2022-05-24-美国心脏协会-2022年美国心脏病和卒中统计数据报告（EN）_487页_12mb

AHA 2022 Statistical Update Summary

Core Content

The 2022 American Heart Association (AHA) Statistical Update provides the most recent data on heart disease, stroke, and cardiovascular risk factors in the United States. It serves as a critical resource for the public, policymakers, clinicians, researchers, and health advocates, offering insights into the prevalence, trends, and outcomes of various cardiovascular conditions and their associated risk factors.

The report includes updated terminology to reflect race and ethnicity more inclusively, aligning with the AHA's commitment to health equity and addressing structural racism. It also emphasizes the global burden of cardiovascular disease (CVD) and the impact of social determinants of health.

Main Chapters and Key Findings

1. Cardiovascular Health (Chapter 2)

• Life's Simple 7 (physical activity, diet, weight, smoking, cholesterol, blood pressure, and glucose control) are key indicators of cardiovascular health (CVH).
• 70.0% of major CVD events in the U.S. are attributed to low or moderate CVH.
• If all U.S. adults achieved high CVH, 2.0 million major CVD events could be prevented annually.
• A partial improvement in CVH could reduce 1.2 million CVD events annually.
• COVID-19 had a significant impact on life expectancy, especially among NH Black, Hispanic, and impoverished populations.

2. Smoking/Tobacco Use (Chapter 3)

• 1.6% of middle school and 4.6% of high school students smoked cigarettes in 2020.
• Despite a 2-decade decline, significant disparities in smoking rates persist among American Indian/Alaska Native and LGBTQ+ adults.
• Electronic cigarette use among adolescents increased sharply from 1.5% to 19.6% between 2011 and 2020, now being the most common tobacco product used by this group.

3. Physical Activity and Sedentary Behavior (Chapter 4)

• 44.1% of high school students met the recommended 60 minutes of physical activity (PA) on at least 5 days of the week.
• 54.2% of adults met the 2018 aerobic PA guidelines.
• Physically active adults had 25%-40% lower risk of CVD mortality, 22%-35% lower risk of all-cause mortality, and better quality of life and cognitive function.

4. Nutrition (Chapter 5)

• Consuming 5 servings of fruits and vegetables daily was linked to 13% lower total mortality, 12% lower CVD mortality, 10% lower cancer mortality, and 35% lower respiratory disease mortality.
• Higher intakes of total fat, polyunsaturated, and monounsaturated fatty acids were associated with lower total mortality, but the role of saturated fats remains controversial.
• Vitamin D supplementation was not supported by clinical trials for improving cardiometabolic health in children and adolescents.

5. Overweight and Obesity (Chapter 6)

• Obesity and severe obesity in U.S. youth increased from 13.9% to 19.3% and 2.6% to 6.1% between 1999–2000 and 2017–2018.
• Males had higher increases in obesity prevalence than females.
• NH Black males showed a significant increase in obesity prevalence from 1999 to 2006, while other groups saw increases from 2006 to 2018.

6. High Blood Cholesterol and Other Lipids (Chapter 7)

• 6.1% of male and 3.0% of female adolescents had LDL ≥130 mg/dL.
• 18.4% of male and 7.4% of female adolescents had HDL <40 mg/dL.
• In adults, 38.1% had total cholesterol ≥200 mg/dL, 27.8% had LDL ≥130 mg/dL, 21.1% had triglycerides ≥150 mg/dL, and 17.2% had HDL <40 mg/dL.

7. High Blood Pressure (Chapter 8)

• High BP was associated with 34.2% increase in death rate from 2009 to 2019.
• Age-adjusted death rates due to high BP varied significantly by race and sex (e.g., 56.7 per 100,000 for NH Black males).
• BP control in adults with hypertension was 31.8% in 1999–2000 and 48.5% in 2007–2008, but declined to 43.7% in 2017–2018.

8. Diabetes (Chapter 9)

• 28.2 million adults had diagnosed diabetes, 9.8 million had undiagnosed diabetes, and 113.6 million had prediabetes in 2015–2018.
• Medication use among diabetic adults increased from 58% to 67%.
• Hemoglobin A1c <7%, BP <140/90 mmHg, and total cholesterol <240 mg/dL improved from 31.6% to 56.2% among newly diagnosed type 2 diabetics.

9. Metabolic Syndrome (Chapter 10)

• Socioeconomic factors were strongly associated with MetS risk.
• Adverse pregnancy outcomes were linked to lower CVH scores at 28 weeks gestation.
• Preterm birth was associated with increased risk of type 1 and 2 diabetes, hypertension, and lipid disorders.

10. Other Chapters

• Chronic kidney disease (CKD) prevalence was 14.9% in 2015–2018, with highest rates among Black adults.
• Sleep duration in the U.S. was 65.2% meeting the recommended ≥7 hours.
• Short and long sleep were both associated with increased heart failure (HF) risk.
• Obstructive sleep apnea was linked to cerebrovascular disease.
• Stroke incidence declined significantly in both males and females from 1993–1994 to 2015, but not for intracerebral hemorrhage or subarachnoid hemorrhage.
• Tight BP control (<130 mmHg) reduced stroke incidence by 42%.
• Alzheimer's disease was the leading cause of mortality among neurological disorders in 2017, with 7.0% of patients developing dementia or cognitive impairment in trials with BP lowering.
• Congenital cardiovascular defects were more common in low socioeconomic status mothers.
• Air pollution (PM2.5, PM10, SO2, NO2) was associated with atrial fibrillation (AF).
• AF detection was 5.3% in a screening group versus 0.5% in a control group.
• AF was linked to increased mortality in patients with COVID-19.
• Out-of-hospital cardiac arrest increased by 119% during the pandemic, with 85% mortality compared to 62% in control periods.
• Subclinical atherosclerosis (CAC) was 53% of individuals at 10 years, with CAC ≥1000 linked to 1.55-fold higher cancer mortality.
• CVH declined from childhood to adulthood, associated with increased carotid intima-media thickness.

Key Information

• The AHA Statistical Update is an annual report that compiles the latest data on CVD and stroke, including epidemiological trends, risk factors, and outcomes.
• It emphasizes health equity, social determinants, and the impact of the pandemic on cardiovascular health.
• The report includes national and global data, clinical trials, and epidemiological studies.
• It provides actionable insights for public health, clinical practice, and policy-making.

Conclusion

The 2022 AHA Statistical Update is a comprehensive resource that highlights the prevalence and impact of cardiovascular diseases and stroke, while also addressing health disparities and the role of social determinants. It underscores the importance of preventive measures, lifestyle changes, and early detection in reducing the burden of CVD. The report is updated annually and has been cited >20,000 times in the literature since 2007.