Synopsis for February 16, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursdays.

1. Mortality from Coronary Heart Disease and Acute Myocardial Infarction — United States, 1998
2. Impact of the 1999 AAP/USPHS Joint Statement on Thimerosal in Vaccines on Infant Hepatitis B Vaccination Practices

MMWR Fact Sheet

February 16, 2001
Contact: Kathy Harben
CDC, National Center for Chronic Disease Prevention
& Health Promotion
(770) 488–5131

Fact Sheet: Death Rates for Coronary Heart Disease and Heart Attacks

• Heart disease is the leading killer of American men and women. An estimated 12 million men and women have a history of coronary heart disease (CHD), which includes heart attack, chest pain, or both. About a million people this year will have a CHD event. Each year about 220,000 fatal CHD events occur suddenly among non-hospitalized people.
• Although death rates from CHD have declined since the late 1960s, the decline has slowed since 1990.
• In 1998, almost 460,000 people died of CHD; 44% of the deaths were from heart attacks.
• Among older men and women (85 years or older), the 1998 death rate from CHD was 3 times higher than the rate for men and women 75-84 years. That rate was 7 times higher than the rate for the next younger group of men and women (65-74 years), which in turn was 21 times higher than the rate for people 55-64 years.
• Among men and women 35 years and older, the death rate in 1998 was higher in men than in women. White men had the highest death rates.
• Among women, African-American women had the highest death rates for CHD and heart attack, followed by white women, American Indian/Alaska Native women, and Asian/Pacific Islander women.
• Death rates from CHD also varied widely by state; they were more than twice as high in New York as in New Mexico. Death rates from heart attack were 3 times higher in Arkansas as in New Mexico.
• Compared with non-Hispanics, people of Hispanic origin had lower death rates from CHD and heart attack.
• CHD can be prevented by reducing or controlling high cholesterol, high blood pressure, and diabetes; not starting or stopping cigarette smoking; eating a low-fat diet with an emphasis on fruits and vegetables; and being moderately physically active on most days of the week.
• To improve current slow declines in heart disease deaths, CDC funds 25 state-based heart health programs to promote policy and environmental changes that help people avoid heart disease by preventing its major risk factors: high blood pressure, high cholesterol cigarette smoking, physical inactivity, and poor nutrition.
• CDC-funded states also promote early identification of heart attack warning signs; rapid response and treatment when those signs appear; and professional education to ensure physicians and other health professionals know the latest treatment guidelines for treating all people with heart disease.

The article will be online at http://www.cdc.gov/mmwr on Friday, February 16, 2001.

Mortality from Coronary Heart Disease and Acute Myocardial Infarction — United States, 1998

Prevention and appropriate treatment are the key to increasing declines in heart disease deaths.

Because treatment has improved and the American public is knowledgeable about risk factors for coronary heart disease (CHD), such as smoking, poor diet, and being inactive, heart disease death rates slowed during the 1990's. More than 12.4 million Americans have CHD, which includes a history of heart attack, chest pain, or both. In 1998, almost 460,000 people died of CHD, and 44% of the deaths were from heart attacks. CHD can be prevented by reducing or controlling high cholesterol, high blood pressure, and diabetes; not starting or stopping cigarette smoking; eating a low-fat diet high in fruits and vegetables; and participating in moderate physical activity on 5 or more days of the week.

Impact of the 1999 AAP/USPHS Joint Statement on Thimerosal in Vaccines on Infant Hepatitis B Vaccination Practices

Routine hepatitis B vaccination policies, for all newborns, should be re-introduced in hospitals that have discontinued these policies and practices.

Changes in hepatitis B immunization recommendations that were intended to be temporary appear to have caused long lasting changes in newborn hepatitis B vaccination practice. In July 1999, the recommendations for routine vaccination of newborns against hepatitis B were temporarily changed because of concerns about the vaccine preservative thimerosal. No harm from thimerosal had been demonstrated, and hepatitis B vaccines without preservatives were available by September 1999. However, analysis of data from immunization registries in Oregon and Oklahoma, and from a survey of hospitals in Wisconsin indicates that vaccination practices have not returned to those found prior to the July 1999 recommendations.

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