Death rates from diseases of the heart and circulation, 1945-55

0

0

1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 III. In what age groups does arteriosclerosis take its greatest toll?

The following answers pertain to arteriosclerotic heart disease alone and exclude consideration of those other cardiovascular diseases which involve arteriosclerosis and hypertension but are not categorized as such.

1. Over 68 percent of the 400,150 deaths in 1955 from arteriosclerotic heart disease and general arteriosclerosis were over 65 years of age. (2)

2. Over 31 percent of these deaths (127,440) were in the working age groups from 25 to 64 years of age.

(2)

IV. What does this loss in the working age group mean to our national economy?

1. if these 127,440 people had been able to live an extra, healthy year, they

could have earned about $592 million in 1955 alone. (3)

2. The Federal Government could have gained in 1 year approximately $77,993,280 in income-tax revenue on these earnings. (3)

V. Do more men die from arteriosclerosis than women?

1. In 1955, the male death rate from arteriosclerotic heart disease was 75 percent higher than the female death rate from the same cause. (2) (a) The female death rate from vascular lesions of the central nervous system (primarily cerebral thrombosis due to arteriosclerosis, cerebral embolism, and cerebral hemorrhage) was 5 percent higher than the male death rate from this cause. (2)

2. The male death rate from arteriosclerotic heart disease shows its greatest increase over the female death rate between the ages of 30 and 60 years. (2) VI. How many people are disabled by arteriosclerosis?

1. No estimates are available at this time on the number of people disabled by arteriosclerosis though it is estimated that between 9 and 10 million Americans are suffering from diseases of the heart and circulation (4), and that arteriosclerotic heart disease is responsibile for 25 to 40 percent of chronic heart disease.

(16)

2. In a recent survey, it is shown that in terms of annual days of disability per 1,000 population, hypertension and arteriosclerosis are the fourth leading cause in the age group 65 and over, and seventh in the age group 45 to 64 years of age. (5)

3. This same survey shows that in the ages 45 to 64 years of age, hypertension and arteriosclerosis are the third leading cause of days of hospital care. (5)

4. About 1,800,000 people are victims of cerebral vascular diseases due to cerebral thrombosis, result of arteriosclerosis), cerebral embolism and cerebral hemorrhage. (6)

5. Approximately 67,625 patients were in public mental hospitals in 1953 (latest year for which such information is available) with mental diseases due to cerebral arteriosclerosis, other circulatory disturbances, and senile brain disease. (7)

(a) While these patients make up about 27 percent of first admissions to public mental hospitals, because of their high death rate, they constitute only about 13 percent of the resident population. (7)

VII. What is the estimated cost of care for cerebral (brain) arteriosclerosis patients in mental hospitals?

1. The average cost per year per patient in 1955 in public mental hospitals was $1,119. (8)

2. Assuming the number of patients in public mental hospitals with cerebral arteriosclerosis, other circulatory disturbances and senile brain disease in 1955 would be substantially the same as in 1953, the cost of care in 1955 alone for all the 67,625 patients in public mental hospitals with these diagnoses totals $75,672,375.

3. Since the average length of stay in a State mental hospital for patients with mental diseases of the senium is 4.1 years (9), these 67,625 resident patients in public mental hospitals with these disorders will cost over the average length of their stay in a mental hospital about $310 million.

VIII. How much is being spent for research in arteriosclerosis and hypertension! 1. An estimated $2,351,248 is currently being spent from major sources for research in arteriosclerosis, hypertension, and cerebral vascular accidents. 2. Government funds in fiscal 1956 for research in arteriosclerosis, hypertension and cerebral vascular accidents total an estimated $1,787,970. (10) (a) The National Heart Institute of the United States Public Health Service during fiscal 1956 supported research in this area totaling an estimated (11)__

NOTE. Since projects are classified on the basis of major interest, this would not be an all-inclusive figure for research in the field. Additional projects bearing on arteriosclerosis may be classified under such categories as coronary heart disease, metabolism, physiology, and others. (11) (b) The National Institute of Neurological Diseases and Blindness of the United States Public Health Service in fiscal 1956 allocated for research in cerebral vascular disorders approximately (12) –

(c) Other agencies of the Federal Government spent during fiscal 1956 for research in these related areas an estimated__.

Total, estimated Government funds_-_

$1,417, 178

262, 305 54, 487

1,787, 970

3. Non-Government funds for fiscal 1956 for research in arteriosclerosis, hypertension, and cerbral vascular accidents total an estimated $563,278. (10) (a) For projects which could be described as belonging more or less in the area of arteriosclerosis, hypertension, and other fields related to cerebrovascular disease, the national office of the American Heart Association allocated (13)---.

The amount allocated by affiliated heart associations for this purpose is not available.

(b) Other non-Government sources spent in fiscal 1956 about (10)---

Total estimated non-Government funds______

$503, 157

60, 121

563, 278

4. In contrast to the total of about $2,351,248 currently being spent from major sources for research in the major causes of death and disability, arteriosclerosis, hypertension, and cerebral vascular diseases:

(a) An estimated $121 million will be spent by the Agricultural Research Service of the United States Department of Agriculture in fiscal 1957. (14)

5. While it is costing over $75 million per year to care for the 67.625 patients in public mental hospitals alone with mental diseases of the senium, we are spending only $2,351,248 for research in arteriosclerosis, hypertension, and cerebral vascular diseases.

The problem of cerebral vascular disease is closely related to the problems of high blood pressure (hypertension), of hardening of the arteries (arteriosclerosis), and of coronary artery disease. Any advance toward solving one of these problems is an advance toward solving the others.

