Section 4: Cardiovascular Diseases

• 4.1 Coronary Heart/Artery Disease
  • 4.1a. Epidemiology
  • 4.1b. Coronary Heart Disease and Driving (Sudden Death at the Wheel)
  • 4.1c. Injury to Others
  • 4.1d. Prodromal Symptoms
  • 4.1e. Predictors of Sudden Death at the Wheel due to Coronary Heart Disease
  • 4.1f. Current Licensing/Guideline Recommendations
• 4.2 Disturbances of Cardiac Rhythm
  • 4.2a. Ventricular Arrhythmias
  • 4.2b. Atrial Fibrillation/Flutter
  • 4.2c. Heart Block
  • 4.2d. Pacemakers
  • 4.2e. Implantable Cardioverter/Defibrillator Devices
• 4.3 Congestive Heart Failure
• 4.4 Abnormal Blood Pressure
  • 4.4a. Hypertension
    4.4b. Hypotension

4. Cardiovascular Diseases - Epidemiology

According to 1996 estimates, 58,800,000 Americans have one or more forms of cardiovascular disease (CVD): 50,000,000 are estimated to have high blood pressure, 12,000,000 coronary heart disease, 7,000,000 myocardial infarction, 6,200,000 angina pectoris, 4,400,000 stroke, and 1,800,00 rheumatic fever/rheumatic heart disease (American Heart Association, 1999).

A summary of the current fitness-to-drive guidelines (Cardiovascular Diseases) for medical practitioners from Australia (1998) and Canada (2000) is presented in Table 9.

4.1 Coronary Heart/Artery Disease

4.1a. Epidemiology

Coronary heart disease (CHD) caused 1 of every 4.9 deaths in the United States in 1996 for a total of 476,124 deaths. Figure 1 shows the estimated prevalence in the United States of coronary artery disease by age and sex for the years 1988-1994 (National Health and Nutrition Examination Survey III [NHANES III], 1988-94, CDC/CHS and the American Heart Association)

Figure 1  Estimated prevalence of coronary artery disease by age and sex in the United States, 1988-1994

Source: National Health and Nutrition Examination Survey III (NHANES III), 1988-94, CDC/CHS and the American Heart Association.