Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). Methods: The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year’s worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year’s edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals. Results: Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. Conclusions: The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000950 ◽

2021 ◽

Cited By ~ 1

Author(s):

Salim S. Virani ◽

Alvaro Alonso ◽

Hugo J. Aparicio ◽

Emelia J. Benjamin ◽

Marcio S. Bittencourt ◽

...

Keyword(s):

Cardiovascular Disease ◽

Heart Disease ◽

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Subclinical Atherosclerosis ◽

Heart Association ◽

The United States ◽

Venous Disease ◽

Adverse Pregnancy

BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year’s worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year’s edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS: Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Abstract P003: Distribution of Ideal Cardiovascular Health Metrics in US and Non-US populations: A Meta-Analysis of Proportions

Circulation ◽

10.1161/circ.131.suppl_1.p003 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Adnan Younus ◽

Ehimen Aneni ◽

Oluseye Ogunmoroti ◽

Omar Jamal ◽

Shozab Ali ◽

...

Keyword(s):

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Meta Analysis ◽

Heart Association ◽

The United States ◽

Free Text ◽

Significant Heterogeneity ◽

Ideal Cardiovascular Health ◽

Us Studies

Introduction: With the development of new health metrics to define ideal cardiovascular health (CVH), several studies have examined the distribution of the American Heart Association (AHA) 2020 ideal CVH metrics both within and outside the United States (US). In this meta-analysis of proportions, we synthesized available data on ideal CVH metrics distribution in US cohorts and compared them with non-US populations. Methods: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “ideal cardiovascular health” between January 2000 and October 2014. Studies were included in the meta-analysis if the proportions achieving ideal for 0, 1, 2, 3, 4, 5 or ≥6 ideal CVH metrics were known or could be estimated. A meta-analysis of proportions was conducted for US and non-US studies using a random effect model (REM). REM models were chosen because of the significant heterogeneity among studies. Results: Overall the pooled data consisted of 10 US cohorts with a total population of 94,761 participants and 6 non-US cohorts with a total of 130,242 participants. The table shows the pooled prevalence of ideal CVH factors in this population. Overall the pooled estimates of US cohorts showed 15% had 0-1 ideal CVH metrics (inter-study range: 7-22%), while 3% (inter-study range: 1-10%) had 6-7 ideal CVH metrics. This is comparable to 12% (inter-study range 1-17%) and 2% (inter-study range: 1-12%) for 0-1 and 6-7 ideal CVH metrics in the non-US studies. Conclusion: The proportion of persons achieving 6 or more ideal CVH metrics in both US and non-US cohorts is very low and the distribution of CVH metrics is similar in both US and non-US populations. Considering the strong association with worse outcomes, a coordinated global effort at improving CVH should be considered a priority.

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American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22–35-year-old adults conceived with and without assisted reproductive technologies

Human Reproduction ◽

10.1093/humrep/dez240 ◽

2019 ◽

Vol 35 (1) ◽

pp. 232-239 ◽

Cited By ~ 2

Author(s):

Markus Juonala ◽

Sharon Lewis ◽

Robert McLachlan ◽

Karin Hammarberg ◽

Joanne Kennedy ◽

...

Keyword(s):

Cardiovascular Risk ◽

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Subclinical Atherosclerosis ◽

Heart Association ◽

Categorical Variables ◽

Inverse Association ◽

Health Score ◽

Ideal Cardiovascular Health

Abstract STUDY QUESTION Is ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis? SUMMARY ANSWER The associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude. WHAT IS KNOWN ALREADY Long-term consequences of ART on cardiovascular health are unknown. STUDY DESIGN, SIZE, DURATION The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22–35 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always >0.2). AHA score was not associated with cIMT or retinal measures in either group (P always >0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) −0.18(−0.26 to −0.10)). A numerically similar relationship was observed in the smaller non-ART group (−0.19(−0.39 to 0.01)). LIMITATIONS, REASONS FOR CAUTION Even though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children’s Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.

