Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association
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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.
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Women in North America carry a larger stroke burden than men, including higher lifetime stroke risk, higher lifetime stroke death risk, and worse post-stroke outcomes.
“In North America, women bear a greater burden of disease due to a higher lifetime risk of stroke,1 a higher lifetime risk of death from stroke, and a higher risk of poor outcomes following stroke compared with men.2–4”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [4]
The Summary’s Stroke section (Chapter 15; page unavailable) reports US stroke-mortality trends by age, but does not compare women with men. Searches for lifetime stroke risk, lifetime risk of stroke death, and post-stroke outcomes found no passage in our copy establishing the claimed sex differences. (LLM, conf=0.70)
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Cholesterol and the Risk of Ischemic Stroke
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Self-citationAmerican Heart Association Childhood Obesity Research Summit: Executive Summary
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Novel genetic markers improve measures of atrial fibrillation risk prediction
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Hemodynamic Predictors of Mortality in Adults with Sickle Cell Disease
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Glycemic Variation and Cardiovascular Risk in the Veterans Affairs Diabetes Trial
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Genome-wide analysis yields new loci associating with aortic valve stenosis
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Physical activity and risk of ischemic stroke in the Northern Manhattan Study
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Self-citationThe Effects of Carbohydrate, Unsaturated Fat, and Protein Intake on Measures of Insulin Sensitivity
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Self-citationDiabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke
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The changing landscape of atherosclerosis
Libby, P. (2021) · Nature · doi:10.1038/s41586-021-03392-8 · Cited by 2,873 · see citing works
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
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Iron Homeostasis and Ferroptosis in Human Diseases: Mechanisms and Therapeutic Prospects
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Global Public Health Burden of Heart Failure: An Updated Review
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Self-citationInterventions for Frailty Among Older Adults With Cardiovascular Disease
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Ultra-processed Foods and Cardiovascular Diseases: Potential Mechanisms of Action
Juul, F., Vaidean, G., & Parekh, N. (2021) · Advances in Nutrition · doi:10.1093/advances/nmab049 · Cited by 374 · see citing works
Sex differences in the prevalence, outcomes and management of hypertension
Connelly, P. J., Currie, G., & Delles, C. (2022) · Current Hypertension Reports · doi:10.1007/s11906-022-01183-8 · Cited by 320 · see citing works
Prediction of mortality from 12-lead electrocardiogram voltage data using a deep neural network
Raghunath, S., Ulloa Cerna, A. E., Jing, L., vanMaanen, D. P., Stough, J., Hartzel, D. N., Leader, J. B., Kirchner, H. L., Stumpe, M. C., Hafez, A., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0870-z · Cited by 314 · see citing works
Hypoxia-induced signaling in the cardiovascular system: pathogenesis and therapeutic targets
Zhao, Y., Xiong, W., Li, C., Zhao, R., Lu, H., Song, S., Zhou, Y., Hu, Y., Shi, B., & Ge, J. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01652-9 · Cited by 264 · see citing works
“252 Cardiac fi brosis is a pathological process involving ECM remodeling and activation of fi broblasts, which occurs in most cardiac injuries including MI. Early cardiac fi brosis can prevent the rupture of infarcted cardiac tissue during MI.”
BackgroundSun, J.-H., Li, Y.-Z., Zhao, M., Yu, X., Zhang, C., Magnussen, C., & Xi, B. (2023) · BMC Medicine · doi:10.1186/s12916-023-02824-8 · Cited by 241 · see citing works
Three-Dimensional Cell Cultures: The Bridge between In Vitro and In Vivo Models
Urzì, O., Gasparro, R., Costanzo, E., Luca, A. D., Giavaresi, G., Fontana, S., & Alessandro, R. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241512046 · Cited by 247 · see citing works
“Heart disease is the leading cause of death worldwide [165], thus representing a major global health concern, and the number of affected patients has doubled in the last 10 years [166].”
