Heart disease and stroke statistics--2014 update: a report from the American Heart Association

Alan S Go, Dariush Mozaffarian, Véronique L Roger, Emelia J Benjamin, Jarett D Berry, Michael J Blaha, Shifan Dai, Earl S Ford, Caroline S Fox, Sheila Franco, Heather J Fullerton, Cathleen Gillespie, Susan M Hailpern, John A Heit, Virginia J Howard, Mark D Huffman, Suzanne E Judd, Brett M Kissela, Steven J Kittner, Daniel T Lackland, Judith H Lichtman, Lynda D Lisabeth, Rachel H Mackey, David J Magid, Gregory M Marcus, Ariane Marelli, David B Matchar, Darren K McGuire, Emile R Mohler 3rd, Claudia S Moy, Michael E Mussolino, Robert W Neumar, Graham Nichol, Dilip K Pandey, Nina P Paynter, Matthew J Reeves, Paul D Sorlie, Joel Stein, Amytis Towfighi, Tanya N Turan, Salim S Virani, Nathan D Wong, Daniel Woo, Melanie B Turner, American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Alan S Go, Dariush Mozaffarian, Véronique L Roger, Emelia J Benjamin, Jarett D Berry, Michael J Blaha, Shifan Dai, Earl S Ford, Caroline S Fox, Sheila Franco, Heather J Fullerton, Cathleen Gillespie, Susan M Hailpern, John A Heit, Virginia J Howard, Mark D Huffman, Suzanne E Judd, Brett M Kissela, Steven J Kittner, Daniel T Lackland, Judith H Lichtman, Lynda D Lisabeth, Rachel H Mackey, David J Magid, Gregory M Marcus, Ariane Marelli, David B Matchar, Darren K McGuire, Emile R Mohler 3rd, Claudia S Moy, Michael E Mussolino, Robert W Neumar, Graham Nichol, Dilip K Pandey, Nina P Paynter, Matthew J Reeves, Paul D Sorlie, Joel Stein, Amytis Towfighi, Tanya N Turan, Salim S Virani, Nathan D Wong, Daniel Woo, Melanie B Turner, American Heart Association Statistics Committee and Stroke Statistics Subcommittee

No abstract available

Keywords: AHA Scientific Statements; cardiovascular diseases; epidemiology; risk factors; statistics; stroke.

Conflict of interest statement

The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

Figures

Chart 2-1

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 2009 to 2010.

Chart 2-2

Age-standardized prevalence 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 adults aged ≥20 years, National Health and Nutrition Examination Survey 2009 to 2010.

Chart 2-3

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 2009 to 2010.

Chart 2-4

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 2009 to 2010.

Chart 2-5

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 from National Health and Nutrition Examination Survey 2009 to 2010.

Chart 2-6

Prevalence estimates of meeting ≥5 criteria for ideal cardiovascular health among US adults aged ≥20 years (age standardized), overall and by sex and race, and US children aged 12 to 19 years (unadjusted), by sex, National Health and Nutrition Examination Survey 2009 to 2010.

Chart 2-7

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 2009 to 2010.

Chart 2-8

Age-standardized cardiovascular health status by US states, Behavioral Risk Factor Surveillance System, 2009. A, Age-standardized prevalence of population with ideal cardiovascular health by states. B, Age-standardized percentage of population with 0 to 2 cardiovascular health metrics by states. C, Age-standardized mean score of cardiovascular health metrics by states. Reprinted from Fang et al with permission. Copyright © 2012, American Heart Association, Inc.

Chart 2-9

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 2009 to 2010. *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 2005 to 2006, 2007 to 2008, and 2009 to 2010 NHANES cycles at the time of this analysis.

Chart 2-10

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 2009 to 2010. *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 2005 to 2006, 2007 to 2008, and 2009 to 2010 NHANES cycles at the time of this analysis.

Chart 2-11

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. The 2020 targets for each cardiovascular health metric assume a 20% relative increase in ideal cardiovascular health prevalence metrics and a 20% relative decrease in poor cardiovascular health prevalence metrics for men and women. Reprinted from Huffman et al with permission. Copyright © 2012, American Heart Association, Inc.

