Gerald Hurowitz, M.D.·Published 1 December 2011·11 min read
Key points
Indeed, since 1999, the Statistical Update has been cited more than 8700 times in the literature (including citations of all annual versions).
The 2007 overall death rate from CVD (International Classification of Diseases 10, I00–I99) was 251.2 per 100 000.
Approximately 2,400 Americans die of CVD each day.
Data from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 indicate that 33.5% of US adults ≥20 years of age have hypertension.
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 on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update.
The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document. Indeed, since 1999, the Statistical Update has been cited more than 8700 times in the literature (including citations of all annual versions). In 2009 alone, the various Statistical Updates were cited ≈1600 times (data from ISI Web of Science).
In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas. For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year and added a new chapter detailing how family history and genetics play a role in cardiovascular disease (CVD) risk.
Also, the 2011 Statistical Update is a major source for monitoring both cardiovascular health and disease in the population, with a focus on progress toward achievement of the AHA's 2020 Impact Goals. Below are a few highlights from this year's Update.
Death Rates From CVD Have Declined, Yet the Burden of Disease Remains High
The 2007 overall death rate from CVD (International Classification of Diseases 10, I00–I99) was 251.2 per 100 000. The rates were 294.0 per 100 000 for white males, 405.9 per 100 000 for black males, 205.7 per 100 000 for white females, and 286.1 per 100 000 for black females. From 1997 to 2007, the death rate from CVD declined 27.8%. Mortality data for 2007 show that CVD (I00–I99; Q20–Q28) accounted for 33.6% (813 804) of all 2 243 712 deaths in 2007, or 1 of every 2.9 deaths in the United States.
On the basis of 2007 mortality rate data, more than 2200 Americans die of CVD each day, an average of 1 death every 39 seconds. More than 150 000 Americans killed by CVD (I00–I99) in 2007 were <65 years of age. In 2007, nearly 33% of deaths due to CVD occurred before the age of 75 years, which is well before the average life expectancy of 77.9 years.
Coronary heart disease caused ≈1 of every 6 deaths in the United States in 2007. Coronary heart disease mortality in 2007 was 406 351. Each year, an estimated 785 000 Americans will have a new coronary attack, and ≈470 000 will have a recurrent attack. It is estimated that an additional 195 000 silent first myocardial infarctions occur each year. Approximately every 25 seconds, an American will have a coronary event, and approximately every minute, someone will die of one.
Written and revised by
Gerald Hurowitz, M.D.
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Cardiovascular Disease and Stroke: Startling Statistics
Highlighted findings from the 2009 Heart Disease and Stroke Statistics report (Lloyd-Jones et al. 2009) reveal these disquieting facts:
Approximately 2,400 Americans die of CVD each day. This means that on average there is one death every 37 seconds from CVD. More than 150,000 Americans killed by CVD in 2005 were under 65 years of age, which is far below the average life expectancy of 77.9 years. One in every 5 deaths in the United States in 2005 was from coronary heart disease (CHD, also referred to as atherosclerotic heart disease), which is the final result of the accumulation of atherosclerotic plaque within the walls of the coronary arteries. On average, someone in the United States has a stroke every 40 seconds. That represents about 1 in every 18 U.S. deaths. Despite health recommendations that all adult Americans complete 30 minutes of somewhat hard physical activity on most days of the week, 62% of adults over 18 years of age lead completely sedentary lifestyles. More than 12% of preschool children 2–5 years of age were overweight in 2005 (as measured by body mass index [BMI]-weight in kilograms divided by height in meters squared), placing them at or above the 95th percentile in body weight among children their age. An estimated 80 million American adults (approximately 1 in 3) have one or more types of CVD. These diseases include high blood pressure, coronary heart disease, myocardial infarction (heart attack), angina pectoris (chest pain), heart failure (inability of the heart to pump enough blood to sustain normal bodily functions), stroke and congenital (present at birth but not necessarily hereditary) cardiovascular defects. In 2005, the leading causes of death in women ≥ 65 years of age were (1) diseases of the heart, (2) cancer, (3) stroke and (4) chronic lower respiratory disease (CLRD, such as emphysema and chronic bronchitis). In older men, they were (1) heart disease, (2) cancer, (3) CLRD and (4) stroke (see Figure 1 for comparison of CVD and cancer by age in the U.S.).
