2006 Georgia data summary. SHAPP (Stroke and heart attack prevention program)

2006 Georgia Data Summary:
STROKE AND HEART ATTACK PREVENTION PROGRAM (SHAPP)

SHAPP is an awareness, detection, treatment and control program that targets lowincome, uninsured, or underinsured patients with uncontrolled high blood pressure.

DEFINITIONS

CARDIOVASCULAR DISEASE DEATHS

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.

Causes
Cardiovascular Disease Total Heart Disease Ischemic Heart Disease Hypertensive Heart Disease Other Heart Disease Stroke Hypertension Atherosclerosis Other

# Deaths 2004
22,378 16,551
8,974 874
6,703 4,050
864 303 610

STROKE DEATHS

ISCHEMIC HEART DISEASE (IHD) DEATHS

Stroke was the third most frequent cause of death in Georgia, accounting for 6% of all deaths, with 4,050 stroke deaths in 2004.
In 2004, Georgia's stroke death rate was 21% higher than the national rate.

Heart disease was the leading cause of death in Georgia, accounting for 25% of all deaths, with 16,551 heart disease deaths in 2004. Of the deaths from heart disease, 8,974 were attributable specifically to ischemic heart disease.

Stroke death rates were 1.4 times higher for blacks than whites in 2004.

In 2004, Georgia's IHD death rate was 14% lower than the national rate.

19% of persons dying from stroke in Georgia in 2004 were less than 65 years old.

IHD death rates were 1.8 times higher for men than women in 2004.

26% of persons dying from IHD in Georgia in 2004 were less than 65 years old.

STROKE HOSPITALIZATIONS

IHD HOSPITALIZATIONS

Approximately 23,500 hospitalizations occurred among Georgia residents due to stroke in 2004.

Approximately 50,100 hospitalizations occurred among Georgia residents due to IHD in 2004.

The average charge per stroke hospitalization in The average charge per IHD hospitalization in

Georgia was $22,700 in 2004.1

Georgia was $32,000 in 2004.1

Total hospital charges for stroke in Georgia were $533 million in 2004.1

Total hospital charges for IHD in Georgia were $1.6 billion in 2003.1

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: o Smoking o Physical Inactivity o Poor Diet o Obesity o High Blood Pressure o High Cholesterol
o Diabetes

PREVALENCE OF MODIFIABLE RISK FACTORS AMONG ADULTS, GEORGIA, 2004

Percentage

100 77
80 58
60

40 22
20

27

27

32

8

0
Current smoker Not meeting <5 Friuts and recommended Vegetables per physical activity day

Obese

Ever high blood Ever high pressure(1) cholesterol(2)

Diabetes

(1) The percentage of Georgians who reported having been told they had high blood pressure (2) Of persons who had their blood cholesterol level checked, the percentage told that they have high cholesterol

SHAPP CLINICS
There are 137 SHAPP clinics throughout Georgia.
SHAPP clinics are present in 16 of the 18 health districts.
SHAPP PATIENT DEMOGRAPHICS
15,718 patients were served by SHAPP during the 2006 fiscal year.
55% 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 52% to 84% with a median control rate for all clinics of 65%.
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 a private setting.3
Nationally, 53% of patients undergoing treatment for high blood pressure are controlled.4

THE ROLE OF HIGH BLOOD PRESSURE 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 CVD. Life expectancy for those with controlled blood pressure is 5.1 years longer for men and 4.9 years longer for women.2

SHAPP COSTS
The annual medication cost is approximately $12.76 per patient.
Clinic visit costs range from $20 and $55 per visit and patients are generally seen on a quarterly basis once blood pressure control is established.
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: August 2006 Publication number: DPH06.140HW Visit http://www.health.state.ga.us/epi/cdiee/cardio.asp for more information about cardiovascular disease in Georgia.