Chart 2-12

US age-standardized death rates* attributable to CVD, 2000 to 2010. *Directly standardized to the age distribution of the 2000 US standard population. †Total CVD: International Classification of Diseases, 10th Revision (ICD-10) I00 to I99 and Q20 to Q28. §Stroke (all cerebrovascular disease): ICD-10 I60 to I69. ¶CHD: ICD-10 I20 to I25. **Other CVD: ICD-10 I00 to I15, I26 to I51, I70 to I78, I80 to I89, and I95 to I99. CHD indicates coronary heart disease; and CVD, cardiovascular disease. Source: Centers for Disease Control and Prevention, National Center for Health Statistics.

Chart 2-13

Incidence of cardiovascular disease according to the number of ideal health behaviors and health factors. Reprinted from Folsom et al with permission from Elsevier. Copyright © 2011, American College of Cardiology Foundation.

Chart 3-1

Prevalence (%) of students in grades 9 to 12 reporting current cigarette use by sex and race/ethnicity (Youth Risk Behavior Surveillance System, 2011). NH indicates non-Hispanic. Data derived from MMWR: Morbidity and Mortality Weekly Report.

Chart 3-2

Prevalence (%) of current smoking for adults >18 years of age by race/ethnicity and sex (National Health Interview Survey: 2009–2011). All percentages are age adjusted. AIAN indicates American Indian/Alaska Native; and NH, non-Hispanic. *Includes both Hispanics and non-Hispanics. Data derived from Centers for Disease Control and Prevention/National Center for Health Statistics, Health Data Interactive.

Chart 4-1

Prevalence of students in grades 9 to 12 who did not participate in ≥60 minutes of physical activity on any day by race/ethnicity and sex (Youth Risk Behavior Surveillance: 2011). NH indicates non-Hispanic. Data derived from MMWR Surveillance Summaries.

Chart 4-2

Percentage of students in grades 9 to 12 who used a computer for ≥3 hours a day by race/ethnicity and sex (Youth Risk Behavior Surveillance: 2011). NH indicates non-Hispanic. Data derived from MMWR Surveillance Summaries.

Chart 4-3

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: 2011). “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. NH indicates non-Hispanic. Data derived from MMWR Surveillance Summaries.

Chart 4-4

Prevalence of children 6 to 19 years of age who attained sufficient moderate to vigorous physical activity to meet public health recommendations (≥60 minutes per day on 5 or more of the 7 days preceding the survey), by sex and age (National Health and Nutrition Examination Survey: 2003–2004). Source: Troiano et al.

Chart 4-5

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: 2012). NH indicates non-Hispanic. Percentages are age adjusted. The aerobic guidelines of the 2008 Federal Physical Activity Guidelines recommend engaging in moderate leisure-time physical activity for ≥150 minutes per week or vigorous activity ≥75 minutes per week or an equivalent combination. Source: Blackwell et al.

Chart 5-1

Age-adjusted trends in macronutrients and total calories consumed by US adults (20–74 years of age), 1971 to 2008. Data derived from National Center for Health Statistics and Wright and Wang.

Chart 5-2

Per capita calories consumed from different beverages by US adults (≥19 years of age), 1965 to 2010. Source: Nationwide Food Consumption Surveys (1965, 1977–1978) and National Health and Nutrition Examination Survey (1988–2010), based on data from Duffey and Popkin and Kit et al. The 2010 data were only analyzed for soda/cola and sweetened fruit drinks.

Chart 5-3

Total US food expenditures away from home and at home, 1977 and 2007. Data derived from Davis and Saltos.

Chart 6-1

Prevalence of overweight and obesity among students in grades 9 through 12 by sex and race/ethnicity. NH indicates non-Hispanic. Data derived from Eaton et al (Table 101).

