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Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association
Open accessAbstract
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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“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]
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“CVDs, particularly coronary artery disease (CAD), continue to be the leading global cause of mortality [183– 185].”
BackgroundDyslipidemia in American Indian Adolescents and Young Adults: Strong Heart Family Study
Reese, J. A., Roman, M. J., Deen, J. F., Ali, T., Cole, S. A., Devereux, R. B., Fretts, A. M., Howard, W. J., Lee, E. T., Malloy, K., et al. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.031741 · Cited by 24
Prediction of outcomes after cardiac arrest by a generative artificial intelligence model
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Implications of Bias in Artificial Intelligence: Considerations for Cardiovascular Imaging
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“The prevalence and outcomes of CVD demonstrate significant disparities across gender and race [1, 16, 17].”
Chapter 1: The Burden of Heart Failure
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“CVD is a major global health issue and one of the leading causes of death worldwide (Virani et al., 2021).”
BackgroundKafili, G., Kabir, H., Kandeloos, A. J., Golafshan, E., Ghasemi, S., Mashayekhan, S., & Taebnia, N. (2023) · Journal of Biomaterials Applications · doi:10.1177/08853282231207216 · Cited by 20
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“INTRODUCTION Pathological cardiac hypertrophy is usually induced by pressure overload and leads to heart failure, which is a prevalent cause of morbidity and mortality worldwide [1, 2].”
BackgroundPark, C. S., Yang, H., Han, K., Lee, H., Kang, J., Han, J., Park, K. W., Kang, H., Koo, B., & Kim, H.-S. (2023) · Journal of Advanced Research · doi:10.1016/j.jare.2023.05.003 · Cited by 23
“However, it remains largely responsible for morbidity and mortality [1], suggesting the need for better risk stratification and tailored management.”
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Kinesiophobia in patients with coronary heart disease: a Rodgers’ evolutionary concept analysis
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“The World Heart Association projects global cardiovascular costs to rise from $863 billion in 2010 to $1,044 billion by 2030 (Virani et al., 2021).”
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A machine learning model to predict heart failure readmission: toward optimal feature set
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Acupuncture for ischemic stroke: where are we now?
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“It ranks fifth among the causes of death after heart disease, cancer, chronic lower respiratory disease, and accidental injury [3] .”
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“The prognosis for HF is poor, with an estimated mortality rate of ~50% within 5 years of the diagnosis 1 .”
InfluentialEffects of Metformin on Ischemia/Reperfusion Injury: New Evidence and Mechanisms
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“and it is predicted that it will increase to more than USD 177 billion by the year 2040 [47].”
BackgroundThree-Dimensional Bioprinting in Cardiovascular Disease: Current Status and Future Directions
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“, 2022) and is a major source of global cardiovascular disease morbidity, mortality, and economic burden on health (Virani et al., 2021).”
Background"Do-not-resuscitate" preferences of the general Swiss population: Results from a national survey.
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“More importantly, if SCAD cannot be timely and effectively controlled, it will develop to ACS, leading to the increased risk of more severe clinical syndrome and death of patients (Virani et al., 2021).”
BackgroundMueller, A. S., & Kim, S. M. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14155573 · Cited by 28
“Cardiovascular disease remains the leading cause of death in the United States, with over 18 million adults currently living with some form of heart disease [1].”
Myocardial infarction, stroke and arterial stenosis: time to reassess a major misunderstanding
Saba, L., & Libby, P. (2025) · Nature Reviews Cardiology · doi:10.1038/s41569-025-01186-3 · Cited by 19
“This complexity rationalizes the categorization of many strokes as ‘embolic strokes of undetermined source’ 30,31 .”
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In vitro vascularization improves in vivo functionality of human engineered cardiac tissues
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Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures
Lenarczyk, R., Proietti, M., Scheitz, J. F., Shah, D., Siebert, E., Gorog, D. A., Kowalczyk, J. P., Bonaros, N. E., Ntaios, G., Doehner, W., et al. (2024) · Nature Reviews Cardiology · doi:10.1038/s41569-024-01076-0 · Cited by 23
“An estimated 1.5 million patients undergo PCI and coronary angiography procedures annually in the USA 22,41,42 .”
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“15 Notably, CKD often coexists with HF, with reported prevalences reaching 53% in those experiencing acute HF and 42% in chronic cases.”
