Nearly Half of Americans Affected by CVD

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Forty-eight percent of US adults have some type of cardiovascular disease (CVD), according to the American Heart Association’s 2019 Statistical Update, published in Circulation.

Incorporating data from a wide range of sources, the annual report provides a comprehensive overview of the impact of heart disease, stroke, and cardiovascular risk factors, nationally and globally. Based on NHANES data from 2013 to 2016, the US prevalence of CVD in US adults—including coronary heart disease, heart failure, stroke, and hypertension—is estimated at 48.0% overall, with 121.5 million Americans affected in 2016.

The 48% figure represents an increase over past years, mainly reflecting a change in the American Heart Association/American College of Cardiology definition of hypertension: 130/80 mm Hg, compared to the previous definition of 140/90 mm Hg. Excluding hypertension, the estimated prevalence of CVD is 9.0%.

The data also show an increase in US CVD deaths: from 836,546 in 2015 to 840,678 in 2016. The rise in CVD mortality comes after decades of steady declines, which continue to be reflected in the worldwide figures: from 17.9 million in 2015 to 17.6 million in 2016. There are encouraging trends in some key CVD risk factors, especially decreases in smoking and physical inactivity.

Based on NHANES 2013–2016 data, 26 million adults have diagnosed diabetes mellitus, while 9.4 million have undiagnosed diabetes and another 91.8 million have prediabetes. United States Renal Data System data suggest that 14.8% of adults have chronic kidney disease, rising to 32.6% for those aged 60 years or older. The report notes that patients with kidney disease have very high rates of comorbid CVD, including nearly two-thirds (65.8%) in patients aged 66 or older. Both all-cause and CVD mortality increase steadily with declining kidney function and rising albumin-to-creatinine ratio.

The full report includes a wealth of data on the rates and impact of CVD, with an expanded focus on the global burden of CVD. The Annual Statistical Report is an important part of understanding the “challenges and opportunities” for reducing the burden of heart disease and stroke, according to an online commentary by Mariell Jessup, MD, Chief Science and Medical Officer, American Heart Association.

The data “hold us accountable and help us chart our progress and determine if and how we need to adjust our efforts,” Jessup writes. “By quantifying the impact of our collective work, we learn how to better invest our resources as we pursue longer, healthier lives for all” [Benjamin EJ, et al., on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139:e1–e473].