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Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association.
Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
(2020) Circulation 141: e139-e596
MeSH Terms: American Heart Association, Comorbidity, Health Status, Heart Diseases, Humans, Life Style, Preventive Health Services, Protective Factors, Risk Assessment, Risk Factors, Risk Reduction Behavior, Stroke, Time Factors, United States
Show Abstract · Added March 3, 2020
BACKGROUND - The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).
METHODS - The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals.
RESULTS - Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.
CONCLUSIONS - The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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14 MeSH Terms
High-Fat, High-Sugar Diet-Induced Subendothelial Matrix Stiffening is Mitigated by Exercise.
Kohn JC, Azar J, Seta F, Reinhart-King CA
(2018) Cardiovasc Eng Technol 9: 84-93
MeSH Terms: Animals, Aorta, Abdominal, Arterial Pressure, Diet, Healthy, Diet, High-Fat, Dietary Sugars, Disease Models, Animal, Elastic Modulus, Exercise Therapy, Extracellular Matrix, Male, Mice, Inbred C57BL, Microscopy, Atomic Force, Peripheral Arterial Disease, Pulse Wave Analysis, Risk Reduction Behavior, Time Factors, Vascular Stiffness
Show Abstract · Added December 7, 2017
Consumption of a high-fat, high-sugar diet and sedentary lifestyle are correlated with bulk arterial stiffening. While measurements of bulk arterial stiffening are used to assess cardiovascular health clinically, they cannot account for changes to the tissue occurring on the cellular scale. The compliance of the subendothelial matrix in the intima mediates vascular permeability, an initiating step in atherosclerosis. High-fat, high-sugar diet consumption and a sedentary lifestyle both cause micro-scale subendothelial matrix stiffening, but the impact of these factors in concert remains unknown. In this study, mice on a high-fat, high-sugar diet were treated with aerobic exercise or returned to a normal diet. We measured bulk arterial stiffness through pulse wave velocity and subendothelial matrix stiffness ex vivo through atomic force microscopy. Our data indicate that while diet reversal mitigates high-fat, high-sugar diet-induced macro- and micro-scale stiffening, exercise only significantly decreases micro-scale stiffness and not macro-scale stiffness, during the time-scale studied. These data underscore the need for both healthy diet and exercise to maintain vascular health. These data also indicate that exercise may serve as a key lifestyle modification to partially reverse the deleterious impacts of high-fat, high-sugar diet consumption, even while macro-scale stiffness indicators do not change.
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18 MeSH Terms
Pregnancy Intention and Maternal Alcohol Consumption.
Pryor J, Patrick SW, Sundermann AC, Wu P, Hartmann KE
(2017) Obstet Gynecol 129: 727-733
MeSH Terms: Adult, Alcohol Drinking, Cohort Studies, Female, Health Promotion, Humans, Intention, Pregnancy, Pregnancy Trimester, First, Pregnancy, Unplanned, Preventive Health Services, Reproductive Behavior, Reproductive Health Services, Risk Reduction Behavior, Tennessee
Show Abstract · Added February 21, 2019
OBJECTIVE - To evaluate whether women planning a pregnancy are less likely to use alcohol in early pregnancy than those with unintended pregnancies.
METHODS - Right From the Start (2000-2012) is a prospective, community-based pregnancy cohort. Maternal demographic, reproductive, and behavioral data were collected in telephone interviews at enrollment (mean±standard deviation 48±13 days of gestation) and later in the first trimester (mean±standard deviation 85±21 days of gestation). Alcohol consumption characteristics were included in the interviews. We used logistic regression to investigate the association of pregnancy intention with alcohol use.
RESULTS - Among 5,036 women, 55% reported using alcohol in the first trimester with 6% continuing use at the first-trimester interview. Pregnancy was planned by 70% of participants. Alcohol use occurred in 55% and 56% of intended and unintended pregnancies, respectively (P=.32). Adjusting for confounders, women with intended pregnancies were 31% less likely to consume any alcohol in early pregnancy (adjusted odds ratio [OR] 0.69, 95% confidence interval [CI] 0.60-0.81) or binge drink (adjusted OR 0.68, 95% CI 0.54-0.86). Most women, regardless of intention, stopped or decreased alcohol consumption in early pregnancy.
CONCLUSION - The majority of women, irrespective of intention, stopped or decreased drinking after pregnancy recognition. This suggests promoting early pregnancy awareness could prove more effective than promoting abstinence from alcohol among all who could conceive.
