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Deaths From All Causes and Deaths From Cardiovascular, Lung, and Blood Diseases, U.S.,
1990 and 2010
Deaths From Specific Cardiovascular, Lung, and Blood Diseases, U.S., 2010
Age-Adjusted Death Rates for Cardiovascular and Noncardiovascular Diseases, U.S., 1963,
1990, and 2010
Deaths Under Age 1 Year Due to Cardiovascular and Lung Diseases, U.S., 2010
Prevalence of Common Cardiovascular and Lung Diseases, U.S., 2007-2011
Direct and Indirect Economic Costs of Illness by Major Diagnosis, U.S., 2009
Cardiovascular, lung, and blood diseases constitute a large morbidity, mortality, and
economic burden on individuals, families, and the Nation. Common forms are
atherosclerosis, hypertension, COPD, and blood-clotting disorders embolisms and
thromboses. The most serious atherosclerotic diseases are CHD, as manifested by heart
attack and angina pectoris, and cerebrovascular disease, as manifested by stroke.
In 2010, cardiovascular, lung, and blood diseases accounted for 1,017,000 deaths and 41
percent of all deaths in the United States (p. 35). The estimated economic cost in 2009 for
these diseases was $424 billion 23 percent of the total economic costs of illness, injuries,
and death (p. 51). Of all diseases, heart disease is the leading cause of death; chronic lower
respiratory diseases (CLRD), which includes COPD and asthma, ranks third (behind
cancer); and cerebrovascular disease is fourth (p. 38). Cardiovascular and lung diseases
account for 3 of the 4 leading causes of death (p. 38) and 4 of the 10 leading causes of
infant death (p. 44). Hypertension, asthma, CHD, and COPD are especially prevalent and
account for substantial morbidity in Americans (p. 47).
The purpose of the biomedical research conducted by the NHLBI is to contribute to the
prevention and treatment of cardiovascular, lung, and blood diseases and sleep disorders.
National disease statistics show that by mid-20th century, morbidity and mortality from
these diseases had reached record high levels. Since then, however, substantial
improvements have been achieved, especially over the past 40 years, as shown by the
significant decline in mortality rates. Because many of these diseases begin early in life,
their early detection and control can reduce the risk of disability and can delay death.
Although important advances have been made in the treatment and control of
cardiovascular, lung, and blood diseases, these diseases continue to be a major burden on
the Nation.
Mortality statistics in this chapter are for diseases or conditions classified as the underlying
cause of death. Heart failure, however, is never truly an underlying cause even though
57,757 deaths in 2010 were nominally coded to it as the underlying cause. Therefore, in this
chapter, mortality statistics attributed to any mention of heart failure represent it as either
the underlying cause or a contributing cause of death.
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Cardiovascular Diseases
In 2010, CVD caused 788,000 deaths 32 percent of all deaths (p. 35).
Heart disease is the leading cause of death; the main form, CHD, caused 380,000 deaths in
2010 (pp. 36, 38).
The annual number of deaths from CVD increased substantially from 1900 to 1970 and
remains high (p. 37).
The death rate (not age-adjusted) for CVD increased from 1920 until it peaked in 1968.
Since then, the trend has been downward. In 2010, the rate was below the all-time low in
1900 (p. 37).
Cerebrovascular disease, the fourth leading cause of death, accounted for 129,000 deaths
in 2010 (pp. 36, 38).
Heart disease is second only to all cancers combined in years of potential life lost (p. 38).
Heart disease is the leading cause of death in blacks, but second to cancer in Hispanics,
Asians, and American Indians. Stroke ranks as the third or fourth leading cause of death in
the minority groups, except in American Indians or Alaska Natives, where it ranks seventh
(p. ?38).
Deaths with heart failure as the underlying or contributing cause increased from 1970 to
1993 and then remained constant to 2010 (p. 39).
From 1999 to 2010, death rates for CHD and stroke declined in non-Hispanic whites and
non-Hispanic blacks; CHD and stroke death rates decreased among Hispanics, Asians, and
American Indians from 1999 to 2008 but remained stable or increased in 2009 to 2010.
CHD and stroke mortality continues to be highest in the black population (p. 40).
Because of the rapid decline in mortality from CHD since the peak in 1968, there were
1,223,000 fewer deaths from CHD in 2010 than would have occurred if there had been no
decline (p. 41).
Substantial improvements have been made in the treatment of CVD. Since 1990, the
percent of hospitalizations for AMI, stroke, and heart failure that were discharged dead
declined appreciably (p. ?41).
