Heart Disease and Stroke Statistics—2011 Update

Abstract

Summary 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. Ap...

Reducing the Blood Pressure–Related Burden of Cardiovascular Disease: Impact of Achievable Improvements in Blood Pressure Prevention and Control

“…Interventions targeting the US white populations with uncontrolled blood pressure would need to achieve approximately a 30% proportional reduction in uncontrolled blood pressure in order to achieve event reduction comparable to those estimated for population‐wide interventions that achieve a 1‐mm Hg shift in SBP. African American populations, among whom blood pressure elevation occurs at earlier ages and show elevated rates of CVD in the United States,1, 40 likely would reap the greatest benefits of population‐wide and targeted above goal blood pressure interventions, particularly for uncontrolled blood pressure, suggesting that both types of interventions have potential for reducing these persistent health disparities.…”

“…The ARIC study was also restricted to participants aged 45 to 64 years at study baseline. Additionally, several studies suggest that the national incidence of CVD events has changed since the 1980s, with the incidence of CHD and stroke declining and the incidence of HF increasing,1, 50, 51 which may over‐ or underestimate the number of events reduced by population‐wide and targeted blood pressure interventions. Secondly, we assumed the same incidence rate reduction when calculating the number of events that could be prevented from interventions that targeted unaware, untreated, and uncontrolled blood pressure above goal.…”

“…Decades of research have characterized the associations between elevated blood pressure and a spectrum of cardiovascular diseases (CVD) including cerebral vascular disease, heart failure (HF), and coronary heart disease (CHD) 1, 2, 3, 4, 5. Among blood pressure–related deaths, published estimates suggest that approximately one third of excess CHD and all‐cause mortality can be attributed to elevated systolic blood pressure (SBP) at levels designated as nonhypertensive,6, 7 indicating that benefits achieved from decreases in blood pressure are not limited to populations with hypertension 8, 9, 10, 11, 12.…”

“…Other published studies examined CHD and stroke events, but were conducted in predominantly white or European populations and considered blood pressure treatment guidelines no longer in use 8, 19, 20, 23. The degree to which modest population‐wide blood pressure shifts may affect the incidence of HF also remains unknown, as do the effects of blood pressure shifts in African American populations,19 who shoulder higher burdens of elevated blood pressure as well as CVD than do white populations 1. Further, the majority of published studies estimated cardiovascular benefits from interventions that completely eliminated hypertension or uncontrolled hypertension from the population, despite the implausibility of such goals 24, 25, 26.…”

Cannabinoids, the Heart of the Matter

“…A person is defined to be hypertensive when blood pressure is 140 mm Hg systolic, or exceeds this value, and/or when it is 90 mm Hg diastolic or higher 13, 14. Most people having their first stroke have a blood pressure higher than 140/90 mm Hg 13.…”