Lloyd-Jones et al. (2010) note that data clearly show the prevalence of hypertension and type 2 diabetes in pediatric populations, which will no doubt lead to CVD at much younger ages for men and women in the future. Additionally, Lloyd-Jones et al. (2009) state that the underlying causes of the majority of CVD events are present and go undetected for decades before the occurrence of a "clinical event," such as a nonfatal myocardial infarction or a disabling stroke.
Each year, ≈795 000 people experience a new or recurrent stroke. Approximately 610 000 of these are first attacks, and 185 000 are recurrent attacks. Mortality data from 2007 indicate that stroke accounted for ≈1 of every 18 deaths in the United States. On average, every 40 seconds, someone in the United States has a stroke. From 1997 to 2007, the stroke death rate fell 44.8%, and the actual number of stroke deaths declined 14.7%.
In 2007, 1 in 9 death certificates (277 193 deaths) in the United States mentioned heart failure. {pagebreak}
Prevalence and Control of Traditional Risk Factors Remains an Issue for Many Americans
Data from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 indicate that 33.5% of US adults ≥20 years of age have hypertension. This amounts to an estimated 76 400 000 US adults with hypertension. The prevalence of hypertension is nearly equal between men and women. African American adults have among the highest rates of hypertension in the world, at 44%. Among hypertensive adults, ≈80% are aware of their condition, 71% are using antihypertensive medication, and only 48% of those aware that they have hypertension have their condition controlled.
Despite 4 decades of progress, in 2008, among Americans ≥18 years of age, 23.1% of men and 18.3% of women continued to be cigarette smokers. In 2009, 19.5% of students in grades 9 through 12 reported current tobacco use. The percentage of the nonsmoking population with detectable serum cotinine (indicating exposure to secondhand smoke) was 46.4% in 1999 to 2004, with declines occurring, and was highest for those 4 to 11 years of age (60.5%) and those 12 to 19 years of age (55.4%).
An estimated 33 600 000 adults ≥20 years of age have total serum cholesterol levels ≥240 mg/dL, with a prevalence of 15.0%.
What are the symptoms of a heart attack?
Chest discomfort, mild pain Coughing Crushing chest pain Dizziness Dyspnea (shortness of breath) Face seems gray A feeling of terror that your life is coming to its end Feeling really awful (general feeling) Nausea Restlessness The person is clammy and sweaty Vomiting
If you experience these symptoms, or witness another person with them, call the emergency services immediately. In the United Kingdom the telephone number is 999, in the USA and Canada it is 911, Australia 000, and New Zealand 111. Many cell phones' emergency number is 112.
A person who is having a heart attack usually feels the pain in his/her chest first. This pain then spreads to the neck, jaw, ears, arms, and wrists. With some patients, the pain also makes its way into the shoulder blades, the back, and the abdomen.
The pain does not feel any better if the patient changes position, rests, or lies down. Often it is a constant pain, but it can come and go. Patients describe the pain as one of pressure, something squeezing. The pain can last from a few minutes to many hours.
People with diabetes, and/or those over the age of 75 may experience a "silent heart attack". This is one that occurs with no pain at all.
Studies indicate that about one fifth of mild heart attacks are not diagnosed. If this is the case, there are many people who are suffering progressive heart muscle damage because it is not being treated.
In 2008, an estimated 18 300 000 Americans had diagnosed diabetes mellitus, representing 8.0% of the adult population. An additional 7 100 000 had undiagnosed diabetes mellitus, and 36.8% had prediabetes, with abnormal fasting glucose levels. African Americans, Mexican Americans, Hispanic/Latino individuals, and other ethnic minorities bear a strikingly disproportionate burden of diabetes mellitus in the United States.
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The 2011 Update Expands Data Coverage of the Obesity Epidemic and Its Antecedents and Consequences
The estimated prevalence of overweight and obesity in US adults (≥20 years of age) is 149 300 000, which represents 67.3% of this group in 2008. Fully 33.7% of US adults are obese (body mass index ≥30 kg/m2). Men and women of all race/ethnic groups in the population are affected by the epidemic of overweight and obesity.
Among children 2 to 19 years of age, 31.9% are overweight and obese (which represents 23 500 000 children), and 16.3% are obese (12 000 000 children). Mexican American boys and girls and African American girls are disproportionately affected. Over the past 3 decades, the prevalence of obesity in children 6 to 11 years of age has increased from ≈4% to more than 20%.