BackgroundButler, J., Filippatos, G., Jamal Siddiqi, T., Brueckmann, M., Böhm, M., Chopra, V. K., Pedro Ferreira, J., Januzzi, J. L., Kaul, S., Piña, I. L., et al. (2022) · Circulation · doi:10.1161/circulationaha.121.057812 · Cited by 206 · see citing works
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Creager, M. A., Matsushita, K., Arya, S., Beckman, J. A., Duval, S., Goodney, P. P., Gutierrez, J. A. T., Kaufman, J. A., Joynt Maddox, K. E., Pollak, A. W., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000967 · Cited by 164 · see citing works
Triglyceride-glucose index and heart failure: a systematic review and meta-analysis
Khalaji, A., Behnoush, A., Khanmohammadi, S., Mardasi, K. G., Sharifkashani, S., Sahebkar, A., Vinciguerra, C., & Cannavo, A. (2023) · Cardiovascular Diabetology · doi:10.1186/s12933-023-01973-7 · Cited by 155 · see citing works
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“According to the American Heart Association, more than 350,000 people die of CHD in the United States each year [1].”
BackgroundThe impact of aerobic exercise on HDL quantity and quality: a narrative review
Franczyk, B., Gluba-Brzózka, A., Ciałkowska-Rysz, A., Ławiński, J., & Rysz, J. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24054653 · Cited by 142 · see citing works
Association between anxiety and hypertension in adults: A systematic review and meta-analysis
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Cardiovascular Disease and Alzheimer's Disease: The Heart–Brain Axis
Saeed, A., López, O., Cohen, A. D., & Reis, S. (2023) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.123.030780 · Cited by 138 · see citing works
“9,11,12 As such, efforts to maintain and improve cardio and cerebrovascular health for curtailing mortality and disability in the United States, and globally, is a shared fundamental priority from a public health domain.”
BackgroundAssessing and Addressing Social Determinants of Cardiovascular Health
Brandt, E. J., Tobb, K., Cambron, J., Ferdinand, K., Douglass, P., Nguyen, P., Vijayaraghavan, K., Islam, S., Thamman, R., Rahman, S., et al. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.01.042 · Cited by 132 · see citing works
Vascular complications of diabetes: A narrative review
Lu, Y., Wang, W., Liu, J., Xie, M., Liu, Q., & Li, S.-H. (2023) · Medicine · doi:10.1097/md.0000000000035285 · Cited by 127 · see citing works
“7% decrease in the age-standardized death rate for the 9-year period from 2010 to 2019.[88,89] DM is associated with an elevated risk of stroke.”
Self-citationDoxorubicin-induced cardiotoxicity and risk factors
Belger, C., Abrahams, C., Imamdin, A., & Lecour, S. (2023) · International Journal of Cardiology: Heart & Vasculature · doi:10.1016/j.ijcha.2023.101332 · Cited by 113 · see citing works
“On the other hand, black Americans have a higher mortality rate due to heart disease than all other ethnic groups [106].”
Wyne, K. L., Nair, L., Schneiderman, C. P., Pinsky, B., Antunez Flores, O., Guo, D., Barger, B., & Tessnow, A. H. (2022) · Journal of the Endocrine Society · doi:10.1210/jendso/bvac172 · Cited by 111 · see citing works
Lipoprotein(a), Oxidized Phospholipids, and Coronary Artery Disease Severity and Outcomes
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Vulnerable or High-Risk Plaque: A JACC: Cardiovascular Imaging Position Statement.
Vergallo, R., Park, S.-J., Stone, G. W., Erlinge, D., Porto, I., Waksman, R., Mintz, G., D'Ascenzo, F., Seitun, S., Saba, L., et al. (2025) · JACC Cardiovascular Imaging · doi:10.1016/j.jcmg.2024.12.004 · Cited by 107 · see citing works
The role of diet and nutrition in heart failure: A state-of-the-art narrative review
Billingsley, H. E., Hummel, S. L., & Carbone, S. (2020) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2020.08.004 · Cited by 106 · see citing works
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Personalized Intervention Based on Early Detection of Atherosclerosis: JACC State-of-the-Art Review.
