AHA: America’s heart health needs improvement

Issue: January 2012

Better heart health begins with knowing the statistics, according to a new report from the American Heart Association. In its “Heart Disease and Stroke Statistical Update 2012,” the association highlights the increasing prevalence of CVD risk factors in the US population and stresses the importance of changing harmful health behaviors.

“By monitoring health, as well as disease, the update provides information essential to public health initiatives, patient care and for people to take personal responsibility for their health — and for their lives,” Veronique L. Roger, MD, MPH, professor of medicine and epidemiology at the Mayo Clinic College of Medicine in Rochester, Minn., said in a press release.

Startling statistics

The report, published in Circulation, showed that, in terms of CV health, there is room for improvement. The AHA defines ideal CV health based on seven health factors:

Smoking status.
Weight.
Physical activity.
Healthy diet.
Cholesterol.
BP and fasting glucose levels.
Absence of a diagnosis of heart or blood vessel disease.

Among US adults, 94% have at least one and 38% have at least three health factors that are at poor levels, according to the updated report. In addition, half of US children aged 12 to 19 years meet four or fewer criteria for ideal CV health. Researchers also found that 31.7% of children aged 2 to 19 years are overweight and obese, and 16.9% are obese.

These poor health levels and high obesity rates may be explained by lack of physical activity, researchers said. Thirty-three percent of adults do not engage in aerobic leisure-time physical activity, and a high proportion of children do not exercise regularly. For instance, 29.9% of girls and 17% of boys in grades nine through 12 reported that they had not regularly engaged in 60 minutes of moderate-to-vigorous physical activity even once in the previous week, despite recommendations for children to engage in physical activity at least 5 days per week.

Caloric intake has also been on the rise, increasing by 22% in women (from 1,542 to 1,886 kcal/day) and 10% in men (from 2,450 to 2,693 kcal/day) during 1971 to 2004, data from the National Health and Nutrition Examination Survey indicate.

Along with the rising prevalence of obesity, the rate of diabetes is also increasing. According to the 2003-2006 NHANES, the prevalence of metabolic syndrome is approximately 34% (35.1% among men and 32.6% among women).

Cost is also an important issue. The cost of CV care and treatment increased by more than $11 billion from 2007 to 2008, according to the report, and the estimated direct and indirect cost of CVD and stroke in 2008 was $297.7 billion.

Looking ahead

Although researchers found that the CVD death rate decreased 30.6% and the stroke death rate decreased 34.8% from 1998 to 2008, the report suggests that the burden of disease remains high. To control the increase of CV risk factors in the US population, the AHA has set up new goals to improve CV health of all Americans by reducing deaths from CVD and stroke by 20% each by 2020. However, to reach this goal, the AHA will need to “engage every segment of the population to focus on improved health behaviors,” Donald Lloyd-Jones, MD, a member of the writing group for the statistical update, said in the release.

“In particular, more children, adolescents and young adults will need to learn how to improve and preserve their ideal levels of health factors and health behaviors into older ages,” said Lloyd-Jones, who is also chair of the department of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago. “Moving people who are at poor health to make small changes in their behavior and reach intermediate health is a step in the right direction that can make a big difference.”

For more information:

Roger VL. Circulation. 2012;doi:10.1161/CTR.0b013e31823ac046.

Disclosure: Drs. Lloyd-Jones and Roger report no relevant financial disclosures.

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