Chart 6-2

Age-adjusted prevalence of obesity in adults 20 to 74 years of age by sex and survey year (National Health Examination Survey: 1960–1962; National Health and Nutrition Examination Survey: 1971–1974, 1976–1980, 1988–1994, 1999–2002, and 2007–2010). Obesity is defined as body mass index of 30.0 kg/m2. Data derived from Health, United States, 2011 (National Center for Health Statistics).

Chart 6-3

Trends in the prevalence of obesity among US children and adolescents by age and survey year (National Health and Nutrition Examination Survey: 1971–1974, 1976–1980, 1988–1994, 1999–2002, 2003–2006, and 2007–2010). Data derived from Health, United States, 2011 (National Center for Health Statistics).

Chart 8-1

Trends in mean serum total cholesterol among adolescents 12 to 17 years of age by race, sex, and survey year (National Health and Nutrition Examination Survey: 1976–1980,* 1988–1994,* 1999–2004, and 2005–2010). Values are in mg/dL. Mex. Am. indicates Mexican American; and NH, non-Hispanic. *Data for Mexican Americans not available. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 8-2

Trends in mean serum total cholesterol among adults aged ≥20 years by race and survey year (National Health and Nutrition Examination Survey: 1988–1994, 1999–2002, 2003–2006, and 2007–2010). Values are in mg/dL. NH indicates non-Hispanic. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 8-3

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 2005–2006, 2007–2008, and 2009–2010). Mex. Am. indicates Mexican American; and NH, non-Hispanic.

Chart 9-1

Prevalence of high blood pressure in adults ≥20 years of age by age and sex (National Health and Nutrition Examination Survey: 2007–2010). Hypertension is defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, if the subject said “yes” to taking antihypertensive medication, or if the subject was told on 2 occasions that he or she had hypertension. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 9-2

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, 1999–2004, and 2005–2010). NH indicates non-Hispanic. Source: National Center for Health Statics and National Heart, Lung and Blood Institute.

Chart 9-3

Extent of awareness, treatment, and control of high blood pressure by race/ethnicity (National Health and Nutrition Examination Survey: 2007–2010). NH indicates non-Hispanic. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 9-4

Extent of awareness, treatment, and control of high blood pressure by age (National Health and Nutrition Examination Survey: 2007–2010). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 9-5

Extent of awareness, treatment, and control of high blood pressure by race/ethnicity and sex (National Health and Nutrition Examination Survey: 2007–2010). NH indicates non-Hispanic. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 10-1

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: 2007–2010). NH indicates non-Hispanic. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 10-2

Age-adjusted prevalence of physician-diagnosed type 2 diabetes mellitus in adults ≥20 years of age by race/ethnicity and years of education (National Health and Nutrition Examination Survey: 2007–2010). NH indicates non-Hispanic. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 10-3

Trends in diabetes mellitus prevalence in adults ≥20 years of age by sex (National Health and Nutrition Examination Survey: 1988–1994 and 2007–2010). Source: National Center for Health Statistics, National Heart, Lung, and Blood Institute.

Chart 10-4

Diabetes mellitus awareness, treatment, and control in adults ≥20 years of age (National Health and Nutrition Examination Survey: 2007–2010). Source: National Heart, Lung, and Blood Institute.

Chart 13-1

Prevalence of cardiovascular disease in adults ≥20 years of age by age and sex (National Health and Nutrition Examination Survey: 2007–2010). These data include coronary heart disease, heart failure, stroke, and hypertension. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-2

Incidence of cardiovascular disease (coronary heart disease, heart failure, stroke, or intermittent claudication; does not include hypertension alone) by age and sex (Framingham Heart Study, 1980–2003). Source: National Heart, Lung, and Blood Institute.

