Air Pollution and Public Health in Utah
Heart Disease and Heart Attacks
Heart Attacks | Heart Disease and Air Pollution | Utah Trends | Data and Indicators
Heart disease is a class of conditions that involve the heart and blood vessels, including coronary artery disease, cardiomyopathies, heart failure, abnormalities of heart rhythm, and inflammatory heart diseases. Coronary artery disease, also called coronary heart disease or ischemic heart disease, is the most common type of heart disease, and the number one cause of death for both men and women in the U.S. (NHLBI, 2012b). It is a condition where a waxy substance called plaque builds up inside the coronary arteries, which supply the heart with oxygen-rich blood. Plaque consists of cholesterol deposits. When cholesterol plaques accumulate over many years, arteries can stiffen and narrow in a process called atherosclerosis (Figure 1) (CDC, 2013b). Over time, these plaques can also break open, forming a blood clot on the surface. A large clot can partially or completely block the flow of blood through the artery (NHLBI, 2012b).
Figure 1: Coronary artery disease
If the flow of blood to the heart is reduced or blocked, angina or heart attack can occur. Angina, the most common symptom of coronary artery disease, causes chest pain or discomfort, which may feel like pressure or squeezing in the chest (CDC, 2013b). The pain may also be experienced in the shoulders, arms, neck, jaw, or back.
Over time, coronary artery disease can weaken the heart and lead to heart failure, a serious condition where the heart cannot pump enough blood to meet the body's needs. An irregular heartbeat, known as arrhythmia, may also develop from coronary artery disease (CDC, 2013b).
Heart Attacks | Top
If a plaque or clot completely blocks the flow of oxygen-rich blood to a section of the heart, a heart attack (also known as a myocardial infarction) occurs (Figure 2). If blood flow is not restored quickly, that section of the heart begins to die, leading to serious health problems or death. If the heart attack victim survives, the damaged heart tissue is replaced with scar tissue, which cannot function in the same manner. (NHLBI, 2013a). This damage to the heart may not be obvious, or it may cause severe and long term problems.
Figure 2: What is a heart attack?
Heart Disease and Air Pollution | Top
While smoking, obesity, high blood pressure, and high cholesterol are well known risk factors for coronary artery disease, exposure to air pollution, particularly particulate matter (PM), is now known to also be a risk factor. Exposure to PM less than 2.5 micrometers in diameter (PM2.5) over hours to weeks can trigger heart disease-related deaths and nonfatal events. Longer exposures (on the order of years) increase the risk for heart disease-related deaths to an even greater extent. Research is progressing on how PM influences heart disease, but it is thought to involve several mechanisms, including increases in inflammation, clotting factors, blood pressure, and coronary artery stiffness (AHA, 2010).
Heart Disease Trends in Utah | Top
Utah has experienced a slow but steady decrease in the rate of emergency department (a.k.a. emergency room) visits for heart disease over the past decade. Figure 3 shows the monthly age-adjusted rate of emergency department visits due to all heart diseases in Utah from 2000 to 2011. The rate ranges from a high of 53 per 100,000 per month in 2001 (i.e., for every 100,000 people in Utah, we would expect 53 people admitted to an emergency department due to heart disease in a given month) to a low of 35 per 100,000 per month in 2011. The rate shows some seasonal variation, being higher between the months of December to March.
Figure 3
The rate of hospital visits due to heart disease has also declined in recent years in Utah, decreasing markedly since 2006. Figure 4 presents the monthly age-adjusted rate of people admitted to a hospital due to heart disease in Utah from 2000 to 2011. The rate ranges from a high of 65 per 100,000 per month in 2001 to a low of 35 per 100,000 per month in 2010. This rate also shows slight seasonal variation and is typically higher in the winter and early spring (December to March).
Figure 4
The rate of death due heart disease in Utah has shown a slight decline since 2000. Figure 5 presents the monthly age-adjusted rate of death due to heart disease in Utah from 2000 to 2011. The rate ranges from a high of 14 per 100,000 per month in 2004 to a low of 7 per 100,000 per month in 2010. As with the emergency department and hospital admission rates, the death rate also shows some indication of seasonal variation and is typically higher from December to March.
Figure 5
Data and Indicators | Top
The Utah Environmental Public Health Tracking Program (EPHT) and Utah's Indicator-Based Information System for Public Health (IBIS-PH) have created a number of indicators exploring data on heart disease and heart attacks in Utah. An indicator is a fact or trend that indicates the level or condition of something. Well known indicators include gross national product, unemployment rates, and presidential approval ratings. In a public health context, indicators show trends like cancer rates, drinking water contamination levels, and blood lead levels in children. Visit the EPHT frequently asked questions page for more information.
Heart Disease Indicators