Nielsen, R., Fuster, V., Bundgaard, H., Fuster, J. J., Johri, A., Kofoed, K. F., Douglas, P. S., Diederichsen, A., Shapiro, M. D., Nicholls, S. J., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.02.053 · Cited by 91 · see citing works
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Understanding exosomes: Part 2—Emerging leaders in regenerative medicine
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Neutrophil extracellular traps mediate deep vein thrombosis: from mechanism to therapy
Yao, M., Ma, J., Wu, D.-W., Fang, C., Wang, Z.-L., Guo, T., & Mo, J. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1198952 · Cited by 89 · see citing works
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Heart failure and obesity: The latest pandemic.
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“Although the stable and even decreased incidence of stroke in the past two decades is encouraging, increased aging and cumulative risk factors result in an increasing risk of lifelong stroke, and the absolute number of stroke incidence, disability-adjusted life-years lost and death owing to stroke increased continuous…”
BackgroundLee, S., Chu, Y., Ryu, J., Park, Y. J., Yang, S., & Koh, S. B. (2022) · Yonsei Medical Journal · doi:10.3349/ymj.2022.63.s93 · Cited by 88 · see citing works
Periodontitis and atherosclerotic cardiovascular disease: A critical appraisal.
Carra, M., Rangé, H., Caligiuri, G., & Bouchard, P. (2023) · Periodontology 2000 · doi:10.1111/prd.12528 · Cited by 83 · see citing works
Vakhshoori, M., Nemati, S., Sabouhi, S., Yavari, B., Shakarami, M., Bondariyan, N., Emami, S. A., & Shafie, D. (2023) · BMC Cardiovascular Disorders · doi:10.1186/s12872-023-03572-6 · Cited by 82 · see citing works
“HF prevalence is still rising rapidly and it has been estimated to increase by 46% in 2030 [3].”
BackgroundMitochondrial dysfunction at the crossroad of cardiovascular diseases and cancer
Rocca, C., Soda, T., Francesco, E. D. D., Fiorillo, M., Moccia, F., Viglietto, G., Angelone, T., & Amodio, N. (2023) · Journal of Translational Medicine · doi:10.1186/s12967-023-04498-5 · Cited by 82 · see citing works
“with a high-energy demand and producing high levels of oxidative stress, such as cardiomyocytes [96, 97].”
BackgroundThe bidirectional association between atrial fibrillation and myocardial infarction
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“3,28,29,37,45,47,51,52 In terms of demographics, it has been reported that black people are less likely to have HFpEF compared with white people.”
Challenges and advances in materials and fabrication technologies of small-diameter vascular grafts
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“6 million deaths in the past 30 years [1].”
BackgroundPrimary Prevention of Subclinical Atherosclerosis in Young Adults: JACC Review Topic of the Week.
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“Hypertension is defined as systolic blood pressure (SBP) higher than 140 mmHg or diastolic blood pressure (DBP) higher than 90 mmHg [3].”
BackgroundRegulation of the JAK/STAT signaling pathway: The promising targets for cardiovascular disease.
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“CVDs have significant health and economic impacts both in the United States and worldwide [1].”
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“Globally, there is an exceptionally high death and recurrence rate associated with CVD, a category of illnesses affecting the heart or blood vessels [52,53].”
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“Numerous known risk factors of MI include smoking, high blood pressure, dyslipidemia, diabetes, obesity, unhealthy diet, and lack of exercise, significantly affecting life quality [2].”
