Know the Facts,
Get the Stats
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
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
immediate CPR and the first shock is delivered
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 brains 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
extremely important indicators of an impending
Don’t ignore them! If symptoms appear,
call 9-1-1 to get medical attention immediately.
Rx for Survival
Warning Signs
• high blood pressure
• tobacco use
• diabetes mellitus
• carotid or other artery disease
• atrial fibrillation or other
heart disease
a history of TIAs
• 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.
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.
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
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
©2002–06, American Heart Association.
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,
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,
cholesterol or blood pressure, excess
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 doctors
Keep diabetes in check
our doctor can
detect diabetes or a pre-diabetic condition
prescribe a program to minimize the risk.
Risks You Can’t Control:
Age The risk gradually increases as people
but this doesn’t mean that younger people are
Advanced age significantly raises the risk
of heart attacks or strokes.
Before menopause, women have a much
lower death rate from coronary attack than men.
Women’s risk rises sharply after menopause, but it still
lower than mens in the same age group.
Each year more women than men have a stroke.
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