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Heart Disease and Stroke Statistics—2016 Update by Dariush Mozaffarian, Emelia J. Benjamin, Alan S. Go, Donna K. Arnett, Michael J. Blaha, Mary Cushman,

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Presentation on theme: "Heart Disease and Stroke Statistics—2016 Update by Dariush Mozaffarian, Emelia J. Benjamin, Alan S. Go, Donna K. Arnett, Michael J. Blaha, Mary Cushman,"— Presentation transcript:

1 Heart Disease and Stroke Statistics—2016 Update by Dariush Mozaffarian, Emelia J. Benjamin, Alan S. Go, Donna K. Arnett, Michael J. Blaha, Mary Cushman, Sandeep R. Das, Sarah de Ferranti, Jean-Pierre Després, Heather J. Fullerton, Virginia J. Howard, Mark D. Huffman, Carmen R. Isasi, Monik C. Jiménez, Suzanne E. Judd, Brett M. Kissela, Judith H. Lichtman, Lynda D. Lisabeth, Simin Liu, Rachel H. Mackey, David J. Magid, Darren K. McGuire, Emile R. Mohler, Claudia S. Moy, Paul Muntner, Michael E. Mussolino, Khurram Nasir, Robert W. Neumar, Graham Nichol, Latha Palaniappan, Dilip K. Pandey, Mathew J. Reeves, Carlos J. Rodriguez, Wayne Rosamond, Paul D. Sorlie, Joel Stein, Amytis Towfighi, Tanya N. Turan, Salim S. Virani, Daniel Woo, Robert W. Yeh, and Melanie B. Turner Circulation Volume 133(4):e38-e360 January 26, 2016 Copyright © American Heart Association, Inc. All rights reserved.

2 Incidence of cardiovascular disease according to the number of ideal health behaviors and health factors. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

3 Prevalence (unadjusted) estimates for poor, intermediate, and ideal cardiovascular health for each of the 7 metrics of cardiovascular health in the American Heart Association 2020 goals among US children aged 12 to 19 years, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

4 Prevalence (unadjusted) estimates of poor, intermediate, and ideal cardiovascular health for each of the 7 metrics of cardiovascular health in the American Heart Association 2020 goals among US adults aged 20 to 49 years and ≥50 years, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

5 Proportion (unadjusted) of US children aged 12 to 19 years meeting different numbers of criteria for ideal cardiovascular health, overall and by sex, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

6 Age-standardized prevalence estimates of US adults aged ≥20 years meeting different numbers of criteria for ideal cardiovascular health, overall and by age and sex subgroups, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

7 Age-standardized prevalence estimates of US adults aged ≥20 years meeting different numbers of criteria for ideal cardiovascular health, overall and in selected race subgroups, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

8 Prevalence of meeting ≥5 criteria for ideal cardiovascular health among US adults aged ≥20 years (age standardized) and US children aged 12 to 19 years, overall and by sex, National Health and Nutrition Examination Survey 2007 to 2008 and 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

9 Prevalence of meeting ≥5 criteria for ideal cardiovascular health among US adults aged ≥20 years (age standardized) and US children aged 12 to 19 years, by race/ethnicity, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

10 Age-standardized prevalence estimates of US adults meeting different numbers of criteria for ideal and poor cardiovascular health for each of the 7 metrics of cardiovascular health in the American Heart Association 2020 goals among US adults aged ≥20 years, National Health and Nutrition Examination Survey 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

11 Age-standardized cardiovascular health status by US states, Behavioral Risk Factor Surveillance System, 2009. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

12 Trends in prevalence (unadjusted) of meeting criteria for ideal cardiovascular health for each of the 7 metrics of cardiovascular health in the American Heart Association 2020 goals among US children aged 12 to 19 years, National Health and Nutrition Examination Survey (NHANES) 1999 to 2000 through 2011 to 2012. *Because of changes in the physical activity questionnaire between different cycles of the NHANES survey, trends over time for this indicator should be interpreted with caution, and statistical comparisons should not be attempted. †Data for the Healthy Diet Score, based on a 2-day average intake, were only available for the 2003 to 2004, 2005 to 2006, 2007 to 2008, 2009 to 2010, and 2011 to 2012 NHANES cycles at the time of this analysis. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