From 1990 to 2010, CHD mortality declined in the United States, but remained higher than
in many other countries, particularly among females (only selected countries are shown)
(p. 42).
From 2001 to 2010, the percentage decline in death rates for CHD and stroke was fairly
similar for whites and blacks (p. 43).
A 2007-2010 national survey showed that an estimated 83.6 million persons in the United
States had CVD, including 77.9 million with hypertension and 15.4 million with CHD (p.
?47).
Since the 1960s, there has been a substantial reduction in the prevalence of CVD risk
factors: hypertension, smoking, and high cholesterol. During that time, the prevalence of
overweight adults has consistently increased (p. 48).
From 1976-1980 to 2007-2010, the percentage of persons with hypertension who were
aware of their condition, on treatment for it, and having their blood pressure under
control increased substantially (p. ?49).
A 2007-2010 national survey showed only about 52?percent of hypertensive patients
(systolic BP ? 140 mmHg or diastolic BP ? 90 mmHg or on antihypertensive medication)
had their condition under control (p. 49).
Hospitalization rates for heart failure in those aged 45 to 64 years increased from 1971 to
1993 and remained stable to 2010. Rates for those aged 65?years and older increased
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from 1971 to 1998 and?remained relatively stable until 2005; rates then declined through
2010 (p. 50).
The estimated economic cost of CVD for 2009 was $313 billion:
o $192 billion in direct health expenditures
o $121 billion in indirect cost of mortality (p. 51).
Lung Diseases
Lung diseases, excluding lung cancer, caused an estimated 235,000 deaths in 2010 (p. 35).
CLRD caused 138,000 deaths in 2010 and is the third leading cause of death (pp. 36, 38).
From 2001 to 2010, death rates for asthma declined in both black and white males and
females; death rates for COPD declined in both black and white males but rose in both
black and white females (p. 43).
From 1980 to 2010, infant death rates for various lung diseases declined markedly (p. 43).
In 2010, of the 10 leading causes of infant mortality, 4 were lung diseases or had a lung
disease component (p. ?44). From 2000 to 2010, changes in mortality for the causes were:
o Congenital malformations (-10 percent)
o Disorders of short gestation (-4 percent)
o Sudden infant death syndrome (-17 percent)
o Respiratory distress syndrome (-48 percent).
In 2010, approximately one in six deaths in children under 1 year of age was due to a lung
disease (p. 44).
From 1990 to 2010, the CLRD death rate for females in the United States and Finland
increased appreciably compared with the rates in several other countries (p. 45).
From 1999 to 2010, death rates for CLRD in males decreased in all racial/ethnic groups
except American Indians; their death rates fluctuated. In females, death rates for CLRD
increased slightly in non-Hispanic whites and remained stable in non-Hispanic blacks,
Hispanics, American Indians, and Asians during the period (p. 46).
Among the sleep disorders from 2000 to 2010, physician office visits for sleep apnea
increased from 2.0 to 2.7 million and for insomnia increased from 2.4 to 5.8 million (p. 46).
Asthma is a common chronic condition, particularly in children (pp. 47, 48, 50).
The economic cost of asthma, COPD, and pneumonia was $106 billion in 2009:
o $81 billion in direct health expenditures
o $25 billion in indirect cost of mortality (p. 51).
Blood Diseases
Approximately 10,000 deaths were attributed to blood diseases in 2010 (p. ?35). These
include the following:
o 4,900 due to anemias
o 1,900 due to coagulation defects
o 800 due to purpura
o 2,400 due to other blood diseases.
A large proportion of deaths from AMI, cerebrovascular disease, and peripheral artery
disease involve blood-clotting problems (no estimate available).
In 2009, anemias cost the Nation's economy $6 billion:
o $5 billion in direct health expenditures
o $1 billion in indirect cost of mortality (p. 51).
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Deaths From All Causes and Deaths From Cardiovascular, Lung, and Blood Diseases,
U.S., 1990 and 2010
1990 2010
1990 Number Percent of 2010 Number of Percent of
Cause of Death of Deaths Total Deaths Total
* Includes 11,838 CVD deaths due to pulmonary heart disease and 485 deaths due to
sarcoidosis.
** Includes 13,808 CVD deaths involving pulmonary heart disease and 947 deaths due to
sarcoidosis.
Source: Vital Statistics of the United States, National Center for Health Statistics (NCHS).