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MeSH Terms
Ideal Cardiovascular Health, Cardiovascular Remodeling, and Heart Failure in Blacks: The Jackson Heart Study.
Spahillari A, Talegawkar S, Correa A, Carr JJ, Terry JG, Lima J, Freedman JE, Das S, Kociol R, de Ferranti S, Mohebali D, Mwasongwe S, Tucker KL, Murthy VL, Shah RV
(2017) Circ Heart Fail 10:
MeSH Terms: Adult, African Americans, Aged, Blood Glucose, Blood Pressure, Comorbidity, Diabetes Mellitus, Exercise, Female, Health Status Disparities, Heart Failure, Humans, Hypertension, Incidence, Kaplan-Meier Estimate, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Mississippi, Prospective Studies, Risk Assessment, Risk Factors, Risk Reduction Behavior, Sedentary Behavior, Smoking, Smoking Cessation, Smoking Prevention, Ventricular Function, Left, Ventricular Remodeling
Show Abstract · Added September 11, 2017
BACKGROUND - The lifetime risk of heart failure (HF) is higher in the black population than in other racial groups in the United States.
METHODS AND RESULTS - We measured the Life's Simple 7 ideal cardiovascular health metrics in 4195 blacks in the JHS (Jackson Heart Study; 2000-2004). We evaluated the association of Simple 7 metrics with incident HF and left ventricular structure and function by cardiac magnetic resonance (n=1188). Mean age at baseline was 54.4 years (65% women). Relative to 0 to 2 Simple 7 factors, blacks with 3 factors had 47% lower incident HF risk (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.39-0.73; <0.0001); and those with ≥4 factors had 61% lower HF risk (HR, 0.39; 95% CI, 0.24-0.64; =0.0002). Higher blood pressure (HR, 2.32; 95% CI, 1.28-4.20; =0.005), physical inactivity (HR, 1.65; 95% CI, 1.07-2.55; =0.02), smoking (HR, 2.04; 95% CI, 1.43-2.91; <0.0001), and impaired glucose control (HR, 1.76; 95% CI, 1.34-2.29; <0.0001) were associated with incident HF. The age-/sex-adjusted population attributable risk for these Simple 7 metrics combined was 37.1%. Achievement of ideal blood pressure, ideal body mass index, ideal glucose control, and nonsmoking was associated with less likelihood of adverse cardiac remodeling by cardiac magnetic resonance.
CONCLUSIONS - Cardiovascular risk factors in midlife (specifically elevated blood pressure, physical inactivity, smoking, and poor glucose control) are associated with incident HF in blacks and represent targets for intensified HF prevention.
© 2017 American Heart Association, Inc.
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29 MeSH Terms
Walking and Calcified Atherosclerotic Plaque in the Coronary Arteries: The National Heart, Lung, and Blood Institute Family Heart Study.
Imran TF, Patel Y, Ellison RC, Carr JJ, Arnett DK, Pankow JS, Heiss G, Hunt SC, Gaziano JM, Djoussé L
(2016) Arterioscler Thromb Vasc Biol 36: 1272-7
MeSH Terms: Adult, Aged, Aortic Diseases, Aortography, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Multidetector Computed Tomography, National Heart, Lung, and Blood Institute (U.S.), Plaque, Atherosclerotic, Prevalence, Protective Factors, Risk Assessment, Risk Factors, Risk Reduction Behavior, Surveys and Questionnaires, United States, Vascular Calcification, Walking
Show Abstract · Added September 29, 2016
OBJECTIVE - Studies have reported mixed findings on the association between physical activity and subclinical atherosclerosis. We sought to examine whether walking is associated with prevalent coronary artery calcification (CAC) and aortic calcification.
APPROACH AND RESULTS - In a cross-sectional design, we studied 2971 participants of the National Heart, Lung, and Blood Institute Family Heart Study without a history of myocardial infarction, coronary artery bypass grafting, or percutaneous transluminal angioplasty. A standardized questionnaire was used to ascertain the number of blocks walked daily to compute walking metabolic equivalent hours. CAC was measured by cardiac computed tomography. We defined prevalent CAC and aortic calcification using an Agatston score of at least 100 and used generalized estimating equations to calculate adjusted prevalence ratios. Mean age was 55 years, and 60% of participants were women. Compared with the ≤3.75-Met-h/wk group, prevalence ratios for CAC after adjusting for age, sex, race, smoking, alcohol use, total physical activity (excluding walking), and familial clustering were 0.53 (95% confidence interval, 0.35-0.79) for >3.75 to 7.5 Met-h/wk, 0.72 (95% confidence interval, 0.52-0.99) for >7.5 to 15 Met-h/wk, and 0.54 (95% confidence interval, 0.36-0.81) for >15 to 22.5 Met-h/wk, (P trend=0.01). The walking-CAC relationship remained significant for those with body mass index ≥25 (P trend=0.02) and persisted with CAC cutoffs of 300, 200, 150, and 50 but not 0. When examined as a continuous variable, a J-shaped association between walking and CAC was found. The walking-aortic calcification association was not significant.