13 Age-standardized trends in prevalence of meeting criteria for ideal cardiovascular health for each of the 7 metrics of cardiovascular health in the American Heart Association 2020 goals among US adults aged ≥20 years, National Health and Nutrition Examination Survey (NHANES) 1999 to 2000 through 2011 to 2012. *Because of changes in the physical activity questionnaire between different cycles of the NHANES survey, trends over time for this indicator should be interpreted with caution, and statistical comparisons should not be attempted. †Data for the Healthy Diet Score, based on a 2-day average intake, were only available for the 2003 to 2004, 2005 to 2006, 2007 to 2008, 2009 to 2010 and 2011 to 2012 NHANES cycles at the time of this analysis. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

14 Prevalence of ideal, intermediate, and poor cardiovascular health metrics in 2006 (American Heart Association 2020 Impact Goals baseline year) and 2020 projections assuming current trends continue. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

15 US age-standardized death rates* attributable to cardiovascular diseases, 2000 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

16 US age-standardized death rates* attributable to cardiovascular disease (CVD) by race/ethnicity, 2000 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

17 US age-standardized death rates* attributable to stroke by race/ethnicity, 2000 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

18 Prevalence (%) of current cigarette smoking for adolescents aged 12 to 17 years by sex and race/ethnicity (National Survey on Drug Use and Health [NSDUH], 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

19 Prevalence (%) of current cigarette smoking for adolescents and adults by sex and age (National Health Interview Survey, 2003–2014; National Survey on Drug Use and Health [NSDUH], 2003– 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

20 Long-term trend in current cigarette smoking prevalence (%) for adults ≥18 years of age by sex (National Health Interview Survey [NHIS], 1965–2014, selected years). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

21 Prevalence (%) of current cigarette smoking for adults ≥18 years of age by sex and race/ethnicity (National Health Interview Survey [NHIS], 2012–2014). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

22 Prevalence (%) of current cigarette smoking for adults ≥18 years of age, by state: United States (National Health Interview Survey [NHIS], 2012–2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

23 Percentage (%) of students who have ever tried electronic cigarettes by school level (National Youth Tobacco Survey, 2011–2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

24 Prevalence of students in grades 9 to 12 who did not participate in ≥60 minutes of physical activity on any day in the past 7 days by race/ethnicity and sex (Youth Risk Behavior Surveillance: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

25 Prevalence of students in grades 9 to 12 who met currently recommended levels of physical activity during the past 7 days by race/ethnicity and sex (Youth Risk Behavior Surveillance: 2013). “Currently recommended levels” was defined as activity that increased their heart rate and made them breathe hard some of the time for a total of ≥60 minutes per day on 5 of the 7 days preceding the survey. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

26 Percentage of students in grades 9 to 12 who used a computer for ≥3 hours on an average school day by race/ethnicity and sex (Youth Risk Behavior Surveillance: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

27 Prevalence of meeting the aerobic guidelines of the 2008 Federal Physical Activity Guidelines among adults ≥18 years of age by race/ethnicity and sex (National Health Interview Survey: 2014). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

28 Prevalence of children 12 to 15 years of age who had adequate levels of cardiorespiratory fitness, by sex and age (National Health and Nutrition Examination Survey, National Youth Fitness Survey: 2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

29 Trends in mean healthy diet scores for children and adults, National Health and Nutrition Examination Survey 2003 to 2004 through 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

30 Healthy diet targets in children (5–19 years old) by survey year: National Health and Nutrition Examination Survey 2003 to 2004, 2005 to 2006, 2007 to 2008, 2009 to 2010, and 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

31 Healthy diet targets in adults (≥20 years of age) by survey year: National Health and Nutrition Examination Survey 2003 to 2004, 2005 to 2006, 2007 to 2008, 2009 to 2010, and 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

32 Trends in American Heart Association (AHA) defined healthy diet score components for children (5–19 years old) by survey year: National Health and Nutrition Examination Survey 2003 to 2004, 2005 to 2006, 2007 to 2008, 2009 to 2010, and 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

33 Trends in American Heart Association (AHA) healthy diet score components for adults (≥20 years of age) by survey year: National Health and Nutrition Examination Survey 2003 to 2004, 2005 to 2006, 2007 to 2008, 2009 to 2010, and 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

34 Percentage of sodium from dietary sources in the United States, 2005 to 2006. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

35 Per capita calories consumed from different beverages by US adults (≥19 years of age), 1965 to 2010. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

36 Total US food expenditures away from home and at home, 1977 and 2007. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

37 Prevalence of overweight and obesity among students in grades 9 through 12 by sex and race/ethnicity. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

38 Age-adjusted prevalence of obesity in adults 20 to 74 years of age by sex and survey year (National Health and Nutrition Examination Survey: 1988–1994, 1999–2002, 2003–2006, and 2009– 2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

