In the United States, heart disease remains the leading cause of mortality. Coronary heart disease, which comprises the largest proportion of heart disease, is a condition in which plaque builds up in within the coronary arteries. High blood pressure and high blood cholesterol are major risk factors for heart disease—conditions that can be modified through medical treatments and monitoring and/or lifestyle changes. Routine screenings for high blood pressure and high blood cholesterol can help further along diagnosing such conditions, allowing for appropriate treatment and monitoring.

In recognition of February as American Heart Month, the following article presents information from PHMC’s 2006 Household Health Survey on heart health and screenings among adults 18 years of age and older residing in the five-county Southeastern Pennsylvania (SEPA) region. In particular, this article focuses on adults who have ever been told by a healthcare professional that they have some type of heart problem—including heart disease, angina, congestive heart failure, heart attack or some other heart problem—or that they have been told that they have high blood pressure or high blood cholesterol; in addition, this article also examines adults whose last blood pressure screen or blood cholesterol screen was more than one year ago.

Heart disease mortality
In the SEPA region, the average annualized (2001-2004) mortality rate for heart disease is 161 per 100,000. More specifically, African-Americans (203 per 100,000) have a higher mortality rate associated with heart disease compared to Whites (156 per 100,000), and Asians (77 per 100,000).

Heart problems
Currently, 10.2% of adults in the SEPA region have ever been told by a healthcare professional at some point in their lives that they have some type of heart problem, which translates to approximately 302,000 adults in the region.

·  An increase in age is met with an increase in the percentage of adults who have ever had a heart problem: 2.1% (18-39 yrs), 4.1% (40-49 yrs), 11.6% (50-59 yrs), 19.6% (60-74 yrs), and 34.6% (75+ yrs) have ever had a heart problem.

·  Males (11.7%) are only slightly more likely than females (9.0%) to have ever had a heart problem.

·  Adults living below 150% of the Federal Poverty level (15.2%) are more likely than adults living at or above 150% poverty (9.1%) to have ever had a heart problem.

·  White (10.9%) and Black (10.2%) adults are equally likely to have ever had a heart problem, compared to 5.0% of Latino adults.

Selected heart health risk factors

Approximately one-third of adults in the SEPA area (29.5%) have ever been told by a healthcare professional that they have high blood pressure and more than one-quarter of adults (27.3%) have ever been told that they have high blood cholesterol.

·  As age increases, the percentage of adults who have ever been told that they have high blood pressure also increases: 11.0% (18-39 yrs), 20.5% (40-49 yrs), 37.5% (50-59 yrs), 55.3% (60-74 yrs), and 57.4% (75+ yrs). Similarly, the percentage of adults who have ever been told that they have high blood cholesterol also increases with age: 9.8% (18-39 yrs), 23.1% (40-49 yrs), 37.0% (50-59 yrs), 47.3% (60-74 yrs), and 47.5% (75+ yrs).

·  Males (30.6%) are only slightly more likely than females (28.6%) to have high blood pressure. However, males (30.2%) are more likely than females (24.8%) to have high blood cholesterol.

·  While nearly two-fifths of adults living in poverty (39.4%), compared to 27.4% of adults not living in poverty, have high blood pressure, the percentage of adults with high blood cholesterol is roughly comparable for adults living in poverty (26.1%) and adults not living in poverty (27.5%).

·  Black adults (40.1%) are more likely to have high blood pressure than their racial/ethnic counterparts: 27.7% (White adults) and 21.6% (Latino adults) (Figure 1). However, White adults (29.2%) are more likely than Black (24.0%) and Latino (20.1%) adults to have high blood cholesterol.

Heart health screenings

In the SEPA region, while 10.4% of adults have not had a blood pressure screening within the past year, a larger percentage of adults (28.3%) have not received a blood cholesterol screening within the past year—an equally important risk factor for heart disease.

·  As age increases, the percentage of adults who have not had a blood pressure screening within the past year decreases: 16.3% (18-39 yrs), 11.9% (40-49 yrs), 7.5% (50-59 yrs), 4.2% (60-74 yrs), and 1.7% (75+ yrs). Similarly, as age increases, the percentage of adults who have not received a blood cholesterol screen within the past year decreases as well: 45.1% (18-39 yrs), 31.7% (40-49 yrs), 20.7% (50-59 yrs), 11.0% (60-74 yrs), and 7.0% (75+ yrs).

·  While males (12.7%) are more likely than females (8.4%) to have not had a blood pressure screen within the past year, the percentage of males (28.0%) and females (28.5%) who have not had a blood cholesterol screen within the past year is similar.

·  Adults living in poverty (12.7%) are more likely than adults not living in poverty (9.9%) to have not received a blood pressure screen within the past year. However, the percentage of adults living in poverty (28.9%) and adults not living in poverty (28.1%) who have not received a blood cholesterol screen within the past year is comparable.

·  More than one-fifth of Latino adults (21.1%), compared to 9.7% of White adults and 8.0% of Black adults, have not received a blood pressure screen within the past year. In addition, more than one-third of Latino adults (36.0%), compared to 29.4% (White adults) and 21.0% (Black adults), have not received a blood cholesterol screen.

·  One-third of adults without public or private health insurance coverage (33.4%), compared to 8.5% of adults with health insurance coverage, have not received a blood pressure screen within the past year (Figure 2). Furthermore, adults without health insurance coverage (58.8%) are twice as likely as adults with health insurance coverage (25.9%) to have not received a blood cholesterol screen within the past year (Figure 2).

Conclusion

Because heart disease remains the leading cause of mortality in the U.S., the Healthy People 2010 initiative has placed targets on some of the major risk factors associated with heart disease—namely blood pressure and cholesterol levels. The Healthy People 2010 campaign aims to reduce the proportion of adults with high blood pressure to 16% as well as reduce the proportion of adults with high blood cholesterol levels to 17%—targets that have yet to be reached among adults in the Southeastern Pennsylvania region. For information regarding PHMC’s Community Health Data Base’s 2006 Household Health Survey, or to learn more about heart health among adults residing within Southeastern Pennsylvania, please contact Nicole Dreisbach at nicoled@phmc.org.