CONCLUSIONS - Our findings suggest that walking is associated with lower prevalent CAC (but not aortic calcification) in adults without known heart disease.
© 2016 American Heart Association, Inc.
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25 MeSH Terms
Associations between dietary fiber and colorectal polyp risk differ by polyp type and smoking status.
Fu Z, Shrubsole MJ, Smalley WE, Ness RM, Zheng W
(2014) J Nutr 144: 592-8
MeSH Terms: Adenomatous Polyps, Adult, Aged, Case-Control Studies, Colonic Polyps, Colonoscopy, Colorectal Neoplasms, Dietary Fiber, Female, Humans, Male, Middle Aged, Precancerous Conditions, Risk Factors, Risk Reduction Behavior, Smoking, Tennessee
Show Abstract · Added March 10, 2014
The association of dietary fiber intake with colorectal cancer risk is established. However, the association may differ between cigarette smokers and nonsmokers. We evaluated this hypothesis in a large colonoscopy-based case-control study. Dietary fiber intakes were estimated by self-administered food frequency questionnaire. Unconditional logistic regression analysis was used to estimate ORs and 95% CIs with adjustment for potential confounders. Analysis also was stratified by cigarette smoking and sex. High dietary fiber intake was associated with reduced risk of colorectal polyps (P-trend = 0.003). This association was found to be stronger among cigarette smokers (P-trend = 0.006) than nonsmokers (P-trend = 0.21), although the test for multiplicative interaction was not statistically significant (P = 0.11). This pattern of association was more evident for high-risk adenomatous polyps (ADs), defined as advanced or multiple ADs (P-interaction smoking and dietary fiber intake = 0.09). Among cigarette smokers who smoked ≥23 y, a 38% reduced risk of high-risk ADs was found to be associated with high intake of dietary fiber compared with those in the lowest quartile fiber intake group (P-trend = 0.004). No inverse association with dietary fiber intake was observed for low-risk ADs, defined as single nonadvanced ADs. Cigarette smoking may modify the association of dietary fiber intake with the risk of colorectal polyps, especially high-risk ADs, a well-established precursor of colorectal cancer.
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17 MeSH Terms
Weight change upon once-daily initiation of insulin detemir with or without dietary intervention in overweight or obese insulin-naïve individuals with type 2 diabetes: results from the DIET trial.
Niswender K, Piletic M, Andersen H, Conradsen Hiort L, Hollander P
(2014) Diabetes Obes Metab 16: 186-92
MeSH Terms: Adult, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Directive Counseling, Drug Administration Schedule, Female, Glycated Hemoglobin A, Humans, Hypoglycemic Agents, Insulin Detemir, Insulin, Long-Acting, Male, Obesity, Risk Reduction Behavior, Treatment Outcome, Weight Loss
Show Abstract · Added February 19, 2015
AIMS - Weight gain upon insulin initiation is opposite to clinical goals in diabetes management. This trial aimed to determine the impact of modest dietary intervention on weight change and examine weight change in baseline body mass index strata when initiating once-daily insulin detemir (IDet) in overweight or obese insulin-naïve individuals with type 2 diabetes (T2D).
METHODS - DIET (Impact of Dietary Intervention on Weight Change in Subjects With Type 2 Diabetes) was a 26-week, randomized, treat-to-target, stratified, controlled, open-label, multinational trial. Subjects were randomized 1 : 1 to either the IDet group, which received basic dietary and physical exercise advice at baseline, or the Diet+IDet group, which had additional dietary consultations with a certified dietician (three face-to-face meetings, three phone contacts).
RESULTS - Mean estimated change in body weight from baseline ± standard error (SE) was -1.05 ± 0.23 kg for Diet+IDet and -0.56 ± 0.23 kg for IDet alone. Estimated mean difference was 0.49 kg (95% confidence interval: -0.15; 1.13, p = 0.132). Glycaemic control, measured by haemoglobin A1c (HbA1c) and fasting plasma glucose, improved similarly in both groups. Both groups reported variable reductions in caloric intake and overall physical activity levels. No difference in hypoglycaemia rates between groups was observed.
