New stats show heart disease still America's No. 1 killer, stroke No. 3

American Heart Association
Thursday, 1 January 2004

Cardiovascular disease (CVD) remains American's No. 1 killer, still claiming more lives than the rest of major causes of death, according to the American Heart Association's Heart Disease and Stroke Statistics 2004 Update released today.

The 2004 Update compiles statistics for 2001 or the most recent year that data are available.

CVD killed 931,108 Americans in 2001. Other major causes of death in 2001 were cancer, 553,768; accidents, 101,537; Alzheimer's disease, 53,852; and HIV 14,175. The report also shows that CVD is the No. 3 cause of death for children under age 15, behind certain conditions originating in the perinatal period and accidents. Cardiovascular diseases include high blood pressure, coronary heart disease (heart attack and angina), congestive heart failure, stroke, and congenital heart defects.

Coronary heart disease alone is the single largest killer of Americans. The disease continues to devastate women as it accounts for one in five women's deaths.

Stroke is the third leading cause of death in the United States. Each year, about 700,000 people experience a new or recurrent stroke. About 500,000 of these are first attacks, and 200,000 are recurrent. Stroke accounted for more than one of every 15 deaths in the country in 2001.

"Because stroke is one of the leading causes of disability, it's public health burden is immense," said Virginia Howard, chair of the new stroke statistics subcommittee. "However, the situation is made worse by the burden falling more heavily on select groups such as African Americans between the ages of 35 and 65."

Stroke in children peaks in the perinatal period (less than 30 days old). According to data from the National Hospital Discharge Survey from 1980-1998, the rate of stroke for infants this age was 26.4 per 100,000 live births. The stroke rate drops to 2.7 per 100,000 for children ages 1-14.

From 1979 to 1998 in the United States, childhood deaths from stroke declined by 58 percent. However, despite current treatment, one of 10 children with ischemic stroke (caused by blood clots) will have a recurrence within five years.

National ranking

The report breaks down CVD death rates by state, including Puerto Rico and the District of Columbia. Puerto Rico had the lowest death rate for total cardiovascular disease in 2000. Mississippi had the highest. Minnesota had the biggest decrease, with a 26.6 percent lower death rate in 2000 compared to 1990.

For coronary heart disease (CHD) alone, Utah had the lowest death rate in 2000, while New York had the highest. Minnesota had the biggest drop in death rate, with a 39.3 percent lower death rate in 2000 compared to 1990. The District of Columbia was the only region where the death rate from CHD increased, with a 6.6 percent higher rate in 2000 compared to 1990.

South Carolina had the highest death rate from stroke in 2000, New York had the lowest. The District of Columbia showed the biggest decrease in stroke death rate in 2000, with a 26.6 percent decline from 1990. Alaska had the greatest increase in stroke death rate, with a 7 percent higher rate in 2000 than in 1990.

Coronary heart disease (CHD)

This year an estimated 700,000 Americans will have a coronary attack. About 500,000 will have a recurrent attack. About 42 percent of the people who experience a coronary attack in a given year will die from it.

This is the first year the association has compiled statistics for acute coronary syndromes (ACS), which includes heart attack and unstable angina. "It is clear from our estimates that ACS is a major reason for hospitalization for men and women in the United States," said Chris O'Donnell, M.D., chair of the statistics committee. "The need is as great as ever to seek better treatments and prevention for coronary heart disease."

  • There were 502,189 coronary heart disease deaths in 2001.
  • The estimated annual incidence of heart attack is 565,000 new attacks and 300,000 recurrent attacks. There were 184,757 heart attack deaths in 2001.
  • 928,000 people were discharged from the hospital with ACS as the primary diagnosis in 2001. When secondary diagnosis was included, the number of hospital discharges for ACS was more than 1.6 million.

Other diseases, risk factors, procedures, and costs

  • One in five Americans (and one in four adults) has high blood pressure.
  • In 2001, more than 130 million adult Americans (65.4 percent of the adult population) were overweight or obese. At the same time, 3.8 million children ages 6-11 and 5 million adolescents ages 12-19 were overweight or obese.
  • Since 1965 smoking in the United States has declined by more than 40 percent among people age 18 and older. An estimated 3.2 million Americans tried their first cigarette in 1997; most of these new users (2.3 million) were ages 12 to 17.
  • From 1995 to 1999 an average of 442,398 Americans died each year of smoking-related illnesses 33.5 percent of these deaths were cardiovascular-related. Smoking costs Americans more than $157 billion annually in health-related economic costs.
  • From 1979 to 2001, the number of cardiovascular operations and procedures increased four-fold.

For more information, or to contact American Heart Association, see their website at:

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