Learn About Your Heart...
Made Simple

By Nicolas Shammas, MD

A new, comprehensive sourcebook for
heart and vascular disease patients

Cardiovascular Health Topics

Statistics about Heart and Blood Vessel Diseases in the United States
Structure and Function of the Heart and Blood Vessels
Diseases of the Blood Vessels of the Heart
Surgical Therapies for the Cardiovascular Patient
Peripheral Vascular Disease
Diseases of the Blood Vessels of the Head and Neck
Strokes: How to Survive Them and How to Prevent Them
Valvular Heart Disease
Heart Rhythms: How to Recognize Them and Treat Them
Congestive Heart Failure
11. Understanding Cardiomyopathy, or Weak Heart Muscle
12. Children and Heart Disease
13. Diseases of the Pericardium
14. Systemic Illnesses, Infections and Drugs that Affect the Heart
15. Erectile Dysfunction: a Vascular Disease
16. Cardiovascular Disease Prevention
17. Heart Healthy Nutritional Tips
18. Cardiac Rehabilitation
19. Medications for Cardiovascular Disorders
20. Heart Tests You Need to Know
21. Learn What to Do in a Medical Emergency
22. How to Choose Your Doctor and Hospital
23. Medical Research and How You Can Get Involved
24. Taking the Next Step — A Few Community Resources to Help You Live More Healthfully
25. How Much Did You Learn from This Book: Take a Simple Test

What is hypertension?

Hypertension is high blood pressure. Blood pressure has 2 components. In a person with normal blood pressure, the top pressure (systolic) should be less than or equal to 135 mmHg, and the bottom pressure (diastolic) should be less than 90 mmHg. When the blood pressure exceeds any of these numbers, the person has hypertension.

How prevalent is hypertension in the United States?

Approximately 15 million people have high blood pressure in the United States. Unfortunately, statistics indicate that physicians are not addressing the problem and treating hypertension aggressively enough in many people suffering from high blood pressure.

Twenty-four percent of black people have high blood pressure, compared to 20% of white adults and 14% of Hispanics.

Blood pressure incidence increases substantially with age. About 65% of people over the age of 60 years have high blood pressure in contrast to 30% of patients between the age of 40 and 59 years, and 7% of patients between the age of 18 and 39 years.

Why is treating hypertension important in preventing heart disease?

Hypertension is a major risk factor for strokes and heart attacks. Also, hypertension increases the risk for heart failure. More than 85% of heart failure patients have been previously diagnosed with high blood pressure or coronary disease. A third of men and women have high blood pressure as the main cause of their heart failure. Also, most people with blockages in their coronary arteries or diabetes also have high blood pressure.

The lifetime risk of developing high blood pressure is about 90%. Lowering blood pressure can reduce the incidence of stroke by about 35% to 40%, heart attacks by 20% to 25%, and heart failure by about 50%.

What is peripheral vascular disease?

Peripheral vascular disease is defined as blockages in the blood vessels of the body except those that supply the heart or the brain. Since all blood vessels in the body are part of the same vascular tree, blockages in the periphery are similar to blockages in the coronary arteries or the arteries of the brain.

What is the prevalence of peripheral vascular disease in the United States?

Approximately 10 million people live with peripheral vascular disease. Half of them have no symptoms, and only a small percentage is being treated (12.5%). More than 700,000 patients receive treatment with either medications or nonsurgical procedures. Approximately 500,000 receive surgical treatment.

The incidence of peripheral vascular disease increases with age. Of individuals over the age of 55, 1% will experience a critical reduction in the blood flow to their lower legs.

The presence of peripheral vascular disease generally indicates a higher risk of mortality in the future. More than 60% of men and 30% of women with peripheral vascular disease will die before their 10-year follow-up.

A considerable overlap exists between the presence of blockages in the blood vessels of the periphery, the heart, and the brain. In fact, patients who have documented blockages in their peripheral vasculature are at 4 times greater risk of heart attacks and 2 to 3 times greater risk of strokes.

The relative 5-year mortality from severe peripheral vascularb disease exceeds that of breast, colon, and rectal cancer, as well as certain types of lymphoma.

How serious of a problem is obesity in the United States?

Obesity refers to either an increase in weight of more than 20% above normal weight for gender, age, and height or a body mass index of 30 or more. The body mass index (or BMI) is determined by the weight in kilograms divided by the square of the height in meters.

Obesity is among the fastest-growing health concerns in the United States—58 million people in the United States are over weight and 40 million are obese.

Eight out of 10 people over the age of 25 years are overweight.

Obesity also affects children in the United States and is reaching epidemic proportions. In 2001, more than a quarter of all white children and a third of black and Hispanic children were categorized as overweight.

This epidemic is associated with a rise in several health problems including diabetes, heart disease, breast and colon cancer, and high blood pressure.

The cost of obesity-related diseases in the United States is staggering. More than $70 billion annually is spent on the treatment of diabetes, high blood pressure, and heart disease, all of which are related to obesity.

Lack of activity in the United States is a key factor in obesity. A quarter of Americans are completely sedentary. Approximately 78% of Americans do not meet recommendations for basic activity level.

What is diabetes?

Diabetes mellitus—elevated blood glucose in the blood—is a disease related to the inability of the body to use sugar effectively. Insulin, a hormone manufactured by the pancreas, helps tissues absorb blood sugar. Diabetes mellitus occurs when the pancreas is not capable of making enough insulin or the available insulin is not effective.

How prevalent is diabetes in the United States?

In the United States, 18.2 million people have diabetes, which is approximately 6.3% of the population.

There are 260,000 people under the age of 20 years who have diabetes, which represents 0.25% of the people in this age group.

Diabetes is on the rise in children primarily because of obesity and sedentary lifestyle.

Of all people over the age of 60 years, 18.3% have diabetes, which represents about 8.6 million people.

Of all black people over the age of 20 years, 11.4% have diabetes, and 8.4% of white and Hispanic people over the age of 20 years have diabetes.

American Indians tend to have a higher incidence of diabetes mellitus, almost 2.3 times higher than white people.

Diabetes was the sixth leading cause of death in the United States in the year 2000, and the risk of death is twice as high in people with diabetes as that of people without diabetes.

The cost of diabetes in the United States in 2002 was a staggering $132 billion.

What are the cigarette-smoking statistics in the United States?

In the United States, approximately 1 out of 4 men and 1 out of 5 women are smokers. This incidence is substantially higher among American Indians and Alaskan Natives.

Among men, 25% of whites, 27.6% of blacks, and 23.2% of Hispanics smoke.

Among women, 21.7% of whites, 18% of blacks, and 12.5% of Hispanics smoke.

The prevalence of smoking decreases with higher education and higher economic status.

Of new smokers, 90% started as teenagers.

Currently, more people are quitting smoking. In 1991, 27% of Americans smoked, in contrast to 1964, when 44% of the population smoked.

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