Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.

BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports 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 2021 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, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS: Each of the 27 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, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Traditional and novel risk factors for clinically diagnosed abdominal aortic aneurysm: the Kaiser multiphasic health checkup cohort study.

BACKGROUND: Identification of risk factors for and early diagnosis of clinically significant abdominal aortic aneurysm (AAA) before rupture is vital to optimize outcomes in these patients. Our aim was to examine traditional and three novel potential risk factors (abdominal obesity, white blood cell count, and kidney function) for abdominal aortic aneurysm (AAA, comprising discharge diagnosis or surgical repair) in a large multiethnic population. METHODS: Cohort study (N =104,813) conducted at an integrated health care delivery system in northern California. RESULTS: After a median of 13 years, 605 AAA events (490 in men and 115 in women; 91 [15%] fatal) were observed. In multivariable analysis, factors significantly associated with risk of clinically detected AAA included male gender, older age, black race (inversely), low educational attainment, cigarette smoking (with dose-response relation), height, treated and untreated hypertension, high total serum cholesterol, elevated white blood cell count, known coronary artery disease, history of intermittent claudication, and reduced kidney function. A significant Asian race by gender interaction was found such that Asian race had a (borderline significant) protective association with AAA in men but not in women. CONCLUSIONS: Our findings confirm that major atherosclerotic risk factors, except for diabetes and obesity, are also prospectively related to AAA and suggest that elevated white blood cell count and reduced kidney function may improve risk stratification for clinically relevant AAA.