BackgroundSex differences in human performance
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“…inclusion of females in clinical trials has contributed to inappropriate treatment options and poor health outcomes for females and even exacerbated cardiovascular mortality rates (Kim et al., 2010; Melloni et al., 2010; Shannon et al., 2019; Virani et al., 2021; Zucker & Prendergast, 2023).”
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Associations Between Life's Essential 8 and Chronic Kidney Disease
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“For AF and CAD, we calculated the sample prevalence by dividing the number of cases by the number of samples reported in the GWAS, and we used a population prevalence of 2.2% for AF and 7.2% for CAD 62,63 .”
InfluentialSelf-citationAdvancements in risk stratification and management strategies in primary cardiovascular prevention.
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Neuroprotection during Thrombectomy for Acute Ischemic Stroke: A Review of Future Therapies
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“Consequently, the prevalence of individuals afflicted with disability due to stroke has increased, making stroke the leading cause of long-term disability worldwide [4].”
BackgroundDecellularized extracellular matrix materials for treatment of ischemic cardiomyopathy
Liu, W., Zhang, X.-M., Jiang, X.-J., Dai, B., Zhang, L., & Zhu, Y. (2023) · Bioactive Materials · doi:10.1016/j.bioactmat.2023.10.015 · Cited by 55 · see citing works
“Ischemic cardiomyopathy (ICM) remain one of the leading causes of death worldwide over the past few decades [1 – 3], opposing heavy medical and financial burdens on patients and community.”
BackgroundDiabetes and Progression of Heart Failure
Echouffo-Tcheugui, J. B., Ndumele, C. E., Zhang, S., Florido, R., Matsushita, K., Coresh, J., Skali, H., Shah, A. M., & Selvin, E. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.03.378 · Cited by 54 · see citing works
An Anatomy- and Topology-Preserving Framework for Coronary Artery Segmentation
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“C ORONARY artery disease (CAD) is one of the most critical cardiovascular diseases in our daily life, which can lead to myocardial ischemia, hypoxia, or necrosis in severe cases [1], [2].”
BackgroundSelf-citationTeam principles for successful interdisciplinary research teams
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“The prevalence of cardiovascular disease in adults in the general population is ~50 % (including hypertension) and ~10 % (excluding hypertension) (4), associated with ~$220 billion in direct costs annually (4).”
BackgroundBillingsley, H. E., Del Buono, M. G., Canada, J. M., Kim, Y., Damonte, J. I., Trankle, C. R., Halasz, G., Mihalick, V., Vecchié, A., Markley, R. R., et al. (2022) · Circulation: Heart Failure · doi:10.1161/circheartfailure.122.009518 · Cited by 52 · see citing works
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Nrf2 and Ferroptosis: A New Research Direction for Ischemic Stroke
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“The absolute number of strokes, related deaths, and loss of disability-adjusted life years are increasing year by year, and the number of patients and deaths is getting younger and younger (Virani et al. 2021).”
BackgroundVascular smooth muscle–specific YAP/TAZ deletion triggers aneurysm development in mouse aorta
Arévalo Martínez, M., Ritsvall, O., Bastrup, J. A., Celik, S., Jakobsson, G., Daoud, F., Winqvist, C., Aspberg, A., Rippe, C., Maegdefessel, L., et al. (2023) · JCI Insight · doi:10.1172/jci.insight.170845 · Cited by 51 · see citing works
Coffee consumption and cardiometabolic health: a comprehensive review of the evidence
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“In accordance with the continuous ageing of the global population, CVD prevalence is steadily rising [3,4].”
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Update on sex specific risk factors in cardiovascular disease
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New Biomarkers for Cardiovascular Disease
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Advances in Acute Ischemic Stroke Treatment: Current Status and Future Directions
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“Atherosclerosis can impair blood flow to the brain causing acute bran injury and ischemic stroke, the leading neurological cause of disability and death with over 77 million cases reported in 2019 [135].”
