Heart Disease

Heart disease includes coronary and hypertensive heart diseases and heart failure. About 13.2 million people have coronary heart disease, and 1.2 million heart attacks occur each year; about 5 million Americans have heart failure, and 550,000 develop it each year²³. Heart disease is the leading cause of death for men and for women in the United States, responsible for almost 700,000 deaths in 2002, and the third leading cause of activity limitation. The total economic cost of heart disease is estimated to be $239 billion, including $131 billion in direct health care expenditures. Coronary heart disease prevalence and heart disease death rates are higher among blacks. Racial, ethnic, and socioeconomic differences in cardiac care, especially invasive cardiovascular procedures, have been demonstrated^{24,25,26,27,28}.

Figure 2.4. Medicare beneficiaries hospitalized for acute myocardial infarction who receive smoking cessation counseling (top) and Medicare beneficiaries hospitalized for acute heart failure who have an evaluation of left ventricular ejection fraction (bottom), by race/ethnicity, 2001-2002

Acute myocardial infarction

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Acute heart failure

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Source: CMS Quality Improvement Organization program, 2001-2002.

Reference population: Elderly Medicare beneficiaries hospitalized for acute myocardial infarction (top) or acute heart failure (bottom).

Note: White, Black, API, and AI/AN are non-Hispanic groups. For findings related to all heart disease measures, go to Tables 2.4a and 2.4b. Available data do not support analyses stratified by SES.

• After a heart attack, patients who are smokers need to quit to reduce the risk of subsequent cardiac events. Provider counseling makes the chances of successfully quitting greater. The proportion of elderly Medicare beneficiaries hospitalized for acute myocardial infarction who received smoking cessation counseling was lower among black and Hispanic elderly compared with non-Hispanic white elderly (Figure 2.4, top).
• To guide appropriate treatment, patients with heart failure need tests to determine how well the heart pumps blood. The proportion of elderly Medicare beneficiaries hospitalized for acute heart failure who received such an evaluation of the left ventricular ejection fraction was lower among AI/AN and Hispanic elderly and higher among black and API elderly compared with non-Hispanic white elderly (Figure 2.4, bottom).

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