The incidence of death due to heart disease and stroke has decreased in recent years, but the prevalence of both conditions remains high worldwide and risk factors such as tobacco use, an unhealthy diet and low levels of physical activity are common in adults and children.
The annual Heart Disease and Stroke Statistics – 2015 Update: A Report From the American Heart Association provides information on heart disease and stroke from 190 countries around the world. The 2015 update includes international data for the first time in the 50 years that the AHA and American Stroke Association have released the report.
Heart disease and stroke
Overall, heart disease is the leading cause of death worldwide, with 17.3 million deaths annually attributable to CV-related illness. This number will have increased to more than 23.6 million annual deaths by 2030, according to a press release.
From 2001 to 2011, CV-related mortality decreased by about 39%. However, the burden and risk for heart disease remain high. Eighty percent of CV-related deaths occur in low- and middle-income countries. In the United States, 787,000 deaths due to heart disease occurred in 2011, equal to approximately one in every three deaths in the country that year.
First-time MI occurs in approximately 635,000 US adults each year, with recurring MI in 300,000, according to the release. An estimated 735,000 US adults have an MI each year, and 120,000 of those result in death.
Stroke-related mortality has decreased by 35% during the past decade and the actual number of stroke deaths has decreased by approximately 21%. However, stroke is currently the fourth most-common cause of death in the United States; one in every 20 deaths are attributable to stroke. Globally, stroke is the second most-prevalent cause of death after heart disease (11.13% of all deaths). A total of 33 million strokes occurred worldwide in 2010, including 16.9 million patients who experienced their first stroke. Stroke is also the leading preventable cause of disability.
As many as 85.6 million US adults live with heart disease or with the after-effects of stroke.
The total costs of heart disease and stroke exceed $320.1 billion, including health expenditures and lost productivity.
The AHA tracks seven risk factors for heart disease and stroke: tobacco use, physical activity, diet, body weight, cholesterol, BP and blood glucose. The report yielded the following information for each of these risk factors:
- Blood glucose: The worldwide prevalence of diabetes in adults is projected to increase from 6.4% in 2010 to 7.7% by 2030. In the United States, approximately 21 million people have been diagnosed with diabetes (9% of the adult population) and the prevalence is expected to rise. Thirty-five percent of Americans have prediabetes, with the greatest burden reported in blacks and Hispanics.
- Body weight: The majority of Americans aged 20 years and older and 32% of children are overweight or obese. Globally, approximately 1.46 billion adults were overweight or obese in 2008, including 205 million men and 297 million women with obesity.
- BP: An estimated 80 million US adults have elevated BP. More than three-quarters of these individuals (77%) are taking antihypertensive medications and approximately half (54%) have controlled BP. Hypertension is most prevalent among black women (46%) and men (45%). Hypertension is projected to increase by 8% from 2013 to 2030.
- Cholesterol: Forty-three percent of US adults have a cholesterol level ≥200 mg/dL, and 13% have levels >240 mg/dL. The prevalence of elevated cholesterol is greatest among Hispanic men (46%) and white women (46%). Elevated levels of LDL cholesterol are present in approximately one-third US adults, and 20% have low levels of HDL cholesterol.
- Diet: From 1971 to 2004, calorie consumption increased by about 10% among men and 22% among women. The current intake is an average of 2,700 daily calories and 1,900 daily calories, respectively. Less than 1% of US adults and almost no children meet the criteria for an ideal healthy diet set by the AHA. The primary challenges for improving diet in the United States are reduced sodium intake and greater consumption of whole grains.
- Physical activity: Nearly one-third of US adults reported participating in no physical activity during their leisure time. Twenty-seven percent of adolescents in grades 9 through 12 participated in 60 minutes of daily exercise, the amount recommended by the AHA. Meeting this recommendation was more common among high school-aged boys than girls.
- Tobacco use: Smoking and secondhand smoke contributed to as many as 6.2 million deaths worldwide in 2010. In the United States, tobacco use has continued to decline in recent years; however, it is the second-most common cause of mortality and disability. Among adults, 20% of men and 16% of women current smoking. Sixteen percent of adolescents in grades 9 through 12 reported smoking. Smoking was most prevalent among male American Indians or Alaskan natives (26%), white men (22%) and black men (21%). Approximately 6,300 people began smoking cigarettes every day during 2012.
“The prevalence of ideal CV health is higher in US children and young adults than in US middle-aged and older adults, largely because of the higher prevalence of ideal levels of health factors in US children and young adults,” according to the report. “However, with regard to health behaviors, children and young adults were similar to or worse than middle-aged older adults.”
See the full report for more statistics.