Heart Disease and Stroke Statistics—2015 Update: A Report From the American Heart Association | Journal Scan

Mozaffarian D, Benjamin EJ, Go AS, et al.
Circulation 2014;Dec 17:[Epub ahead of print].
The following are 10 points to remember from the 2015 update of the Heart Disease and Stroke Statistics report:

1. Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics related to heart disease, stroke, and other cardiovascular and metabolic diseases and presents them in its Heart Disease and Stroke Statistical Update.

2. From 2001 to 2011, death rates attributable to cardiovascular disease (CVD) declined 30.8% and stroke rate declined by 35%, but in 2011, CVD still accounted for 31.3% of all deaths and about 25% were <65 years of age. About 1 million hospital discharges for heart failure occur yearly, which has not changed.

3. For 2011, the estimated annual costs for CVD and stroke were $320.1 billion, including $195.6 billion in direct costs (all services) and $124.5 billion in indirect costs from lost future productivity. Mean per patient charge for surgical coronary revascularization in 2012 was $149K and for percutaneous coronary intervention (PCI) was about $70K. Avoidable adverse event rates occurring between 2005 and 2011 have reduced by about one third for hospitalized patients with a myocardial infarction and congestive heart failure, but only 66% of outpatients receive optimal evidence-based care.

4. The prioritization of both health behaviors (healthy diet pattern, appropriate energy intake, physical activity, and nonsmoking) and health factors (optimal blood lipids, blood pressure, glucose levels) throughout the lifespan are primary goals unto themselves.

5. Familial aggregation of CVD is related to the clustering of specific lifestyle factors and risk factors, both of which have environmental and genetic contributors. The risk is higher in the presence of a family history of parent and/or sibling including CVD (45%), stroke (50%), atrial fibrillation (80%), heart failure (70%), and peripheral arterial disease (80%).

6. About 75% of children and 50% of adults have ideal cholesterol levels; about one third of adults or about 80 million people have hypertension (blacks about 45%) and about 10% of adults have diabetes.

7. Current cigarette use declined from 24.1% in 1998 to 17.9% in 2013; but about one third of deaths are attributable to smoking and exposure to secondhand smoke. To date, the risks and benefits of e-tobacco products remain controversial. Experts are concerned that e-cigarettes may be a gateway to smoking traditional cigarettes.

8. In 2013, 15.2% of adolescents reported being inactive during the prior week. Inactivity was more commonly reported by black and Hispanic girls and boys than their white counterparts. Only half of American adults met the current aerobic physical activity (PA) guidelines (≥150 minutes of moderate PA or 75 minutes of vigorous PA or an equivalent combination each week), and women and minorities were less likely to meet the guidelines.

9. The leading risk factor for death and disability in the United States is suboptimal diet quality. Major contributors were insufficient intakes of fruits, nuts/seeds, whole grains, vegetables, and seafood, as well as excess intakes of sodium. Comparing extremes of unhealthful versus healthful food-based diet patterns, the more healthful patterns cost on average approximately $1.50 per day more. Obesity decreased among those of higher socioeconomic status, but increased among those of lower socioeconomic status, and severe obesity increased in US youth.

10. Current evidence supports a range of complementary strategies to improve cardiovascular health, including: individual-focused approaches, which target lifestyle and treatments at the individual level; health care system approaches, which encourage, facilitate, and reward efforts by providers to improve health behaviors and health factors; and population approaches, which target lifestyle and treatments in schools or workplaces, local communities, and states, as well as throughout the nation.

Clinical Topics: Arrhythmias and Clinical EP, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Prevention, Atherosclerotic Disease (CAD/PAD), Atrial Fibrillation/Supraventricular Arrhythmias, Lipid Metabolism, Nonstatins, Acute Heart Failure, Interventions and Vascular Medicine, Diet, Hypertension, Smoking

Keywords: African Americans, American Heart Association, Atrial Fibrillation, Blood Pressure, Centers for Disease Control and Prevention (U.S.), Cereals, Cholesterol, Diabetes Mellitus, Electronic Cigarettes, Energy Intake, European Continental Ancestry Group, Fruit, Glucose, Health Behavior, Heart Failure, Hispanic Americans, Hypertension, Life Style, Motor Activity, Myocardial Infarction, National Institutes of Health (U.S.), Nuts, Obesity, Obesity, Morbid, Percutaneous Coronary Intervention, Peripheral Arterial Disease, Risk Assessment, Risk Factors, Seafood, Smoking, Social Class, Sodium, Stroke, Tobacco Smoke Pollution, Vegetables

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