Chart 13-3

Deaths attributable to diseases of the heart (United States: 1900–2010). See Glossary (Chapter 26) for an explanation of “diseases of the heart.” Note: In the years 1900 to 1920, the International Classification of Diseases codes were 77 to 80; for 1925, 87 to 90; for 1930 to 1945, 90 to 95; for 1950 to 1960, 402 to 404 and 410 to 443; for 1965, 402 to 404 and 410 to 443; for 1970 to 1975, 390 to 398 and 404 to 429; for 1980 to 1995, 390 to 398, 402, and 404 to 429; and for 2000 to 2009, I00 to I09, I11, I13, and I20 to I51. Before 1933, data are for a death registration area and not the entire United States. In 1900, only 10 states were in the death registration area, and this increased over the years, so part of the increase in numbers of deaths is attributable to an increase in the number of states. Source: National Center for Health Statistics.

Chart 13-4

Deaths attributable to cardiovascular disease (United States: 1900–2010). Cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99) does not include congenital. Before 1933, data are for a death registration area and not the entire United States. Source: National Center for Health Statistics.

Chart 13-5

Percentage breakdown of deaths attributable to cardiovascular disease (United States: 2010). Total may not add to 100 because of rounding. Coronary heart disease includes International Classification of Diseases, 10th Revision (ICD-10) codes I20 to I25; stroke, I60 to I69; heart failure, I50; high blood pressure, I10 to I15; diseases of the arteries, I70 to I78; and other, all remaining ICD-I0 I categories. *Not a true underlying cause. With any-mention deaths, heart failure accounts for 35% of cardiovascular disease deaths. Source: National Heart, Lung, and Blood Institute from National Center for Health Statistics reports and data sets.

Chart 13-6

Cardiovascular disease (CVD) deaths vs cancer deaths by age (United States: 2010). CVD includes International Classification of Diseases, 10th Revision codes I00 to I99 and Q20 to Q28; cancer, C00 to C97. Source: National Center for Health Statistics.

Chart 13-7

Cardiovascular disease (CVD) and other major causes of death: total, International Classification of Diseases, 10th Revision codes I00 to I09, I11, I13, and I20 to I51; stroke, I60 to I69; all other CVD, I10, I12, I15, and I70 to I99; cancer, C00 to C97; chronic lower respiratory disease (CLRD), J40 to J47; Alzheimer disease, G30; and accidents, V01 to X59 and Y85 to Y86. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-8

Cardiovascular disease (CVD) and other major causes of death in males: total, International Classification of Diseases, 10th Revision codes I00 to I09, I11, I13, and I20 to I51; stroke, I60 to I69; all other CVD, I10, I12, I15, and I70 to I99; cancer, C00 to C97; chronic lower respiratory disease (CLRD), J40 to J47; and accidents, V01 to X59 and Y85 to Y86. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-9

Cardiovascular disease (CVD) and other major causes of death in females: total, International Classification of Diseases, 10th Revision codes I00 to I09, I11, I13, and I20 to I51; stroke, I60 to I69; all other CVD, I10, I12, I15, and I70 to I99; cancer, C00 to C97; chronic lower respiratory disease (CLRD), J40 to J47; and Alzheimer disease, G30. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-10

Cardiovascular disease and other major causes of death for all males and females (United States: 2010). A indicates cardiovascular disease plus congenital cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99 and Q20–Q28); B, cancer (C00–C97); C, accidents (V01–X59 and Y85–Y86); D, chronic lower respiratory disease (J40–J47); E, diabetes mellitus (E10–E14); and F, Alzheimer disease (G30). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-11

Cardiovascular disease and other major causes of death for white males and females (United States: 2010). A indicates cardiovascular disease plus congenital cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99 and Q20–Q28); B, cancer (C00–C97); C, accidents (V01–X59 and Y85–Y86); D, chronic lower respiratory disease (J40–J47); E, diabetes mellitus (E10–E14); and F, Alzheimer disease (G30). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-12

Cardiovascular disease and other major causes of death for black males and females (United States: 2010). A indicates cardiovascular disease plus congenital cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99 and Q20–Q28); B, cancer (C00–C97); C, accidents (V01–X59 and Y85–Y86); D, diabetes mellitus (E10–E14); E, chronic lower respiratory disease (J40–J47); F, nephritis (N00–N07, N17–N19, and N25–N27). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-13

