Heart Disease and Stroke Statistics: 2016 Update

Mozaffarian D, Emelia BJ, Go AS, et al.
Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association. Circulation 2015;Dec 16:[Epub ahead of print].

The following are key points to remember from this American Heart Association (AHA) annual update on heart disease and stroke statistics:

  1. The annual AHA Statistical Update brings up-to-date information on the core health behaviors and health factors that define cardiovascular (CV) health. It summarizes major clinical disease conditions and the associated outcomes (including quality of care, procedures, and economic costs).
  2. Poor lifestyle behavior (most important is suboptimal diet) and lifestyle-related CV risk factors are the leading causes of death and disability in the United States and in the world. Among US adults, the prevalence of ideal CV status currently varies from about 1.5% for the healthy diet pattern to up to 78% for the smoking metric, which remains the primary attributable risk in about one-third of coronary heart disease (CHD) deaths. The risks and benefits of e-cigarettes are controversial. While having the greatest potential for improvement, fewer children and adults over time are meeting the ideal diet (cost compared to unhealthful is ~$1.50 per day), physical activity, and weight/body mass index.
  3. Among overweight and obese individuals, existing cardiometabolic risk factors should be monitored and treated intensively with diet quality, physical activity, and pharmacological or other treatments as necessary. Each of these interventions provides benefits independent of weight loss. Estimated mean annual per capita health care expenses attributable to obesity are $1,160 for men and $1,525 for women.
  4. The risk of most CV disease (CVD) conditions is higher in the presence of a family history, including CVD (45% with sibling history), stroke (50% with a first-degree relative), atrial fibrillation (80% with parental history), heart failure (70% with parental history), and peripheral arterial disease (80% with family history). Excess risk reflects genetic, epigenetic, and shared behavioral and environmental risk factors.
  5. From 2003 to 2013, death rates attributable to CVD declined 28.8%. In the same 10-year period, the actual number of CVD deaths per year declined by 11.7%. Yet in 2013, CVD still accounted for 30.8% (800,937) of all 2,596,993 deaths, or approximately one of every three deaths in the United States.
  6. From 2003 to 2013, the relative rate of stroke death fell by 33.7% (more among those >65 years) and the actual number of stroke deaths declined by 18.2%. Yet each year, ~795,000 people continue to experience a new or recurrent stroke (ischemic or hemorrhagic).
  7. The age-adjusted incidence and prevalence of atrial fibrillation in white participants increased approximately fourfold, yet the multivariable adjusted hazard of stroke (74%) and death (25%) associated with atrial fibrillation declined over the same time period.
  8. Each year, approximately 359,800 people experienced emergency medical services–assessed out-of-hospital cardiac arrests in the United States. Survival to hospital discharge after nontraumatic emergency medical services–treated cardiac arrest with any first recorded rhythm was 10.6% for patients of any age. Of the approximately 20,150 bystander-witnessed out-of-hospital cardiac arrests in 2011, 31.4% of victims survived to hospital discharge. Each year, approximately 209,000 people are treated for in-hospital cardiac arrest.
  9. Coronary artery calcium (CAC) detected by computed tomography was noted as highly predictive of CHD event risk across all age groups, suggesting that once CAC is known, chronological age has less importance. Compared with a CAC score of 0, CAC >100 imparted an increased multivariable-adjusted CHD event risk in younger individuals (45-54 years old) with a hazard ratio (HR) of 12.4. The respective risk was similar even in the very elderly (75-84 years of age), with an HR of 12.1.
  10. Between 2005 and 2011, adverse event rates in hospitalized patients declined for both myocardial infarction (from 5.0% to 3.7%) and congestive heart failure (from 3.7% to 2.7%). However, only 66.5% of eligible patients with coronary artery disease received the optimal evidence-based combination of medications.
  11. For 2011 to 2012, the estimated annual costs for CVD and stroke were $316.6 billion, including $193.1 billion in direct costs and $123.5 billion from lost future productivity (cardiovascular and stroke premature deaths). By comparison, in 2011, the estimated direct cost of all cancer was $88.7 billion.

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