*Excludes 13,808 deaths from pulmonary heart Source: Vital Statistics of the United States,
disease and 947 deaths due to sarcoidosis. NCHS.
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Deaths From Specific Cardiovascular, Lung, and Blood Diseases, U.S., 2010
Lung Blood
Cardiovascular Deaths Deaths
Cause of Death Deaths (Thousands) (Thousands) (Thousands)
Other Atherosclerosis 26 — —
Asthma — 3 —
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Deaths From Cardiovascular Deaths From Lung Diseases, Deaths From Blood Diseases,
Diseases, U.S., 2010 U.S., 2010 U.S., 2010
Text-only with data points Text-only with data points Text-only with data points
* Includes heart failure, cardiac dysrhythmias, hypertensive disease, deep vein thrombosis,
and other heart and blood vessel diseases.
Note: Numbers do not sum to 100 percent due to rounding.
Source: Vital Statistics of the United States, NCHS.
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Death Rates* for Cardiovascular Diseases, U.S., 1900?2010
*Not age-adjusted.
Source: Vital Statistics of the United States, NCHS.
* Not age-adjusted.
** Includes 122.9 deaths per 100,000 population from CHD (dark bar).
? CLRD is the term used in the ICD/10 for COPD and asthma.
?Based on the average remaining years of life up to age 78.7 years (life expectancy at birth
in 2010).
Note: Diseases shown in bold are those addressed in Institute programs.
Source: Vital Statistics of the United States, NCHS.
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Text-only with data Text-only with data Text-only with data Text-only with data
points points points points
Note: Causes of death shown in bold are those addressed in Institute programs.
Source: Vital Statistics of the United States, NCHS.
* Age-adjusted.
** ICD 10/9 comparability ratio (1.0502) applied.
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?
ICD 10/9 comparability ratio (1.0411) applied.
Source: Vital Statistics of the United States, NCHS.
*
Heart failure as the underlying cause of death or otherwise mentioned on the death
certificate.
Note: Breaks in trend line indicate change in ICD codes.
Source: Vital Statistics of the United States, NCHS.
Age-Adjusted Death Rates for Coronary Heart Disease by Race/Ethnicity and Sex,
U.S., 1999–2010
*Non-Hispanic.
Source: Vital Statistics of the United States, NCHS.
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Age-Adjusted Death Rates for Stroke by Race/Ethnicity and Sex, U.S., 1999?2010
*Non-Hispanic.
Source: Vital Statistics of the United States, NCHS.
Common Cardiovascular and Lung Diseases With High Percentage Discharged Dead
From Hospitals, U.S., 1990, 2000, and 2010
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Text-only with data points
Death Rates* for Coronary Heart Disease in Males, Ages 35?74, in Selected
Countries, 1990?2010
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Death Rates* for Coronary Heart Disease in Females, Ages 35?74, in Selected
Countries, 1990?2010
Percent Change in Age-Adjusted Death Rates for Selected Causes by Race and Sex,
U.S., 2001?2010
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Text-only with data points
* Congenital CVD and congenital respiratory diseases accounted for 43.1 deaths under
age 1 per 100,000 live births (black bar), which is 34 percent of infant deaths due to all
congenital malformations.
** From 2000 to 2010, congenital CVD declined 27 percent; congenital malformations of
the respiratory system declined 41 percent; other congenital malformations increased 7
percent.
Note: Diseases shown in bold are those addressed in Institute programs.
Source: Vital Statistics of the United States, NCHS.
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Deaths Under Age 1 Year Due to Cardiovascular and Lung Diseases, U.S., 2010
Deaths
Cause of Death Under
Age 1
Other 507
Bronchopulmonary Dysplasia 56
(BPD)
Atelectasis 248
Death Rates* for Chronic Lower Respiratory Diseases in Males, Ages 35 Years and
Older, in Selected Countries, 1990–2010
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Text-only with data points
Death Rates* for Chronic Lower Respiratory Diseases in Females, Ages 35 Years and
Older, in Selected Countries, 1990–2010
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Age-Adjusted Death Rates for Chronic Lower Respiratory Diseases by Race/Ethnicity
and Sex, U.S., 1999–2010
*
Non-Hispanic.
Source: Vital Statistics of the United States, NCHS.
Hypertension** 77,900,000
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Coronary Heart Disease 15,400,000
Stroke 6,800,000
Asthma? 39,500,000
COPD§ 12,700,000
* Includes hypertension, CHD, stroke, or heart failure for ages 20 years and older.
