AHA 2019 Heart Disease and Stroke Statistics

Benjamin EJ, Muntner P, Alonso A, et al.
Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019;Jan 31:[Epub ahead of print].

The following are key points to remember about this annual update on the statistics regarding heart disease, stroke, and cardiovascular risk factors:

  1. Cardiovascular disease (CVD) remains the leading cause of death in the United States, responsible for 840,768 deaths (635,260 cardiac) in 2016. From 2006 to 2016, the US death rate from CVD decreased by 18.6% and from coronary heart disease by 31.8%.
  2. The annual total cost of CVD in the United States was estimated at $351.2 billion in 2014-2015, with $213.8 billion in direct cost, including 46% for inpatient care.
  3. Approximately every 40 seconds, an American will have a myocardial infarction. The average age of first myocardial infarction is 65.6 years old for men and 72.0 years old for women.
  4. In the United States in 2019, coronary events are expected to occur in about 1,055,000 individuals, including 720,000 new and 335,000 recurrent coronary events.
  5. In 2017, emergency medical services-assessed out-of-hospital cardiac arrest occurred in an estimated 356,461 Americans; emergency medical services treatment was initiated in 52%. The initial recorded cardiac rhythm was ventricular fibrillation, ventricular tachycardia, or shockable by automated external defibrillator in only 18.7%. Adult survival to hospital discharge was 10.4%; 8.4% had good functional status at discharge.
  6. About 6.2 million American adults had heart failure (HF) in 2013-2016. Patients who were newly hospitalized for HF were almost evenly divided by those with reduced ejection fraction and those with preserved ejection fraction. HF prevalence continues to rise. As of April 27, 2018, 3,994 Americans were on a waiting list for heart transplant, and 55 were waiting for heart and lung transplant.
  7. Every 40 seconds on average, an American will have a stroke. About 795,000 Americans have a new or recurrent stroke annually. About 90% of stroke risk is due to modifiable risk factors; 74% is due to behavioral risk factors.
  8. Approximately 5.3 million Americans have atrial fibrillation. In 2014, atrial fibrillation or flutter was the principal diagnosis in approximately 454,000 US hospitalizations.
  9. Admissions for intravenous drug-related endocarditis have increased in parallel with the opioid drug crisis.
  10. In 2014, pulmonary embolism was principal diagnosis in 178,000 US hospitalizations.
  11. Prevalence of congenital cardiovascular defects is relatively stable, with a trend toward improved outcomes. Pulse oximetry screening for critical congenital heart disease in neonates has been implemented in almost all states since 2011. Kawasaki disease is the most common cause of acquired heart disease in US children.
  12. Hospital readmission reduction programs are associated with reduced 30-day and 1-year hospitalization rates but increased 30-day and 1-year mortality.
  13. US estimated procedural volume and 2014 mean hospital charges are described below:
  14. Procedure Volume Year of Data Hospital Charge
    Cardiac Catheterization 1,016,000 2014 $57,494
    Percutaneous Coronary Intervention (Inpatient) 480,000 2014 $84,813
    Pacemaker 351,000 2014 $83,521
    Implantable Cardioverter Defibrillator 60,000 2014 $171,476
    Coronary Artery Bypass Grafting, All 371,000 2014 $168,541
    Heart Transplant 3,244 2017 $808,770
  15. The most recent data regarding CVD risk factors and behaviors are described below:
  16. Behavior/Risk Factor Prevalence
    Smoking, Adults 15.5%
    Obesity, Adults 39.6%
    Obesity, Youth 18.5%
    Low-Density Lipoprotein Cholesterol ≥130 mg/dl, Adults 28.5%
    Hypertension, Adults* 45.6%
    Diabetes Mellitus, Diagnosed 9.8%
    Diabetes Mellitus, Undiagnosed 3.7%
    Chronic Kidney Disease 14.8%
    Recommended Exercise (2008 guidelines) 22.5%
    *Hypertension defined by 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Aortic Surgery, Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Lipid Metabolism, Nonstatins, Acute Heart Failure, Heart Transplant, Interventions and Vascular Medicine, Hypertension

Keywords: Cardiovascular Diseases, Coronary Disease, Risk Factors, Stroke, Stroke Volume, American Heart Association, Heart Failure, Atrial Fibrillation, Myocardial Infarction, Ventricular Fibrillation, Tachycardia, Ventricular, Hypertension, Cholesterol, LDL, Defibrillators, Implantable, Pacemaker, Artificial, Endocarditis, Pulmonary Embolism, Inpatients, Emergency Medical Services, Cardiac Catheterization, Coronary Artery Bypass, Percutaneous Coronary Intervention, Heart Transplantation, Lung Transplantation, Oximetry

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