6. Though the new drugs for hypertension (Rauwolfia serpentina and its derivatives and others) have contributed to the declines in the death rates from hypertension with and without mention of heart disease, a basic solution to the problem of arteriosclerosis must be found, as well as even better drugs for hypertension, and many leads are at hand.

(a) Between 1952 and 1955, the death rate for hypertension with heart disease has declined 18 percent; the death rate from hypertension without mention of heart disease has declined 14 percent. (2)

IX. How much do the people of the United States spend on commercial productsfor self-improvement in contrast with the $2,351,248 currently being spent for research in arteriosclerosis and hypertension in order to prevent disability and stay alive?

1. The people of the United States spent in 1955 approximately: (15) (a) $99,840,000 for face creams;

(b) $27,120,000 for men's packaged toiletry sets;

(c) $24,860,000 for face powder.

X. What are the needs in the fight against arteriosclerosis?

1. More funds for research, training, and education in the field of arteriosclerosis are urgently needed.

2. A simple method for the early detection and diagnosis of arteriosclerosis must be found, as well as better methods of treatment, cures, and methods of prevention.

3. It is essential that the technical language presently in use in the field of arteriosclerosis and heart disease be simplified and the terminology made uniform and understandable to the lay public.

REFERENCE LIST

(1) Personal communication from Paul D. White, M. D., Howard B. Sprague, M. D., and Frederick J. Stare, M. D., Boston, Mass., 1956.

(2) National Office of Vital Statistics, Washington, D. C.

(3) If the 127,440 people in the working age groups 25-64 years of age had been able to work and earn the 1955 average money income before taxes of $4,650 (1956 Survey of Consumer Finances, The Financial Position of Consumers, reprinted from the Federal Reserve Bulletin, June 1956) for just 1 year, their total earnings in that 1 year would have amounted to approximately $592 million. If each claimed on the average 2 dependents, they would each pay $612 in Federal income taxes on this average income of $4,650, totaling in all about $77,993,280. (4) Dr. Rolla E. Dyer, former Director, National Institutes of Health; estimate based on analysis of the health of the Nation, 1950. (Memorandum dated May 28, 1947.)

91359-57- -108

(5) Major Causes of Illness and of Death in Six Age Periods, Public Health Monograph No. 30, United States Public Health Service, Washington, D. C.

(6) Statement, Neurological and Sensory Disorders, prepared for the hearings of the House Committee on Interstate and Foreign Commerce, October 7, 1953, Washington, D. C., by the National Committee for Research into Neurological Disorders. Statement begins on page 974, part 4 of the hearings.

(7) National Institute of Mental Health, Bethesda, Md., in letter dated November 2, 1956, from Harold P. Halpert, Chief, Publications and Reports, Office of the Director.

(8) Patients in Mental Institutions, 1955, prepared by the Biometrics Branch, National Institute of Mental Health, United States Public Health Service, Washington, D. C.

(9) Statement, Mental Illness, prepared for the Committee on Interstate and Foreign Commerce of the United States House of Representatives, October 8, 1953, by the National Institute of Mental Health, United States Public Health Service, Washington, D. C.

(10) Letter dated November 2, 1956, from Dr. Stella Leche Deignan, director, Bio-Sciences Information Exchange, Washington, D. C.

(11) C. R. Strom, Chief, Heart Information Center, National Heart Institute, Bethesda, Md., October 29, 1956.

(12) Data supplied November 1, 1956, by Office of the Assistant to the Director, National Institute of Neurological Diseases and Blindness, Bethesda, Md.

(13) American Heart Association, Inc., New York, Ira Sherman, information director, in letter dated January 10, 1957. "The national office of the American Heart Association allocated $1,851,116.61 for research in 1955-56, of which $503,157.09 could be described as belonging more or less in the area of arteriorsclerosis, hypertension, and other fields related to cerebrovascular disease. Of this $503,157, $174,500 was for fellowships and $328,657 for grants-in-aid. A greal deal of the research supported by the American Heart Association was of a basic nature not clearly identifiable as belonging in the cerebral vascular field, but some of which might provide long-range benefits in that area. In addition to the awards of the national office, affiliated heart associations allocated approximately $2,901,505.44 for cardiovascular research in 1955-56, but information was not available concerning which of these fell into the cerebrovascular or related classifications."

(14) Budget of the United States for fiscal year ending June 30, 1957.

(15) From a survey compiled and published annually by Drug Topics, Topics Publishing Co., New York, N. Y., 1956.

(16) Text Book of Medicine. Eighth edition, edited by Russell L. Cecil, M. D., and Robert F. Loeb, M. D.; W. B. Saunders Co.

WHAT ARE THE FACTS ABOUT CEREBRAL VASCULAR DISEASES (MAINLY ARTERIOSCLEROSIS OF THE BRAIN)?

I. How many people die from cerebral vascular diseases each year?

1. In 1955, 175,120 people died of vascular lesions (popularly called strokes) affecting the central nervous system (primarily cerebral thrombosis due to arteriorsclerosis (thickening and hardening of the arteries), cerebral hemorrhage, cerebral embolism). (1)

(a) This is over four times the number of people who died from diabetes and tuberculosis combined in the same year. (1)

(b) Very frequently a person suffering any type of cerebral vascular accident, whether a cerebral thrombosis, cerebral hemorrhage or cerebral embolism, is said to have had a "stroke." This is a catchall term used by many people, including doctors, to describe any of the cerebral vascular accidents, and it is hoped that better understanding of these disorders will lead to correct and exact diagnoses rather than the use of a too general, and therefore ambiguous, term as "stroke."

2. There has been neither a decline nor an appreciable upward trend in these death rates over the years 1940–55. (1) (2)

(a) The 1955 death rate represents about 3-percent increase over the adjusted death rate for 1940. (1955 death rate, 106.6; 1940 death rate, 102.9)