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Abstract P209: Socioeconomic Position is Associated with Cardiovascular Health Following the E-Mechanic Exercise Intervention

Circulation ◽

10.1161/circ.133.suppl_1.p209 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Candice A Myers ◽

Stephanie T Broyles ◽

Corby Martin ◽

Timothy S Church

Keyword(s):

Socioeconomic Position ◽

American Heart Association ◽

Cardiovascular Health ◽

Exercise Intervention ◽

American Heart ◽

Heart Association ◽

The United States ◽

Socioeconomic Factor ◽

Post Intervention ◽

Health Factors

Cardiovascular disease is the leading cause of death in the United States. The American Heart Association set national goals for cardiovascular health, including 7 metrics for ideal cardiovascular health. Research has shown that social factors, such as socioeconomic position (i.e., income, education), are important influences on cardiovascular health. Specifically, disparities in cardiovascular health exist between higher and lower socioeconomic positions. We assessed the hypothesis that higher socioeconomic position would be associated with improved cardiovascular health, measured as 4 cardiovascular health factors as outlined by the American Heart Association Life’s Simple 7, following an exercise intervention. This study used data from the Examination of Mechanisms (E-Mechanic) of Exercise-Induced Weight Compensation randomized control trial. Cardiovascular health factors included 1) BMI, 2) cholesterol, 3) glucose, and 4) systolic blood pressure, which were used to create composite cardiovascular health scores based upon ideal (2 points), intermediate (1 point), and poor (0 points) health for each factor for a possible range of 0 points (worst CVH) to 8 points (best CVH). These scores were calculated pre- and post-intervention. The primary covariate, socioeconomic position, was created using principal components analysis with income and educational attainment to produce a single socioeconomic factor that was dichotomized to indicate high socioeconomic position (=1). We also included covariates for age, sex, race, and marital status. Among the 114 participants (21-65 years old; 72% female; 30% black) who received the E-MECHANIC exercise intervention, the mean cardiovascular health factor score pre-intervention was 5.1 points (SD=1.2 points) and post-intervention 5.4 (SD=1.2 points). Regression analysis revealed that the exercise intervention increased cardiovascular health overall (p=0.03). However, participants with higher socioeconomic position had significantly (p=0.002) greater improvement in cardiovascular health factor scores. At baseline participants with higher socioeconomic position had better cardiovascular health, but not significantly better (LS-means difference = 0.38; p=0.35). Yet, after the intervention the difference in cardiovascular health between high and low socioeconomic position participants had increased (LS-means difference = 0.71; p=0.01). Although cardiovascular health improved for all intervention participants, those with higher socioeconomic position demonstrated better improvement in cardiovascular health thusly increasing socioeconomic health disparities. This provides further evidence that in order for interventions to be equally effective among participants consideration should be given to socioeconomic influences and interventions may need to be customized for different populations.

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The American Heart Association 2030 Impact Goal: A Presidential Advisory From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000758 ◽

2020 ◽

Vol 141 (9) ◽

Cited By ~ 18

Author(s):

Sonia Y. Angell ◽

Michael V. McConnell ◽

Cheryl A.M. Anderson ◽

Kirsten Bibbins-Domingo ◽

Douglas S. Boyle ◽

...

Keyword(s):

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Mission Statement ◽

Healthcare Delivery ◽

Heart Association ◽

Well Being ◽

The United States ◽

Research Quality ◽

Strategic Direction

Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA’s new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force’s main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.

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Workplace Wellness Recognition for Optimizing Workplace Health

Circulation ◽

10.1161/cir.0000000000000206 ◽

2015 ◽

Vol 131 (20) ◽

Cited By ~ 46

Author(s):

Gregg C. Fonarow ◽

Chris Calitz ◽

Ross Arena ◽

Catherine Baase ◽

Fikry W. Isaac ◽

...

Keyword(s):

Cardiovascular Disease ◽

Stroke Prevention ◽

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Heart Association ◽

Wellness Programs ◽

The United States ◽

Workplace Wellness ◽

Workplace Wellness Programs

The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life’s Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous standards, facilitating access to high-quality comprehensive workplace wellness programs for both employees and dependents, and fostering innovation and additional research.

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A Study of Arterial Vasodilation as a Means of Modulating Wall Shear Stress

Advances in Bioengineering ◽

10.1115/imece2002-32323 ◽

2002 ◽

Author(s):

Javier A. Kypuros ◽

Edmundo Marrufo

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Shear Stress ◽

Heart Disease ◽

Wall Shear Stress ◽

American Heart Association ◽

American Heart ◽

Heart Association ◽

The United States ◽

National Institutes Of Health

Diseases of the heart continue to be the number 1 killer of Americans. In 2001, cardiovascular disease and stroke cost the United States an estimated $298.2 billion [American Heart Association]. Heart disease and related vascular disorders remain focus areas during this decade for the National Institutes of Health (NIH) as reported in Healthy People 2010.

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