39 Trends in the prevalence of obesity among US children and adolescents by age and survey year (National Health and Nutrition Examination Survey: 1988–1994, 1999–2002, 2003–2006, 2009– 2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

40 Trends in mean serum total cholesterol among adolescents 12 to 19 years of age by race, sex, and survey year (National Health and Nutrition Examination Survey: 1988–1994, 1999–2006, and 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

41 Age-adjusted trends in mean serum total cholesterol among adults ≥20 years old by race and survey year (National Health and Nutrition Examination Survey: 1988–1994, 1999–2006, and 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

42 Age-adjusted trends in the prevalence of serum total cholesterol ≥200 mg/dL in adults ≥20 years of age by sex, race/ethnicity, and survey year (National Health and Nutrition Examination Survey 2007–2008, 2009–2010, and 2011–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

43 Age-adjusted trends in the prevalence of serum total cholesterol ≥240 mg/dL in adults ≥20 years of age by sex, race/ethnicity, and survey year (National Health and Nutrition Examination Survey 2009–2010 and 2011–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

44 Prevalence of high blood pressure in adults ≥20 years of age by age and sex (National Health and Nutrition Examination Survey: 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

45 Age-adjusted prevalence trends for high blood pressure in adults ≥20 years of age by race/ethnicity, sex, and survey (National Health and Nutrition Examination Survey: 1988–1994, 1999–2006, and 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

46 Extent of awareness, treatment, and control of high blood pressure by race/ethnicity (National Health and Nutrition Examination Survey: 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

47 Extent of awareness, treatment, and control of high blood pressure by age (National Health and Nutrition Examination Survey: 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

48 Extent of awareness, treatment, and control of high blood pressure by race/ethnicity and sex (National Health and Nutrition Examination Survey: 2007–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

49 Age-adjusted prevalence of physician-diagnosed diabetes mellitus in adults ≥20 years of age by race/ethnicity and sex (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

50 Age-adjusted prevalence of physician-diagnosed diabetes mellitus in adults ≥20 years of age by race/ethnicity and years of education (National Health and Nutrition Examination Survey: 2009– 2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

51 Trends in diabetes mellitus prevalence in adults ≥20 years of age by sex (National Health and Nutrition Examination Survey: 1988–1994 and 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

52 Trends in the prevalence of diagnosed and undiagnosed diabetes mellitus (calibrated hemoglobin A1c levels >6.5%), by race/ethnic group. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

53 Diabetes mellitus awareness, treatment, and control in adults ≥20 years of age (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

54 Trends in age-standardized rates of diabetes mellitus–related complications among US adults with and without diagnosed diabetes. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

55 Secular trend of metabolic syndrome components in the US National Health and Nutrition Examination Survey (NHANES) and the Korean NHANES (KNHANES) cohorts over the past decade. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

56 Age-adjusted prevalence of metabolic syndrome in the United States, National Health and Nutrition Examination Survey 1999 to 2010. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

57 Age-adjusted prevalence of metabolic syndrome among men by race, National Health and Nutrition Examination Survey 1999 to 2010. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

58 Age-adjusted prevalence of metabolic syndrome among women by race, National Health and Nutrition Examination Survey 1999 to 2010. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

59 Prevalence and trends of the 5 components of metabolic syndrome in the adult US population (≥20 years old), 1999 to 2010, by sex (first column), race/ethnicity (second column), and race/ethnicity and sex (third and fourth columns). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

60 Age-standardized prevalence of metabolic syndrome by sex and Hispanic/Latino background, 2008 to 2011. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

61 Age-standardized prevalence of metabolic syndrome by age and sex in Hispanics/Latinos, 2008 to 2011. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

62 Age-standardized prevalence of metabolic syndrome (MetS) and metabolically healthy obesity (MHO) among obese (body mass index ≥30 kg/m2) men (A) and women (B) in different cohorts. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

63 Prevalence of cardiovascular disease in adults ≥20 years of age by age and sex (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

64 Deaths attributable to diseases of the heart (United States: 1900–2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

65 Deaths attributable to cardiovascular disease (United States: 1900–2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

66 Percentage breakdown of deaths attributable to cardiovascular disease (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

67 Cardiovascular disease (CVD) deaths vs cancer deaths by age (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

68 Cardiovascular disease (CVD) and other major causes of death: total, <85 years of age, and ≥85 years of age. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

69 Cardiovascular disease (CVD) and other major causes of death in males: total, <85 years of age, and ≥85 years of age. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

