Heart disease and prevention: race and age differences in heart disease prevention, treatment, and mortality.
OBJECTIVE
The objective of this study was to analyze race and age differences in the distribution of health promotion and cardiovascular screening tests, and the prevalence of serious heart disease and cardiovascular mortality in the United States. DATA SOURCES/STUDY POPULATION: Data are from 7 federal datasets represented in the first National Healthcare Quality Report and the National Healthcare Disparities Report, and include surveys, administrative and vital statistics data systems. The study analyzes blacks and whites.


METHODS
Counseling on diet and nutrition, exercise, and tobacco during an outpatient visit indicate the availability of health promotion services, and screening for high blood pressure and cholesterol represent preventive services. Hospitalizations for heart-related conditions and use of certain cardiac procedures identify serious heart disease. Deaths from coronary artery disease and stroke are the heart-related mortality measures.


RESULTS
Counseling and education services tend to occur more on outpatient visits by individuals aged 45 to 64 years than in younger age groups. Screening rates among individuals aged 45 to 64 years of approximately 90% for hypertension and 80% for high cholesterol suggest progress in early detection of cardiac risk factors. However, blacks aged 45 to 64 years are 5.6 times more likely than their white counterparts to be hospitalized for hypertension, approximately one third less likely to receive a cardiac procedure, and almost twice as likely to die of coronary heart disease.


CONCLUSIONS
Although findings indicate few racial differences in health promotion services in ambulatory care or screening for cardiac risk factors, the prevalence of serious cardiovascular disease, use of cardiac procedures, and heart-related mortality suggest continuing racial disparities in heart disease.
Holmes
Julia S
JS
National Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services, Hyattsville, MD 20782, USA. zbv3@cdc.gov
Arispe
Irma E
IE
Moy
Ernest
E
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002648:Child; D002675:Child, Preschool; D003376:Counseling; D019992:Databases as Topic; D006293:Health Promotion; D006296:Health Services / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008403:Mass Screening; D008875:Middle Aged; D044469:Racial Groups; D012044:Regression Analysis; D012307:Risk Factors; D044465:White People