Association (Hypertension Journal)
• American Heart Association (Silent Ischemia and Ischemic Heart Disease)
• The American Institute of Stress (Stress and Heart Disease)
• American Journal of Cardiovascular Disease
• American Kidney Fund (Nephrotic Syndrome in Adults)
• American Liver Foundation
• Atherosclerosis Journal
• CDC (Cerebrovascular Disease or Stroke)
• CDC (Heart Failure Facts)
• CDC (High Blood Pressure)
• CDC (National Heart Disease and Stroke Prevention Program)
• CDC (Pneumonia)
• Healthy People 2020 (Heart Disease and Stroke)
• Healthy People 2030 (Respiratory Diseases)
• Heart Failure Society of America
• Institute for Health Care Improvement (How-To Guide: Improved Care for Acute Myocardial Infarction)
• John Ritter Foundation for Aortic Health
• Journal of Stroke and Cerebrovascular Diseases
• Medline Plus (Heart Attack)
• Medline Plus (Nephrotic Syndrome)
• The National Coalition for Females with Heart Disease
• National Emphysema Foundation
• National Heart, Lung, and Blood Institute (Atherosclerosis)
• National Heart, Lung, and Blood Institute (Heart Failure)
• National Jewish Health (Emphysema)
• The Nephcure Foundation
• NIH Senior Health (High Blood Pressure)
• US National Library of Medicine (Heart Failure Overview)
• World Health Organization (Pneumonia)