Current Strategies for Engineered Vascular Grafts and Vascularized Tissue Engineering
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“Cardiovascular i , i l i g, but not limited to, coronary heart disease (CHD) and peripheral arterial disease (PAD), are the principle cause of death world ide, especially in developed countries, where cardiovascular diseases affect more people than all types of cancer combined [11,12].”
BackgroundMachine Learning and the Conundrum of Stroke Risk Prediction
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Neuro-immune interactions: Exploring the anti-inflammatory role of the vagus nerve.
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Amyloid-β and heart failure in Alzheimer’s disease: the new vistas
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“N -acetylgalactosyltransferase 2) 141 .”
Rossi, L. P., Granger, B. B., Bruckel, J. T., Crabbe, D. L., Graven, L. J., Newlin, K. S., Streur, M. M., Vadiveloo, M. K., Walton-Moss, B. J., Warden, B. A., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001141 · Cited by 42 · see citing works
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“Introduction Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide [1].”
Background
- Authors
- Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Cheng, S., Delling, F. N., Elkind, M. S. V., Evenson, K. R., Ferguson, J. F., Gupta, D. K., Khan, S. S., Kissela, B. M., Knutson, K. L., Lee, C. D., Lewis, T. T., Liu, J., Loop, M. S., Lutsey, P. L., Ma, J., Mackey, J., Martin, S. S., Matchar, D. B., Mussolino, M. E., Navaneethan, S. D., Perak, A. M., Roth, G. A., Samad, Z., Satou, G. M., Schroeder, E. B., Shah, S. H., Shay, C. M., Stokes, A., VanWagner, L. B., Wang, N.-Y., Tsao, C. W., & On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
- ORCID
- Virani, Salim S.
- Aparicio, Hugo J.
- Benjamin, Emelia J.
- Callaway, Clifton W.
- Carson, April P.
- Chamberlain, Alanna M.
- Cheng, Susan
- Delling, Francesca N.
- Elkind, Mitchell S.V.
- Evenson, Kelly R.
- Ferguson, Jane F.
- Gupta, Deepak K.
- Khan, Sadiya S.
- Knutson, Kristen L.
- Lee, Chong D.
- Lewis, Tené T.
- Liu, Junxiu
- Loop, Matthew Shane
- Lutsey, Pamela L.
- Ma, Jun
- Mackey, Jason
- Martin, Seth S.
- Matchar, David B.
- Navaneethan, Sankar D.
- Perak, Amanda Marma
- Roth, Gregory A.
- Samad, Zainab
- Satou, Gary M.
- Schroeder, Emily B.
- Shah, Svati H.
- Shay, Christina M.
- Stokes, Andrew
- VanWagner, Lisa B.
- Wang, Nae-Yuh
- Tsao, Connie W.
- Venue
- Circulation
- Published
- 2021-02-23
- Volume
- 143
- Issue
- 8
- Pages
- e254-e743
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC13036842
- OpenAlex
- W3122226502
- Cited by
- 5,784
- References
- 0
- Citations by year
- 2026: 503 · 2025: 658 · 2024: 915 · 2023: 1282 · 2022: 1694 · 2021: 646 · 2020: 11 · 2019: 1 · 2018: 1 · 2017: 2 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 764.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R03HL145195, R01HL155717)
- National Institute of Neurological Disorders and Stroke (L30 NS093634, R01NS017950)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- heart disease, stroke, cardiovascular disease statistics, cardiovascular risk factors, cardiovascular health behaviors, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary artery disease, heart failure, valvular heart disease, venous disease, peripheral arterial disease, quality of care, health care costs, social determinants of health, adverse pregnancy outcomes, cardiovascular disease prevention
- MeSH terms
- Global Burden of Disease, Diet, Healthy, American Heart Association, Blood Pressure, Cholesterol, Diabetes Mellitus, Heart Diseases, Hospitalization, Humans, Obesity, Risk Factors, Smoking, United States, Health Behavior, Exercise, Prevalence, Stroke
About these checks
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