2005 Georgia Data Summary: SHAPP (Stroke and Heart Attack Prevention Program) During the 2005 fiscal year, over 13,000 patients were served by SHAPP clinics. DEFINITIONS Stroke and heart attack (ischemic heart disease) are two of the seven disease categories that comprise cardiovascular disease (CVD). Stroke (cerebrovascular disease) refers to an infarct (loss of blood supply due to a blocked artery) or hemorrhage in the brain. Ischemic heart disease (IHD), also known as coronary heart disease, refers to narrowing of the coronary arteries, which reduces blood flow and oxygen to the heart. Ischemic heart disease includes acute myocardial infarctions ("heart attacks") and complications resulting from previous myocardial infarctions. STROKE DEATHS Stroke was the third most frequent cause of death in Georgia, accounting for 6% of all deaths, with 4,285 stroke deaths in 2003. In 2003, Georgia's stroke death rate was 20% higher than the national rate. Stroke death rates were similar for men and women in 2003. Stroke death rates were 1.5 times higher for blacks than whites in 2003. 19% of persons dying from stroke in Georgia in 2003 were less than 65 years old. STROKE HOSPITALIZATIONS 23,164 Georgia residents were hospitalized because of stroke in 2003. The average charge per stroke hospitalization in Georgia was $21,200 in 2003.1 Total hospital charges for stroke in Georgia were $490 million in 2003.1 CARDIOVASCULAR DISEASE DEATHS Causes # GA Deaths (2003) Heart Disease 17,180 Ischemic Heart Disease 9,579 Hypertensive Heart Disease 855 Other Heart Disease 6,746 Stroke 4,285 Hypertension 894 Atherosclerosis 305 Other 631 ----------------------------------------------------------------------- Cardiovascular Disease Deaths (total) 23,295 ISCHEMIC HEART DISEASE (IHD) DEATHS Heart disease was the leading cause of death in Georgia, accounting for 26% of all deaths, with 17,180 heart disease deaths in 2003. Of the deaths from heart disease, 9,579 were attributable to ischemic heart disease. In 2003, Georgia's IHD death rate was 16% lower than the national rate. IHD death rates were 1.8 times higher for men than women in 2003. IHD death rates were similar for blacks and whites in 2003. 26% of persons dying from IHD in Georgia in 2003 were less than 65 years old. IHD HOSPITALIZATIONS 50,098 Georgia residents were hospitalized because of IHD in 2003. The average charge per IHD hospitalization in Georgia was $27,900 in 2003.1 Total hospital charges for IHD in Georgia were $1.4 billion in 2003.1 Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 gdphinfo@dhr.state.ga.us http://health.state.ga.us RISK FACTORS FOR STROKE AND HEART DISEASE Modifiable risk factors are those which can be changed in order to slow or reverse the disease process and decrease the risk of disease. Modifiable risk factors for stroke and heart attack include: - Smoking - Physical inactivity - Poor diet - Obesity - High blood pressure - High cholesterol - Diabetes PREVALENCE OF MODIFIABLE RISK FACTORS AMONG ADULTS, GEORGIA, 2003 Percentage 100 80 60 40 20 0 77 58 23 25 28 33 8 Current smoker Not meeting <5 Friuts and recommended Vegetables physical per day activity Obese Ever Ever high hypertension cholesterol Diabetes THE ROLE OF HYPERTENSION IN STROKE AND HEART ATTACK Blood pressure is defined as "controlled" if the systolic and diastolic readings are below 140 and 90 mm Hg, respectively. Some people can control their high blood pressure by losing weight and engaging in physical activity. For those who are unable to decrease their blood pressure by lifestyle modification alone, medications prescribed by a physician can often control high blood pressure successfully. Adults with increased blood pressure have reduced life expectancy as well as more time spent living with cardiovascular disease. Life expectancy for those with controlled blood pressure is 5.1 years longer for men and 4.9 years longer for women compared to those with uncontrolled blood pressure.2 SHAPP CLINICS There are 142 SHAPP clinics throughout Georgia. SHAPP clinics are present in 16 of the 18 health districts. SHAPP PATIENT DEMOGRAPHICS 13,776 patients were served by SHAPP during the 2005 fiscal year. 54% of the patients were African American. 74% of patients were less than 65 years old. SHAPP CONTROL RATES SHAPP clinics have varying blood pressure control rates, ranging from 34% to 93% with a median control rate for all clinics of 61%. Private health plans in Georgia had a range of control rates from 47% to 68% with a median control rate of 60% for patients treated in their private setting.3 Nationally, 53% of hypertension patients are controlled.4 SHAPP COSTS The annual medication cost is approximately $29.68 per patient. Clinic visit costs range from $24 and $64 per visit and patients are generally seen on a quarterly basis once blood pressure control is established. Data sources: 1 Hospital charges from acute care non-federal hospitals 2 Franco et al. Blood Pressure in Adulthood and Life Expectancy with Cardiovascular Disease in Men and Women. Life Course Analysis. Hypertension.2005; 46: 280-286. 3 Based on performance indicators on the Health Plan Employer Data and Information Set (HEDIS), implemented by the National Committee for Quality Assurance. 4 Hajjer, I, Kotchen TA. Trends in Prevalence, Awareness, Treatment, and Control of Hypertension in the United States, 1988-2000. JAMA 2003;290:199-206. Date updated: December 2005 Publication number: DPH05.124H Visit http://www.health.state.ga.us/epi/cdiee/cardio.asp for more information about cardiovascular disease in Georgia. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 gdphinfo@dhr.state.ga.us http://health.state.ga.us