AHA Annual Stats Update Highlights Heart-Brain Connection

Megan Brooks

February 03, 2022

The American Heart Association (AHA) draws attention to the important bidirectional link between cardiovascular health and brain health in its annual statistical update on heart disease and stroke.

"For several years now, the AHA and the scientific community have increasingly recognized the connections between cardiovascular health and brain health, so it was time for us to cement this into its own chapter, which we highlight as the brain health chapter," Connie W. Tsao, MD, MPH, chair of the statistical update writing group, with Harvard Medical School, Boston, Massachusetts, said in an AHA podcast.

"The global rate of brain disease is quickly outpacing heart disease," Mitchell S. V. Elkind, MD, immediate past president of the AHA, added in a news release.

"The rate of deaths from Alzheimer's disease and other dementias rose more than twice as much in the past decade compared to the rate of deaths from heart disease, and that is something we must address," said Elkind, with Columbia University Vagelos College of Physicians and Surgeons in New York City.

"It's becoming more evident that reducing vascular disease risk factors can make a real difference in helping people live longer, healthier lives, free of heart disease and brain disease," Elkind added.

The AHA's Heart Disease and Stroke Statistics – 2022 Update was published online January 26 in Circulation.

The report highlights some of the research connecting heart and brain health, including the following:

  • A meta-analysis of 139 studies showed that people with midlife hypertension were five times more likely to experience impairment on global cognition and about twice as likely to experience reduced executive function, dementia, and Alzheimer's disease.

  • A meta-analysis of four longitudinal studies found that the risk for dementia associated with heart failure was increased nearly twofold.

  • In the large prospective Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study, atrial fibrillation was associated with greater cognitive decline and dementia over 20 years.

  • A meta-analysis of 10 prospective studies (including 24,801 participants) showed that coronary heart disease (CHD) was associated with a 40% increased risk of poor cognitive outcomes, including dementia, cognitive impairment, or cognitive decline.

"This new chapter on brain health was a critical one to add," Tsao said in the news release.

"The data we've collected brings to light the strong correlations between heart health and brain health and makes it an easy story to tell ― what's good for the heart is good for the brain," Tsao added.

Along with the new chapter on brain health, the 2022 statistical update provides the latest statistics and heart disease and stroke. Among the highlights:

  • Cardiovascular disease (CVD) remains the leading cause of death worldwide. In the US in 2019, CVD, listed as the underlying cause of death, accounted for 874,613 deaths ― about 2396 deaths each day. On average, someone dies of CVD every 36 seconds.

  • CVD claims more lives each year in the US than all forms of cancer and chronic lower respiratory disease combined.

  • In 2019, CHD was the leading cause (41.3%) of deaths attributable to CVD, followed by other CVD (17.3%), stroke (17.2%), hypertension (11.7%), heart failure (9.9%), and diseases of the arteries (2.8%).

  • In 2019, stroke accounted for roughly 1 in every 19 deaths in the US. On average, someone in the US has a stroke every 40 seconds and someone dies of stroke every 3 minutes 30 seconds. When considered separately from other CVD, stroke ranks number five among all causes of death in the US.

While the annual statistics update aims to be a contemporary update of annual heart disease and stroke statistics over the past year, it also examines trends over time, Tsao explains in the podcast.

"One noteworthy point is that we saw a decline in the rate of cardiovascular mortality over the past three decades or so until about 2010. But over the past decade now, we're also seeing a rise in these numbers," she said.

This could be due to rising rates of obesity, diabetes, and poor hypertension control, as well as other lifestyle behaviors, Tsao said.

Key Risk Factor Data

Each year, the statistical update gauges the cardiovascular health of Americans by tracking seven key health factors and behaviors that increase risk for heart disease and stroke. Below is a snapshot of the latest risk factor data.

Smoking

In 2019, smoking was the leading risk factor for years of life lost to premature death and the third leading risk factor for years of life lived with disability or injury.

According to the 2020 surgeon general's report on smoking cessation, more than 480,000 Americans die as a result of cigarette smoking, and more than 41,000 die of secondhand smoke exposure each year (roughly 1 in 5 deaths annually).

One in 7 adults are current smokers, 1 in 6 female adults are current smokers, and 1 in 5 high school students use e-cigarettes.

Physical Inactivity

In 2018, 25.4% of US adults did not engage in leisure-time physical activity, and only 24.0% met the 2018 Physical Activity Guidelines for Americans for both aerobic and muscle strengthening.

Among US high school students in 2019, only 44.1% were physically active for 60 minutes or more on at least 5 days of the week.

Nutrition

While there is some evidence that Americans are improving their diet, fewer than 10% of US adults met guidelines for whole grain, whole fruit, and nonstarchy vegetable consumption each day in 2017–2018.

Overweight/Obesity

The prevalence of obesity among adults increased from 1999–2000 through 2017–2018 from 30.5% to 42.4%. Overall prevalence of obesity and severe obesity in US youth 2 to 19 years of age increased from 13.9% to 19.3% and 2.6% to 6.1% between 1999–2000 and 2017–2018.

Cholesterol

Close to 94 million (38.1%) US adults have total cholesterol of 200 mg/dL or higher, according to 2015–2018 data; about 28.0 million (11.5%) have total cholesterol of 240 mg/dL or higher; and 27.8% have high levels of low-density lipoprotein cholesterol (130 mg/dL or higher).

Diabetes

In 2019, 87,647 US deaths were attributed to diabetes; data show that 9.8 million US adults have undiagnosed diabetes, 28.2 million have diagnosed diabetes, and 113.6 million have prediabetes.

Hypertension

A total of 121.5 million (47.3%) US adults have hypertension, based on 2015–2018 data. In 2019, 102,072 US deaths were primarily attributable to hypertension.

This statistical update was prepared by a volunteer writing group on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Disclosures for the writing committee are listed with the original article.

Circulation. Published online January 26, 2022. Abstract

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