Cardiovascular disease and other major causes of death for Hispanic or Latino males and females (United States: 2010). A indicates cardiovascular disease plus congenital cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99 and Q20–Q28); B, cancer (C00–C97); C, accidents (V01–X59 and Y85–Y86); D, diabetes mellitus (E10–E14); E, chronic lower respiratory disease (J40–J47); and F, nephritis (N00–N07, N17–N19, and N25–N27). Number of deaths shown may be lower than actual because of underreporting in this population. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-14

Cardiovascular disease and other major causes of death for Asian or Pacific Islander males and females (United States: 2010). “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). More specific data on these groups are not available. A indicates cardiovascular disease plus congenital cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99 and Q20–Q28); B, cancer (C00–C97); C, accidents (V01–X59 and Y85–Y86); D, diabetes mellitus (E10–E14); E, chronic lower respiratory disease (J40–J47); and F, influenza and pneumonia (J09–J18). Number of deaths shown may be lower than actual because of underreporting in this population. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-15

Cardiovascular disease and other major causes of death for American Indian or Alaska Native males and females (United States: 2010). A indicates cardiovascular disease plus congenital cardiovascular disease (International Classification of Diseases, 10th Revision codes I00–I99 and Q20–Q28); B, cancer (C00–C97); C, accidents (V01–X59 and Y85–Y86); D, diabetes mellitus (E10–E14); E, chronic liver disease (K70 and K73–K74); and F, chronic lower respiratory disease (J40–J47). Number of deaths shown may be lower than actual because of underreporting in this population. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-16

Age-adjusted death rates for coronary heart disease (CHD), stroke, and lung and breast cancer for white and black females (United States: 2010). 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. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-17

Cardiovascular disease mortality trends for males and females (United States: 1979–2010). Cardiovascular disease excludes congenital cardiovascular defects (International Classification of Diseases [ICD], 10th Revision codes I00–I99). The overall comparability for cardiovascular disease between the ICD, 9th Revision codes (1979–1998) and ICD, 10th Revision codes (1999–2010) is 0.9962. No comparability ratios were applied. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-18

US maps corresponding to state death rates (including the District of Columbia), 2010.

Chart 13-19

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). BP indicates blood pressure; and HDL, high-density lipoprotein. Data derived from D’Agostino et al.

Chart 13-20

Hospital discharges for cardiovascular disease (United States: 1970–2010). Hospital discharges include people discharged alive, dead, and “status unknown.” Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 13-21

Hospital discharges for the 10 leading diagnostic groups (United States: 2010). Source: National Hospital Discharge Survey/National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 14-1

Prevalence of stroke by age and sex (National Health and Nutrition Examination Survey: 2007–2010). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 14-2

Annual age-adjusted incidence of first-ever stroke by race. Hospital plus out-of-hospital ascertainment, 1993 to 1994, 1999, and 2005. ICH indicates intracerebral hemorrhage; and SAH, subarachnoid hemorrhage. Data derived from Kleindorfer et al.

Chart 14-3

Annual rate of first cerebral infarction by age, sex, and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1999). Rates for black men and women 45 to 54 years of age and for black men ≥75 years of age are considered unreliable. Source: unpublished data from the Greater Cincinnati/Northern Kentucky Stroke Study.

Chart 14-4

Annual rate of all first-ever strokes by age, sex, and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1999). Rates for black men and women 45 to 54 years of age and for black men ≥75 years of age are considered unreliable.

Chart 14-5

Age-adjusted incidence of stroke/transient ischemic attack by race and sex, ages 45 to 74, Atherosclerosis Risk in Communities study cohort, 1987 to 2001. Data derived from the National Heart, Lung, and Blood Institute, Incidence and Prevalence: 2006 Chart Book.

Chart 14-6

Age-adjusted death rates for stroke by sex and race/ethnicity, 2010. Death rates for the American Indian/Alaska Native and Asian or Pacific Islander populations are known to be underestimated. Stroke includes International Classification of Diseases, 10th Revision codes I60 to I69 (cerebrovascular disease). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 14-7

Stroke death rates, 2008 through 2010. Adults ≥35 years of age, by county. Rates are spatially smoothed to enhance the stability of rates in counties with small populations. International Classification of Diseases, 10th Revision codes for stroke: I60 to I69. Data source: National Vital Statistics System and the US Census Bureau.