Obesity (body mass index ≥30 kg/m2) is associated with marked excess mortality in the US population. Even more notable is the excess morbidity associated with overweight and obesity in terms of risk factor development and incidence of diabetes mellitus, CVD end points (including coronary heart disease, stroke, and heart failure), and numerous other health conditions, including asthma, cancer, degenerative joint disease, and many others.
The prevalence of diabetes mellitus is increasing dramatically over time, in parallel with the increases in prevalence of overweight and obesity.
The Mediterranean diet: is it cardioprotective? Coronary heart disease is one of the leading causes of morbidity and mortality in the United States. Dietary interventions are first-line therapy for coronary heart disease prevention and treatment. Increasing scientific evidence suggests that the traditional Mediterranean diet may reduce the risk of cardiovascular disease. The cardiovascular benefits of this whole-diet approach may outweigh those of typically prescribed low-fat diets. The burden of coronary heart disease is enormous, and nutritional approaches that optimize cardiovascular health are essential. Clinical trial evidence supporting the role of the Mediterranean diet in cardiovascular health is presented with an emphasis on the physiological effects of omega-3 fatty acids. Implications for clinical practice and future research are also discussed.
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by Marita C Bautista, Margurite M Engler Progress in Cardiovascular Nursing (2005) Volume: 20, Issue: 2, Pages: 70-76
On the basis of NHANES 2003–2006 data, the age-adjusted prevalence of metabolic syndrome, a cluster of major cardiovascular risk factors related to overweight/obesity and insulin resistance, is 34% (35.1% among men and 32.6% among women).
The proportion of youth (≤18 years of age) who report engaging in no regular physical activity is high, and the proportion increases with age. In 2007, among adolescents in grades 9 through 12, 29.9% of girls and 17.0% of boys reported that they had not engaged in 60 minutes of moderate-to-vigorous physical activity, defined as any activity that increased heart rate or breathing rate, even once in the previous 7 days, despite recommendations that children engage in such activity ≥5 days per week.
Thirty-six percent of adults reported engaging in no vigorous activity (activity that causes heavy sweating and a large increase in breathing or heart rate).
Data from NHANES indicate that between 1971 and 2004, average total energy consumption among US adults increased by 22% in women (from 1542 to 1886 kcal/d) and by 10% in men (from 2450 to 2693 kcal/d; see Chart 19-1).
The increases in calories consumed during this time period are attributable primarily to greater average carbohydrate intake, in particular, of starches, refined grains, and sugars. Other specific changes related to increased caloric intake in the United States include larger portion sizes, greater food quantity and calories per meal, and increased consumption of sugar-sweetened beverages, snacks, commercially prepared (especially fast food) meals, and higher energy-density foods.
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Ve'ronique L. Roger, MD, MPH, FAHA; Alan S. Go, MD; Donald M. Lloyd-Jones, MD, ScM, FAHA; Robert J. Adams, MD, MS, FAHA; Jarett D. Berry, MD; Todd M. Brown, MD, MSPH; Mercedes R. Carnethon, PhD, FAHA; Shifan Dai, MD, PhD; Giovanni de Simone, MD, FAHA; Earl S. Ford, MD, MPH, FAHA; Caroline S. Fox, MD, MPH; Heather J. Fullerton, MD; Cathleen Gillespie, MS; Kurt J. Greenlund, PhD; Susan M. Hailpern, DPH, MS; John A. Heit, MD, FAHA; P. Michael Ho, MD, PhD; Virginia J. Howard, PhD, FAHA; Brett M. Kissela, MD; Steven J. Kittner, MD, FAHA; Daniel T. Lackland, DrPH, MSPH, FAHA; Judith H. Lichtman, PhD, MPH; Lynda D. Lisabeth, PhD, FAHA; Diane M. Makuc, DrPH; Gregory M. Marcus, MD, MAS, FAHA; Ariane Marelli, MD; David B. Matchar, MD, FAHA; Mary M. McDermott, MD; James B. Meigs, MD, MPH; Claudia S. Moy, PhD, MPH; Dariush Mozaffarian, MD, DrPH, FAHA; Michael E. Mussolino, PhD; Graham Nichol, MD, MPH, FAHA; Nina P. Paynter, PhD, MHSc; Wayne D. Rosamond, PhD, FAHA; Paul D. Sorlie, PhD; Randall S. Stafford, MD, PhD, MHS, FAHA; Tanya N. Turan, MD, FAHA; Melanie B. Turner, MPH; Nathan D. Wong, PhD, MPH, FAHA; Judith Wylie-Rosett, EdD, RD on behalf of the American Heart
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