CONCLUSION - This study suggests that a modest dietary intervention plus basic lifestyle advice, compared with basic lifestyle advice alone, resulted in similar weight change, efficacy, safety and tolerability when initiating IDet once daily in overweight or obese insulin-naïve individuals with T2D.
© 2013 John Wiley & Sons Ltd.
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17 MeSH Terms
An academic, business, and community alliance to promote evidence-based public health policy: the case of primary seat belt legislation.
Goldzweig IA, Schlundt DG, Moore WE, Smith PE, Zoorob RJ, Levine RS
(2013) J Health Care Poor Underserved 24: 1364-77
MeSH Terms: Adolescent, Adult, Commerce, Community Networks, Evidence-Based Practice, Female, Health Policy, Health Promotion, Humans, Male, Middle Aged, Public Health, Risk Reduction Behavior, Seat Belts, Universities, Young Adult
Show Abstract · Added March 7, 2014
An academic, business, and community alliance comprising 285 organizations, including 43 national groups represented on a Blue Ribbon Panel organized by the U.S. Secretary of Transportation, targeted Arkansas, Florida, Mississippi, Minnesota, Tennessee, and Wisconsin for high involvement/intervention consisting of community organization and other political action to support passage of primary seat belt laws. State-level alliance activities began in January 2003. All six states enacted a primary seat belt law between 2004 and 2009. From January 2003 to May 2010, passage of primary legislation was 4.5 times as likely (95% CI 1.90, 10.68) in states with high versus low alliance involvement. Positive interaction between high alliance involvement and offers of federal incentives may have occurred as well. This evidence of success suggests that academic-business-community alliances for action to promote evidence-based public health policy may be effective.
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16 MeSH Terms
Optimizing natural fertility: the role of lifestyle modification.
McLean M, Wellons MF
(2012) Obstet Gynecol Clin North Am 39: 465-77
MeSH Terms: Adult, Alcohol Drinking, Body Mass Index, Coitus, Directive Counseling, Evidence-Based Medicine, Exercise, Female, Fertility, Humans, Male, Middle Aged, Obesity, Patient Education as Topic, Polycystic Ovary Syndrome, Preconception Care, Pregnancy, Risk Reduction Behavior, Smoking Cessation, Weight Loss
Show Abstract · Added February 28, 2014
Preconception counseling provides an opportunity for health care providers to promote maternal and neonatal health, and to make recommendations regarding the optimization of natural fertility. While educating patients on the negative impact of maternal obesity on fertility and maternal and neonatal health; many health care providers recommend weight loss to reduce these negative outcomes. The recommendations start with lifestyle modifications, including diet and exercise. This article focuses on the available evidence regarding lifestyle modifications and fertility, and on the type of lifestyle modifications that health care providers should recommend to patients seeking to optimize their natural fertility.
Copyright © 2012. Published by Elsevier Inc.
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20 MeSH Terms
Coping skills training in a telephone health coaching program for youth at risk for type 2 diabetes.
Jefferson V, Jaser SS, Lindemann E, Galasso P, Beale A, Holl MG, Grey M
(2011) J Pediatr Health Care 25: 153-61
MeSH Terms: Adaptation, Psychological, Adolescent, Advanced Practice Nursing, Child, Diabetes Mellitus, Type 2, Female, Health Promotion, Hotlines, Humans, Life Style, Male, Program Evaluation, Risk Factors, Risk Reduction Behavior, School Nursing
Show Abstract · Added March 11, 2015
INTRODUCTION - The purpose of this article is to describe components of a health coaching intervention based on coping skills training delivered via telephone. This intervention was provided to urban adolescents at risk for type 2 diabetes mellitus (T2DM), reinforcing a school-based curriculum designed to promote a healthy lifestyle and prevent T2DM.
METHOD - Health coaching via telephone was provided to at-risk urban youth enrolled in a study of an intervention to reduce risk for T2DM. Vignettes are used to describe the use of several coping skills in this high-risk youth population.
RESULTS - A variety of vignettes illustrate how telephone health coaching reinforced lifestyle changes in students by incorporating coping skills training.
DISCUSSION - Given the benefits and the challenges of the telephone health coaching intervention, several suggestions for others who plan to use a similar method are described.
Copyright © 2011 National Association of Pediatric Nurse Practitioners. Published by Elsevier, Inc. All rights reserved.
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15 MeSH Terms