70 Cardiovascular disease (CVD) and other major causes of death in females: total, <85 years of age, and ≥85 years of age. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

71 Cardiovascular disease and other major causes of death for all males and females (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

72 Cardiovascular disease and other major causes of death for non-Hispanic (NH) white males and females (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

73 Cardiovascular disease and other major causes of death for non-Hispanic (NH) black males and females (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

74 Cardiovascular disease and other major causes of death for Hispanic or Latino males and females (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

75 Cardiovascular disease and other major causes of death for non-Hispanic (NH) Asian or Pacific Islander males and females (United States: 2013). “Asian or Pacific Islander” is a heterogeneous category that includes people at high cardiovascular disease risk (eg, South Asian) and people at low cardiovascular disease risk (eg, Japanese). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

76 Cardiovascular disease and other major causes of death for non-Hispanic (NH) American Indian or Alaska Native males and females (United States: 2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

77 Age-adjusted death rates for coronary heart disease (CHD), stroke, and lung and breast cancer for white and black females (United States: 2013).CHD includes International Classification of Diseases, 10th Revision codes I20 to I25; stroke, I60 to I69; lung cancer, C33 to C34; and breast cancer, C50. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

78 Cardiovascular disease mortality trends for males and females (United States: 1979–2013). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

79 US maps corresponding to state death rates (including the District of Columbia), 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

80 Estimated average 10-year cardiovascular disease risk in adults 50 to 54 years of age according to levels of various risk factors (Framingham Heart Study). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

81 Hospital discharges for cardiovascular disease (United States: 1970–2010). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

82 Hospital discharges (International Classification of Diseases, 9th Revision) for the 10 leading diagnostic groups (United States: 2010). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

83 Prevalence of stroke by age and sex (National Health and Nutrition Examination Survey: 2009– 2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

84 Annual age-adjusted incidence of first-ever stroke by race. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

85 Annual rate of first cerebral infarction by age, sex, and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1999). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

86 Annual rate of all first-ever strokes by age, sex, and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1999). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

87 Age-adjusted incidence of stroke/transient ischemic attack by race and sex, ages 45 to 74 years, Atherosclerosis Risk in Communities study cohort, 1987 to 2001. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

88 Age-adjusted death rates for stroke by sex and race/ethnicity, 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

89 Stroke death rates, 2011 through 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

90 Estimated 10-year stroke risk in adults 55 years of age according to levels of various risk factors (Framingham Heart Study). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

91 Probability of death within 1 year after first stroke. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

92 Probability of death within 5 years after first stroke. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

93 Probability of death with recurrent stroke in 5 years after first stroke. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

94 Trends in carotid endarterectomy and carotid stenting procedures (United States: 1993–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

95 Trends in age-adjusted death rates attributable to congenital heart defects, 1999 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

96 Trends in age-adjusted death rates attributable to congenital heart defects by race/ethnicity, 1999 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

97 Trends in age-adjusted death rates attributable to congenital heart defects by sex, 1999 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

98 Trends in age-adjusted death rates attributable to congenital heart defects by age at death, 1999 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

99 Trends in age-adjusted death rates attributable to congenital heart defects by sex and race/ethnicity, 1999 to 2013. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

100 Long-term outcomes in individuals with prolonged PR interval (>200 ms; first-degree atrioventricular block) compared with individuals with normal PR interval in the Framingham Heart Study. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

101 Primary indications (in thousands) for pacemaker placement between 1990 and 2002 from the National Hospital Discharge Survey. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

102 Incidence rate of paroxysmal supraventricular tachycardia per 100 000 person-years by age and sex. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

103 Current and future US prevalence projections for atrial fibrillation (AF). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

104 Atrial fibrillation incidence by race. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

105 Lifetime cumulative risk for atrial fibrillation (AF) at different ages (through age 94 years) by sex. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

106 Population attributable fraction of major risk factors for atrial fibrillation in the Atherosclerosis Risk in Communities study. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

107 Cumulative incidence of events in the 5 years after diagnosis of incident atrial fibrillation (AF) in Medicare patients. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

108 Atrial fibrillation (AF) cost estimates, where AF is the primary diagnosis in inpatient and outpatient encounters. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

109 Global age-adjusted atrial fibrillation prevalence rates (per 100 000 population) in the 2010 Global Burden of Disease Study. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

110 Detailed causes of arrest by age group. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

111 Chart 17-2. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

112 Out-of-hospital cardiac arrest witness status, 2014. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

113 Prevalence (%) of coronary calcium: US adults 33 to 45 years of age. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

