Know the Facts,

Get the Stats

2006

Our guide to heart disease, stroke and risks

Heart Attack/Sudden Cardiac Death

Some heart attacks are sudden and intense, but most

start slowly, with mild pain or discomfort. Often the

people affected aren’t sure what’s wrong and wait too

long before getting help. Here are some signs that

can mean a heart attack is happening.

• Chest discomfort. Most heart attacks involve

discomfort in the center of the chest that lasts

more than a few minutes, or that goes away

and comes back. It can feel like uncomfortable

pressure, squeezing, fullness or pain.

• Discomfort in other areas of the upper body.

Symptoms can include pain or discomfort in one

or both arms, the back, neck, jaw or stomach.

• Shortness of breath. May occur with or without chest

discomfort.

• Other signs. These may include breaking out in

a cold sweat, nausea or lightheadedness.

If you or someone you’re with has chest discomfort,

especially with one or more of the other signs, don’t wait

longer than 5 minutes before calling for help.

Call 9-1-1.

Calling 9-1-1 is almost always the fastest way to get

lifesaving treatment. Emergency medical services (EMS)

staff can begin treatment when they arrive — up to an hour

sooner than if someone gets to the hospital by car. The

staff are trained to revive someone whose heart

has stopped. You’ll also get treated faster in the hospital if

you come by ambulance.

A heart attack occurs when the blood supply to part of

the heart muscle (the myocardium) is severely reduced

or stopped because one or more of the heart’s arteries is

blocked. The process usually begins with atherosclerosis,

the buildup of fatty deposits (plaque) inside artery walls.

The plaque can rupture, causing a blood clot to form and

block the artery. If the blood supply is cut off for more

than a few minutes, heart muscle cells suffer permanent

injury or die. This can kill or disable someone, depending

on how much heart muscle is damaged.

Sudden Death From Cardiac Arrest

Cardiac arrest is the stopping of the heartbeat. When a

person’s heartbeat stops abruptly and unexpectedly, it’s

called sudden cardiac arrest. Death can occur within

minutes after the victim collapses. This is called sudden

cardiac death or SCD. The term “massive heart attack”

is often mistakenly used to describe SCD. A heart attack

may cause cardiac arrest and sudden death, but it’s not

the same thing.

The most common underlying cause of sudden cardiac

arrest is a heart attack that results in ventricular fibrillation

(VF) (quivering of the heart’s lower chambers). This

irregular heart rhythm causes the heart to suddenly stop

pumping blood. No statistics are available for the exact

number of sudden cardiac arrests that occur each year.

However, about 330,000 people a year die of coronary

heart disease (CHD) in an emergency department or

before reaching a hospital. That’s two-thirds of all deaths

from CHD — more than 900 Americans each day. Most of

these deaths are from sudden cardiac arrest.

When Minutes Count

A victim of VF sudden cardiac arrest suddenly collapses,

is unresponsive to gentle shaking and stops breathing

normally. Brain damage can start to occur in just 4 to 6

minutes after the heart stops pumping blood. Death may

prevented if the sudden cardiac arrest victim receives

immediate bystander cardiopulmonary resuscitation (CPR)

and defibrillation within a few minutes after collapse. CPR

consists of mouth-to-mouth rescue breathing and chest

compressions. It can help keep blood flowing to the heart

and brain until emergency help arrives. Defibrillation

can stop the abnormal, erratic rhythm and allow the heart

to resume its normal rhythm. An automated external

defibrillator (AED) provides an electric shock, which is the

only way to defibrillate.

If no bystander CPR is provided, a victim’s chances of

survival are reduced by 7 to 10 percent with every minute

of delay until defibrillation. The cardiac arrest survival rate

is only about 5 percent if a system for providing early

defibrillation is not present in a community. In cities

with “community AED programs,” when bystanders

provide

immediate CPR and the first shock is delivered

within

3 to 5 minutes, the reported survival rates from VF

sudden cardiac arrest are as high as 48 to 74 percent.

Thousands of portable, computerized AEDs are now used

in police and emergency vehicles and many public

buildings. Lay rescuers can be trained to use them. If

survival rates from sudden cardiac arrest increased from

5 percent to 20 percent, about 40,000 more lives could be

saved each year.

•

If symptoms last more than a few minutes, call 9-1-1 or the emergency medical services (EMS) immediately. Note the time that the first symptom started.

•

If someone collapses suddenly and

is unresponsive, begin CPR immediately. If you don’t know how to do CPR, the EMS dispatcher can tell you what to do. Use an automated external defibrillator to shock the

victim’s heart, if an AED is available and if you’re trained to use it.

