The prevalence of coronary heart disease (CHD) in the U.S. declined from 6.7 percent in 2006 to 6 percent in 2010, according to a report released Oct. 14 by the Centers for Disease Control and Prevention (CDC). The results suggest that CHD incidence has declined, thanks to the prevention and control of CHD risk factors.

CDC analysts used Behavioral Risk Factor Surveillance System (BRFSS) surveys, conducted between 2006 and 2010 to assess self-reported CHD prevalence. The surveys consisted of a telephone poll of non-institutionalized adults that included two CHD-related questions: one asking if a health professional ever told the respondent he or she had a heart attack; and the other asking if a health professional ever told the respondent he or she had angina or CHD. The median response rate was 52.3 percent.

Respondents who answered “yes” to either question were designated as a self-reported CHD. Answers of “no,” “I don’t know” or refusals to answer were excluded. The data then were analyzed by age group, sex, educational status and race/ethnicity. All estimates were weighted to the state population, and the age-adjusted prevalence of CHD was standardized to 2000 for all years studied.

Overall, the CDC found that CHD prevalence declined from 6.7 percent to 6 percent but varied by sex, race, education and state of residence. CHD prevalence was:

• 7.8 percent for men, compared to 4.6 percent for women;
• 11.6 percent for American Indians and Alaskan natives compared to 3.9 percent for Asians or native Hawaiians and other Pacific Islanders;
• 9.2 percent for respondents with less than a high school education compared to 4.6 percent for those with more than a college degree;
• 8.2 percent for residents of Kentucky compared to 3.7 percent for residents of Hawaii; and
• Overall, the South saw the greatest regional prevalence.

The CDC noted that CHD mortality has declined for several decades, which would suggest that more survivors would lead to an increase in prevalence. “However, the decline in prevalence in this report is affected not only by CHD mortality but also by CHD incidence, which is decreased by the prevention and control of CHD risk factors," the authors wrote. "Given that CHD mortality is declining, the observed decline in prevalence of CHD in this study suggests that CHD incidence also has declined.”

The analysis was designed to help state and national health agencies identify gaps and opportunities for improvement in their efforts to reduce CHD deaths by 20 percent, which is a goal of the Healthy People 2020 campaign. The campaign’s target is 100.6 deaths resulting from CHD per 100,000 population, down from a 2007 baseline of 126 deaths per 100,000 population.

The survey has several drawbacks that could limit generalizability, including its response rate, reliance solely on landline telephones, being in English and Spanish only and being subject to self-reporting and recall biases.