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Ambulatory Care Visits for Selected Cardiovascular Diseases

Somnath Pal, BS (Pharm), MBA, PhD
Professor of Pharmacy Administration
College of Pharmacy & Allied Health Professions, St. John's University
Jamaica, New York



2/18/2011

US Pharm. 2011;36(2):11.

According to the CDC, 24%, 12%, 6%, and 3% of U.S. adults were told during ambulatory care visits in 2006 that they had hypertension, heart disease, coronary heart disease, and stroke, respectively. The prevalence of hypertension was similar between men and women. With increasing age, the percentages of adults with heart disease (including coronary heart disease), hypertension, and stroke rose.

Heart Disease: Heart disease is the leading cause of death and a major cause of disability in the United States. Half of the 631,636 heart disease-related deaths that occurred in 2006 were in women. Heart disease is estimated to cost more than $316 billion in 2010. The most common type of heart disease is coronary heart disease. In 2009, 785,000 Americans had a new coronary attack, and 470,000 of these will have a recurrent attack. According to the CDC, almost half of cardiac deaths occurred before emergency services and hospital treatment could be administered.

Heart Failure: In the U.S., nearly 6 million people have heart failure; 670,000 people are diagnosed with it each year, and 20% of them die within 1 year of diagnosis. Heart failure is estimated to cost about $39 billion in 2010. The most common causes of heart failure are coronary artery disease, high blood pressure, and diabetes. Early diagnosis and treatment can improve quality of life and life expectancy for people with heart failure.

Stroke: Stroke is the third leading cause of death in the U.S. Annually, 795,000 Americans have a stroke--of which 610,000 are first or new strokes--and 185,000 of those who survive eventually have another stroke. More than 1 million stroke survivors reported difficulty performing basic activities of daily life. Nearly 22% of ambulatory care visits relating to diseases of the arteries, arterioles, and capillaries occurred in medical specialty offices. It is estimated that stroke will cost nearly $74 billion in 2010. Transient ischemic heart attack can increase the risk of stroke. About 58% of primary diagnoses were made in medical specialty offices, and approximately 30% in primary care offices.

Hypertension: Essential hypertension was the primary diagnosis recorded most frequently (almost 41 million) during ambulatory care visits. Close to 76% (nearly 31 million) of these diagnoses occurred in primary care offices, accounting for about 6% of the nearly 526 million visits to this setting in 2006. Among the broad therapeutic classes, cardiovascular agents (15.4 mentions per 100 drugs) were prominent. Use of drug therapy rose significantly between 1996 and 2006 in all settings except surgical specialties.

To comment on this article, contact rdavidson@uspharmacist.com.

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