•

Clot-busting drugs are a major advance in treating acute heart attack and stroke. If given within a few hours of the start

of a heart attack, they can minimize heart damage. If given within 3 hours of the onset of a stroke caused by blood clots, they can reduce long-term disability.

Warning Signs

A stroke occurs when a blood vessel that brings oxygen

and nutrients to the brain bursts or is clogged by a blood

clot or some other particle. Because of this rupture or

blockage, part of the brain doesn’t get the blood and

oxygen it needs. Deprived of oxygen, nerve cells in the

affected area of the brain die within minutes.

There are two main types of stroke. One is caused by

blood clots or other particles (ischemic strokes), and the

other by bleeding from a burst blood vessel (hemorrhagic

strokes). Ischemic strokes are the most common.

Cerebral thrombosis is the most common type of

ischemic stroke. It occurs when a blood clot (thrombus)

forms and blocks blood flow in an artery bringing blood

to part of the brain. Blood clots usually form in arteries

narrowed by fatty deposits called plaque. Cerebral

embolism, another kind of ischemic stroke, occurs when a

wandering clot or some other particle (an embolus) forms

away from the brain, usually in the heart. The bloodstream

carries the clot until it lodges and blocks blood flow in an

artery leading to or in the brain.

A subarachnoid hemorrhage occurs when a blood vessel

on the brain’s surface ruptures and bleeds into the space

between the brain and the skull (but not into the brain itself).

Another type of hemorrhagic stroke occurs when a defective

artery in the brain bursts, flooding the surrounding tissue

with blood. This is a cerebral hemorrhage. Bleeding from an

artery in the brain can be caused by a head injury or a burst

aneurysm. Aneurysms are blood-filled pouches that balloon

out from weak spots in the artery wall. They’re often caused

or made worse by high blood pressure. If an aneurysm

bursts in the brain, it causes a hemorrhagic stroke.

After-Effects of Stroke

When brain cells injured by a stroke can’t work, the part

of the body they control can’t work either. This is why a

stroke can be so devastating. Brain injury from a stroke can

affect the senses, motor activity, speech and the ability to

understand speech. It can also affect a person’s behavior

and thought patterns, memory and emotions. Paralysis or

weakness on one side of the body is common. These effects

may be temporary or lasting, depending on the area of the

brain affected and the extent of the brain injury.

Injured and dead brain cells can’t heal or replace

themselves. Recovery from a severe stroke usually takes

months or years of medical treatment, rehabilitation

therapy and determined effort by the stroke survivor.

Many survivors never regain all their lost functions.

Stroke is a leading cause of serious, long-term disability.

Preventing Stroke

Risk factors are traits and lifestyle habits that increase

the risk of disease. The risk factors for stroke that you

can control or treat are...

• Sudden numbness or weakness of the face,

arm or leg, especially on one side of the body.

•

Sudden confusion, trouble speaking

or understanding.

• Sudden trouble seeing in one or both eyes.

• Sudden trouble walking, dizziness, loss

of balance or coordination.

• Sudden, severe headache with no known cause.

Any of the above symptoms may be temporary and

last only a few minutes. This may be due to a “mini-

stroke” called a transient ischemic attack (TIA). TIAs

are

extremely important indicators of an impending

stroke.

Don’t ignore them! If symptoms appear,

call 9-1-1 to get medical attention immediately.

Rx for Survival

Stroke

Warning Signs

• high blood pressure

• tobacco use

• diabetes mellitus

• carotid or other artery disease

• atrial fibrillation or other

heart disease

• a history of TIAs

(“mini-strokes”)

• a high red blood cell count

• sickle cell anemia

• high blood cholesterol

• physical inactivity

• overweight and obesity

• excessive alcohol intake

• some illegal drugs

Work with your healthcare provider to reduce or control as

many risk factors as you can.

•

If symptoms last more than a few minutes, call 9-1-1 or the emergency medical services (EMS) immediately. Note the time that the first symptom started.

•

If someone collapses suddenly and

is unresponsive, begin CPR immediately. If you don’t know how to do CPR, the EMS dispatcher can tell you what to do. Use an automated external defibrillator to shock the

victim’s heart, if an AED is available and if you’re trained to use it.

•

Clot-busting drugs are a major advance in treating acute heart attack and stroke. If given within a few hours of the start

of a heart attack, they can minimize heart damage. If given within 3 hours of the onset of a stroke caused by blood clots, they can reduce long-term disability.