Chart 14-8

Estimated 10-year stroke risk in adults 55 years of age according to levels of various risk factors (Framingham Heart Study). AF indicates atrial fibrillation; and CVD, cardiovascular disease. Data derived from Wolf et al.

Chart 14-9

Proportion of patients dead 1 year after first stroke. Source: pooled data from the Framingham Heart Study, Atherosclerosis Risk in Communities study, and Cardiovascular Health Study of the National Heart, Lung, and Blood Institute.

Chart 14-10

Proportion of patients dead within 5 years after first stroke. Source: pooled data from the Framingham Heart Study, Atherosclerosis Risk in Communities study, and Cardiovascular Health Study of the National Heart, Lung, and Blood Institute.

Chart 14-11

Proportion of patients with recurrent stroke within 5 years after first stroke. Source: pooled data from the Framingham Heart Study, Atherosclerosis Risk in Communities study, and Cardiovascular Health Study of the National Heart, Lung, and Blood Institute.

Chart 14-12

Trends in carotid endarterectomy and carotid stenting procedures (United States: 1980–2010). Source: Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality.

Chart 17-1

Prevalence (%) of coronary calcium: US adults 33 to 45 years of age. P<0.0001 across race-sex groups. Data derived from Loria et al.

Chart 17-2

Prevalence (%) of coronary calcium: US adults 45 to 84 years of age. P<0.0001 across ethnic groups in both men and women. Data derived from Bild et al.

Chart 17-3

Hazard ratios (HR) 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). All HRs P<0.0001. Major CHD events included myocardial infarction and death attributable to CHD; any CHD events included major CHD events plus definite angina or definite or probable angina followed by revascularization. Data derived from Detrano et al.

Chart 17-4

Hazard ratios (HR) for coronary heart disease events associated with coronary calcium scores: US adults (reference group, coronary artery calcification [CAC]=0 and Framingham Risk Score

Chart 17-5

Mean values of carotid intima-media thickness (IMT) for different carotid artery segments in younger adults by race and sex (Bogalusa Heart Study). Data derived from Urbina et al.

Chart 17-6

Mean values of carotid intima-media thickness (IMT) for different carotid artery segments in older adults, by race. Data derived from Manolio et al.

Chart 18-1

Prevalence of coronary heart disease by age and sex (National Health and Nutrition Examination Survey: 2007–2010). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 18-2

Prevalence of myocardial infarction by age and sex (National Health and Nutrition Examination Survey: 2007–2010). Myocardial infarction includes people who answered “yes” to the question of ever having had a heart attack or myocardial infarction. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 18-3

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: 2005–2010 and Cardiovascular Health Study). These data include myocardial infarction (MI) and fatal CHD but not silent MI. Source: National Heart, Lung, and Blood Institute.

Chart 18-4

Incidence of heart attack or fatal coronary heart disease by age, sex, and race (Atherosclerosis Risk in Communities Surveillance: 2005–2010). Source: National Heart, Lung, and Blood Institute.

Chart 18-5

Incidence of myocardial infarction by age, sex, and race (Atherosclerosis Risk in Communities Surveillance: 2005-2010). Source: Unpublished data from Atherosclerosis Risk in Communities study, National Heart, Lung, and Blood Institute.

Chart 18-6

Estimated 10-year coronary heart disease risk in adults 55 years of age according to levels of various risk factors (Framingham Heart Study). HDL-C indicates high-density lipoprotein-cholesterol. Data derived from Wilson et al.

Chart 18-7

Prevalence of low coronary heart disease risk, overall and by sex (National Health and Nutrition Examination Survey: 1971–2006). Low risk is defined as systolic blood pressure 2; currently not smoking cigarettes; and no prior myocardial infarction or diabetes mellitus. Source: Personal communication with the National Heart, Lung, and Blood Institute, June 28, 2007.

