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Last Edited: 9/30/2010

Heart Attack: Who is at Risk?

Heart attacks are acute events that most often occur among people with chronic cardiovascular disease (CVD). To understand who is at risk for a heart attack in California, it is helpful to understand how rates of CVD , heart disease, and heart attacks differ between various segments of the population. By looking at these patterns, we will gain a better understanding of how to prevent heart attacks from occurring.


Deaths due to CVD

Cardiovascular disease (CVD) is the leading cause of death in the nation and in California. In 2004, CVD accounted for 31% of all causes of death in California, that’s approximately 73,000 deaths. That includes 52,177 deaths due to heart disease .

 

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Hospitalizations due to heart disease and heart attacks

Annually, about 575,000 hospitalization discharges are due to heart disease1. For heart attacks alone, in 2005, there were approximately 57,158 hospitalizations (38.7 per 10,000 residents) among Californians over the age of 352.

Hospitalizations due to heart attacks differ by age, race/ethnicity, and gender.

 

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Racial and ethnic disparities in hospitalizations

In 2005, by race/ethnicity, hospitalizations due to heart attacks were as follows:

Asian/Pacific Islander: 25.3 per 10,000
Black: 44.1 per 10,000
Hispanic: 33.0 per 10,000
White: 40.2 per 10,000
Other: 114.1 per 10,000

Data source: Patient Discharge Database, Office of Statewide Health Planning and Development, 2005


This disparity was also seen among the broader heart disease category. In 2005, Blacks had the highest heart disease hospitalization rate (25.5 per 1,000), followed by Whites (18.7 per 1,000), Hispanics (15.8 per 1,000), Asian/Pacific Islanders (12.1 per 1,000), and American Indians (6.0 per 1,000)1.

When it comes to classifying an individual’s race and ethnicity, there is a potential for misclassification to occur. Although the rate of hospitalizations due to heart disease among American Indian’s is lower than the other race/ethnicity categories, the prevalence for certain risk factors are much higher:

Race/ethnicity
Obesity % Smoking % Diabetes %
American Indian/Alaskan Native 30.2 24.7 14.9
Asian 7.1 10.7 6.5
Black 33.2 16.5 10.1
Hispanic 27.9 11.6 8.0
White 19.6 15.6 6.0
Other 24.1 17.9 7.2

Data Source: California Health Interview Survey, 2005

There have also been studies that have looked specifically at the American Indian population and have found the rates for heart disease are much higher than what’s captured in statewide surveillance efforts3 .

 

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Gender disparities in hospitalizations

Men have higher hospitalizations rates for heart attacks than women. In 2005, among California men aged 35 and over, the hospitalization rate for heart attacks was 39.2 per 10,000 residents, compared to 23.7 per 10,000 residents for California women aged 35 and over 2.

 

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Age disparities in hospitalizations

As age increases, the hospitalization rates for heart attacks likewise increases:

Age group

Rate per 10,000 residents
35-44 4.1
45-54 15.3
55-64 34.2
65-74 61.4
75-84 102.0
85 and over 157.6

Data source: Patient Discharge Database, Office of Statewide Health Planning and Development, 2005

 

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Geographic disparities in hospitalizations

In California, the range of hospitalization rates due to heart attacks vary by county. In 2005, the rate of hospitalizations for Lassen County was 15.7 per 10,000 California residents ages 35 and over, compared to 59.6 per 10,000 in Solano County2.

 

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1. Reynen DJ, Kamigaki AS, Pheatt N, Chaput LA. Th e Burden of Cardiovascular Disease in California: A Report of the California Heart Disease and Stroke Prevention Program. Sacramento, CA: California Department of Public Health, 2007.
2. Patient Discharge Data, Office of Statewide Planning and Development, 2005
3. Howard BV, Lee ET, Cowan LD, Fabsitz RR, Howard WJ, Oopik AJ, et al. Coronary Heart Disease Prevalence and its Relation to Risk Factors in American Indians. The Strong Heart Study. Am J Epidemiol. 1995;142:254–68.