BackgroundShiyovich, A., Berman, A. N., Besser, S. A., Biery, D. W., Kaur, G., Divakaran, S., Singh, A., Huck, D. M., Weber, B., Plutzky, J., et al. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.034493 · Cited by 30
Ubiquitous regulation of cerebrovascular diseases by ubiquitin‐modifying enzymes
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“116,163 Recent studies have elucidated the pivotal roles of UMEs in CVDs, shedding light on the mechanism and therapy of these medical emergencies.”
BackgroundAtherectomy - The Options, the Evidence, and When Should it be Used.
Pinto, P., & Chaar, C. O. (2024) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2023.12.104 · Cited by 19
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“Notwithstanding, the prevalence of HF is projected to rise as a result of an ageing population, improved risk factors management and rising survival rates [4, 5].”
BackgroundThreats of per- and poly-fluoroalkyl pollutants to susceptible populations
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Res-BiANet: A Hybrid Deep Learning Model for Arrhythmia Detection Based on PPG Signal
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Mesenchymal stem cells as future treatment for cardiovascular regeneration and its challenges
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“It is an ever-growing healthcare problem accounting for a total of 32% of global deaths and taking approximately 17.9 million of lives annually (3).”
BackgroundInfluentialVagus nerve stimulation as immunomodulatory therapy for stroke: A comprehensive review
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“It is also a major cause of premature death as it represents the second highest cause of death worldwide with 6.6 million deaths every year (Virani et al., 2021; Kim et al., 2020).”
InfluentialJackson, S. L., Woodruff, R., Nagavedu, K., Fearrington, J. A., Rolka, D. B., Twentyman, E., Carton, T. W., Puro, J., Denson, J., Kappelman, M., et al. (2023) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.122.030240 · Cited by 19
Frailty Status Modifies the Efficacy of ICD Therapy for Primary Prevention Among Patients With HF.
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Mitral Regurgitation in Female Patients: Sex Differences and Disparities
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“3,5 This Swedish analysis revealed that MR made up 24.2% of valvular disease diagnoses, 3,5 but, world-wide, MR represents the most common valvular disease.”
BackgroundInfluentialMalnutrition and poststroke depression in patients with ischemic stroke.
Gu, M.-M., Wang, J.-J., Xiao, L.-L., Chen, X.-L., Wang, M., Huang, Q., Zhou, J.-S., & Sun, W. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.04.104 · Cited by 19
Correlation Between Coronary and Retinal Microangiopathy in Patients With STEMI
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Hypoxia and Tissue Regeneration: Adaptive Mechanisms and Therapeutic Opportunities
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“This problem is reflected in 18 million deaths annually and approximately 64 million people living with Heart failure and functional limitations [77].”
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“With over 300 million being performed worldwide on an annual basis 1 , the 12-lead electrocardiogram (ECG) has established itself as a bedrock diagnostic in the assessment of cardiovascular disease 2 – 5 .”
van Diepen, S., May, M. L. L., Alfaro, P., Goldfarb, M. J., Luk, A., Mathew, R., Peretz-Larochelle, M., Rayner‐Hartley, E., Russo, J. J., Senaratne, J., et al. (2024) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2024.01.012 · Cited by 18
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“Pulmonary embolism (PE) is the third most common cause of cardiovascular death in the United States [1] with an estimated mortality approaching 300,000 annually [2].”
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“Coronary artery disease (CAD) imposes a signi fi cant global disease burden and stands as a prominent contributor to human mortality on a global scale (1, 2).”
BackgroundInterplay between microglia and environmental risk factors in Alzheimer's disease
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“32,33”
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“Acute myocardial infarction is a fatal disease with a high death rate worldwide [1].”
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Application of Chalcone in the Structural Modification of Natural Products: An Overview
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“Approximately 690 million cases of diabetes are expected by 2045 [106].”
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The Role of Spirituality in Stroke Survivors and Their Caregivers: A Systematic Review
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“In the USA, approximately 3% of males and 2% of females were disabled because of stroke (Virani et al., 2021).”
BackgroundMachine Learning Identifies Higher Survival Profile In Extracorporeal Cardiopulmonary Resuscitation*
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Metadata
- 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
- 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
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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