114 Prevalence (%) of coronary calcium: US adults 45 to 84 years of age. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

115 Ten-year trends in CAC in individuals without clinical cardiovascular disease in MESA. Data derived from Bild et al.16. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

116 Hazard ratios (HRs) for coronary heart disease (CHD) events associated with coronary calcium scores: US adults 45 to 84 years of age (reference group, coronary artery calcification [CAC]=0). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

117 Hazard ratios (HRs) for coronary heart disease events associated with coronary calcium scores: US adults (reference group, coronary artery calcification [CAC]=0 and Framingham Risk Score <10%). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

118 Mean values of carotid intima-media thickness (IMT) for different carotid artery segments in younger adults by race and sex (Bogalusa Heart Study). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

119 Mean values of carotid intima-media thickness (IMT) for different carotid artery segments in older adults, by race. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

120 Prevalence of coronary heart disease by age and sex (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

121 Prevalence of myocardial infarction by age and sex (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

122 Annual number of adults per 1000 having diagnosed heart attack or fatal coronary heart disease (CHD) by age and sex (Atherosclerosis Risk in Communities Surveillance: 2005–2011 and Cardiovascular Health Study). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

123 Incidence of heart attack or fatal coronary heart disease by age, sex, and race (Atherosclerosis Risk in Communities Surveillance: 2005–2011). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

124 Incidence of myocardial infarction by age, sex, and race (Atherosclerosis Risk in Communities Surveillance: 2005-2011). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

125 Estimated 10-year coronary heart disease risk in adults 55 years of age according to levels of various risk factors (Framingham Heart Study). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

126 Prevalence of low coronary heart disease risk, overall and by sex (National Health and Nutrition Examination Survey: 1971–2006). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

127 Hospital discharges for coronary heart disease by sex (United States: 1970–2010). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

128 Prevalence of angina pectoris by age and sex (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

129 Secular trends in age-and sex-standardized prevalence rates of angina for adults aged ≥40 years in the United States, by race, for angina symptoms defined using the Rose questionnaire. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

130 Incidence of angina pectoris (deemed uncomplicated on the basis of physician interview of patient) by age and sex (Framingham Heart Study 1986–2009). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

131 Incidence of peripartum cardiomyopathy. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

132 Prevalence of heart failure by sex and age (National Health and Nutrition Examination Survey: 2009–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

133 First acute decompensated heart failure annual event rates per 1000 from Atherosclerosis Risk in Communities community surveillance (2005–2012). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

134 Hospital discharges for heart failure by sex (United States: 1980–2010). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

135 Rheumatic heart disease prevalence trends per 1000 people for each World Health Organization region: A, The Americas; B, Europe; C, Africa; D, Eastern Mediterranean; E, Western Pacific; and F, Southeast Asia. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

136 Association between the diameter and the minimum and maximum risk of abdominal aortic aneurysm (AAA) rupture per year. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

137 Numbers needed to screen to avoid an abdominal aortic aneurysm (AAA)–associated death and a ruptured abdominal aortic aneurysm. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

138 Estimates of prevalence of peripheral artery disease in males by age and ethnicity. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

139 Estimates of prevalence of peripheral artery disease in females by age and ethnicity. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

140 Age-specific prevalence estimates for peripheral artery disease by sex and country income level. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

141 Survival rates after out-of-hospital cardiac arrest in US sites of Resuscitation Outcomes Consortium, 2006 to 2014. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

142 Trends in cardiovascular procedures, United States: 1979 to 2010; inpatient procedures only. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

143 Number of surgical procedures in the 10 leading diagnostic groups, United States: 2010. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

144 Trends in heart transplantations, 1975 to 2014. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

145 Heart transplantations in the United States by recipient age, 2014. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

146 Direct and indirect costs of cardiovascular disease (CVD) and stroke (in billions of dollars), United States, average annual 2011 to 2012. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

147 The 23 leading diagnoses for direct health expenditures, United States, average annual 2011 to 2012 (in billions of dollars). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

148 Projected total costs of cardiovascular disease (CVD), 2015 to 2030 (2012 $ in billions) in the United States. Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

149 Projected total (direct and indirect) costs of total cardiovascular disease by age (2012 $ in billions). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.

150 Projected direct costs of total cardiovascular disease by type of cost (2010 $ in billions). Dariush Mozaffarian et al. Circulation. 2016;133:e38-e360 Copyright © American Heart Association, Inc. All rights reserved.


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