55-1030 12/05

2006 Heart Disease and Stroke Statistics

Coronary Heart Disease

• This year about 1.2 million Americans will have a first or recurrent

coronary attack. About 479,000 of these people will die. Coronary

heart disease is the nation’s single leading cause of death.

• About 7.2 million Americans age 20 and older have survived a heart attack

(myocardial infarction). About 6.5 million Americans have angina pectoris

(chest pain or discomfort due to reduced blood supply to the heart).

Sudden Cardiac Death

• 330,000 coronary heart disease deaths occur out-of-hospital or in

hospital emergency departments annually.

Stroke

• Each year about 700,000 people suffer a new or recurrent stroke in the

United States. Nearly 158,000 of these people die, making stroke the

third leading cause of death.

• About 5.5 million U.S. stroke survivors are alive today, many of them

with permanent stroke-related disabilities.

• Women account for more than 6 in 10 stroke deaths.

High Blood Pressure

• Data from the National Health and Nutrition Examination Survey 1999-

2002 shows that the estimated prevalence of high blood pressure in

adults age 20 and older in the United States is now 65.0 million.

• Up to 95 percent of high blood pressure cases stem from unknown

causes, but the condition is easily detectable and most cases can be

controlled with proper treatment. Normal blood pressure in adults is

below 120/80 mm Hg. High blood pressure is 140/90 mm Hg or higher.

Tobacco

• An estimated 25.5 million men and 21.5 million women put themselves

at increased risk of heart attack and stroke by smoking cigarettes.

High Blood Cholesterol

• About 34.5 million American adults have cholesterol levels of 240

mg/dL or higher

— the point at which it becomes a major risk factor

for coronary heart

disease and stroke. Your total cholesterol should

be below 200 mg/dL, and

your HDL (good) cholesterol should be

40 mg/dL or higher.

Physical Inactivity

• Data released by the Centers for Disease Control and Prevention show

that

30.1 percent of American adults engage in light-moderate physical

activity for at least 30 minutes on 5 or more days a week, or vigorous

physical activity for at least 20 minutes on 3 or more days a week.

Overweight and Obesity

•

About 65 percent of Americans age 20 and older are overweight or obese.

Diabetes Mellitus

• At least 65 percent of people with diabetes die of some form of heart or

blood vessel disease.

For more information about heart disease and stroke or about the

statistics in this publication, contact your nearest American Heart

Association or call 1-800-AHA-USA1 (1-800-242-8721), or visit

americanheart.org.

Risk Reduction Checklist for

Heart Attack and Stroke

What You Can Do on Your Own:

• Don’t use tobacco — It’s the No. 1 preventable

cause of serious illness such as heart disease,

stroke,

lung cancer and emphysema.

• Be physically active — It can build endurance,

control blood pressure, reduce cholesterol

levels, aid in weight control and reduce your risk of

developing diabetes.

• Eat healthy foods — Foods high in saturated

fat, trans fat and cholesterol contribute to

atherosclerosis, a primary cause of heart attack

and stroke. Consuming too much salt (sodium) can

cause high blood pressure in some people.

• Watch your weight —

Obesity is a major

risk factor.

• Avoid excessive alcohol — One or two drinks

a day may help increase “good” HDL cholesterol,

but heavy drinking can contribute to high blood

pressure, heart disease and stroke.

What You Can Do With Your Doctor’s Help:

• Have regular checkups — A doctor can

pinpoint major risk factors such as smoking,

elevated

cholesterol or blood pressure, excess

weight

and diabetes.

• Control your cholesterol —

A simple blood

test can show your blood cholesterol level. If it’s too

high, dietary changes, exercise, weight loss, and/or

drug therapy can bring it down to a safer level.

• Keep tabs on your blood pressure —

Even if it’s less than 120/80 mm Hg, have it checked

at least every two years. If it’s 120/80 or above, have

it checked more often, according to your doctor’s

recommendations.

• Keep diabetes in check —

our doctor can

detect diabetes or a pre-diabetic condition

and

prescribe a program to minimize the risk.

Risks You Can’t Control:

• Age — The risk gradually increases as people

age,

but this doesn’t mean that younger people are

immune.

Advanced age significantly raises the risk

of heart attacks or strokes.

• Sex —

Before menopause, women have a much

lower death rate from coronary attack than men.

Women’s risk rises sharply after menopause, but it still

remains

lower than men’s in the same age group.

Each year more women than men have a stroke.

• Heredity —

Some families have a higher-

than-normal genetic risk of heart attack and

stroke. African Americans are more likely than

Caucasians to have high blood pressure, and

they tend to have

strokes earlier in life and with

more severe

results.