** Hypertension is defined as systolic blood pressure ? 140 mmHg, or diastolic blood
pressure ? 90 mmHg, or being on antihypertensive medication, or being told twice of
having hypertension.
? Range from 650,000 to 1,300,000 for ages 18 years and older (Am Heart J
2004;147:425?439).
? 25,900,000 still have asthma and of those, 13,200,000 have had an attack in the past 12
months, for all ages.
§ An estimated 12,700,000 diagnosed (2011) and 12,000,000 undiagnosed (2006), for ages
18 years and older.
Sources: National Health and Nutrition Examination Survey (NHANES) 2007?2010,
NCHS and National Health Interview Survey (NHIS) 2011, NCHS.
*
Hypertension, CHD, stroke, or heart failure. Hypertension is defined as systolic blood
pressure ? 140 mmHg, or diastolic blood pressure ? 90 mmHg, or being on antihypertensive
medication.
Source: NHANES, 2007?2010, NCHS.
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Prevalence of Common Cardiovascular and Lung Diseases by Age, U.S., 2007?2011
Notes: Hypertension is defined as systolic blood pressure ?140 mmHg or diastolic blood
pressure ?90 mmHg, or being on antihypertensive medication. High cholesterol is ?240
mg/dL. Overweight is BMI ?25 kg/m2. Data were collected at six time periods: 1960–1961
(plotted at 1961), 1971–1974 (plotted at 1972), 1976–1980 (plotted at 1978), 1988–1994
(plotted at 1991), 1999–2002 (plotted at 2002), 2003–2006 (plotted at 2006), and 2007–
2010 (plotted at 2010).
Sources: NHIS for smoking, ages ?18, NCHS; NHANES for the other risk factors, ages
20–74, NCHS.
Hypertensive* Population Aware, Treated, and Controlled, Ages 18 and Older, U.S.,
1976?1980 to 2007?2010
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Text-only with data points
*
Hypertension is defined as systolic blood pressure ? 140 mm Hg, or diastolic blood
pressure > 90 mm Hg, or being on antihypertensive medication.
Source: NHANES, NCHS.
*
Hypertension is systolic blood pressure ? 140 mm Hg, diastolic blood pressure ? 90 mm
Hg, or being on antihypertensive medication.
**
Non-Hispanic.
Sources: NHANES, NCHS.
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Hospitalization Rates for Heart Failure, Ages 45?64 and 65 and Older, U.S.,
1971?2010
Direct and Indirect Economic Costs of Illness by Major Diagnosis, U.S., 2009
Amount Amount Amount Percent Percent Percent
(Dollars (Dollars in (Dollars Distribution Distribution Distribution
in Billions) in Direct Cost Indirect Total
Billions) Indirect Billions) Cost of
Direct Cost of Total Mortality
* **
Cost Mortality
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Cardiovascular $192.1 $120.5 $312.6 15.2% 20.0% 16.8%
Diseases
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Other and Not 171.5 110.7 282.1 13.6 18.4 15.1
Linked to Specific
Condition
* Direct costs are personal health care expenditures for hospital and professional services
care, prescribed medications, and home care reported by the Medical Expenditure Panel
Survey (MEPS), Agency for Healthcare Research and Quality (AHRQ), by diagnosis,
excluding nursing home care costs and costs due to comorbidities.
** The mortality cost for each disease group was estimated for 2009 by multiplying the
number of deaths by age, sex, and cause of death in 2009 by the 2009 present value of
lifetime earnings discounted at 3 percent.
†
Includes costs for COPD, asthma, and pneumonia.
Note: Estimates are not available for total lung diseases and blood clotting disorders.
Source: Prepared by NHLBI from direct costs on the MEPS Web site; numbers of deaths
from Vital Statistics of the United States, NCHS; present value of lifetime earnings from
the Institute for Health and Aging, University of California. Total direct cost obtained from
MEP Statistical Brief #355, National Health Care Expenses in the U.S. Civilian
Noninstitutionalized Population, 2009.
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Direct Economic Cost and Percent Distribution for Selected Conditions by Type of
Service, U.S., 2009
Percent Distribution by Type of Service
Total Hospital
Direct Outpatient or Hospital
Cost (in Office-Based Inpatient Emergency Prescribed Home
Condition Billions) Provider Visits Stays Room Visits Medicines Health
Source: Medical Expenditure Panel Survey, Household Component Summary Data Tables.
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