Chart 18-8

Hospital discharges for coronary heart disease by sex (United States: 1970–2010). Hospital discharges include people discharged alive, dead, and “status unknown.” Source: National Hospital Discharge Survey/National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 18-9

Prevalence of angina pectoris by age and sex (National Health and Nutrition Examination Survey: 2007–2010). Angina pectoris includes people who either answered “yes” to the question of ever having angina or angina pectoris or were diagnosed with Rose Angina. Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 18-10

Incidence of angina pectoris (deemed uncomplicated on the basis of physician interview of patient) by age and sex (Framingham Heart Study 1986–2009). Data derived from National Heart, Lung, and Blood Institute.

Chart 19-1

Prevalence of heart failure by sex and age (National Health and Nutrition Examination Survey: 2007–2010). Source: National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 19-2

First acute decompensated heart failure annual event rates per 1000 (from ARIC Community Surveillance 2005–2010). Source: National Heart, Lung, and Blood Institute.

Chart 19-3

Hospital discharges for heart failure by sex (United States: 1980–2010). Note: Hospital discharges include people discharged alive, dead, and status unknown. Source: National Hospital Discharge Survey/National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 20-1

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. Reprinted from Seckeler and Hoke with permission of Dove Medical Press; permission conveyed through Copyright Clearance Center, Inc. Copyright © 2011, Seckeler and Hoke,

Chart 21-1

Prevalence estimates for peripheral arterial disease in males by age and ethnicity. Amer. indicates American; and NH, non-Hispanic. Source: Reprinted from Allison et al with permission from Elsevier. Copyright © 2007, American Journal of Preventive Medicine.

Chart 21-2

Prevalence estimates for peripheral arterial disease in females by age and ethnicity. Amer. indicates American; and NH, non-Hispanic. Source: Reprinted from Allison et al with permission from Elsevier. Copyright © 2007, American Journal of Preventive Medicine.

Chart 23-1

Trends in cardiovascular procedures, United States: 1979 to 2010. Note: Inpatient procedures only. PCI indicates percutaneous coronary intervention. Source: National Hospital Discharge Survey, National Center for Health Statistics, and National Heart, Lung, and Blood Institute.

Chart 23-2

Number of surgical procedures in the 10 leading diagnostic groups, United States: 2010. Source: National Hospital Discharge Survey/National Center for Health Statistics and National Heart, Lung, and Blood Institute.

Chart 23-3

Trends in heart transplantations (United Network for Organ Sharing: 1975–2012). Source: United Network for Organ Sharing, scientific registry data.

Chart 23-4

Heart transplantations in the United States by recipient age, 2012. Source: Organ Procurement and Transplantation Network data as of April 11, 2013.

Chart 24-1

Direct and indirect costs of cardiovascular disease (CVD) and stroke (in billions of dollars), United States, 2010. Source: Prepared by the National Heart, Lung, and Blood Institute.,

Chart 24-2

The 22 leading diagnoses for direct health expenditures, United States, 2010 (in billions of dollars). COPD indicates chronic obstructive pulmonary disease; and GI, gastrointestinal tract. Source: National Heart, Lung, and Blood Institute; estimates are from the Medical Expenditure Panel Survey, Agency for Healthcare Research and Quality, and exclude nursing home costs.

Chart 24-3

Projected total costs of cardiovascular disease (CVD), 2015 to 2030 (2012 $ in billions) in the United States. CHD indicates coronary heart disease; CHF, congestive heart failure; and HBP, high blood pressure. Unpublished data tabulated by the American Heart Association using methods described by Heidenreich et al.

Chart 24-4

Projected total (direct and indirect) costs of total cardiovascular disease by age (2012 $ in billions). Unpublished data tabulated by the American Heart Association using methods described by Heidenreich et al.

Chart 24-5

Projected direct costs of total cardiovascular disease by type of cost (2012 $ in billions). Unpublished data tabulated by the American Heart Association using methods described by Heidenreich et al.