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Cited by 8,300Cardiovascular Health and Risk FactorsHealthcare Systems and Public HealthHealth Promotion and Cardiovascular Prevention

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Open access
Tsao, Connie W., Aday, Aaron W., Almarzooq, Zaid I., Anderson, Cheryl A.M., Arora, Pankaj, Avery, Christy L., Baker-Smith, Carissa M., Beaton, Andrea Z. +36 more·2023·Circulation
DOI 10.1161/cir.0000000000001123PMC PMC12135016
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Abstract

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 Epidemiology and Prevention 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 with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the 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, policymakers, 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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Crossref · 10.1161/cir.0000000000001123

Cites

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Claims the paper makes

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  • Findingown data

    In 2017-2020, 32.8% of US adult males and 36.2% of adult females had total cholesterol ≥200 mg/dL.

    “In 2017 to 2020, among adults, total cholesterol ≥200 mg/dL occurred in 32.8% of males and 36.2% of females”
    Quote in the paperNot a substantial claim
  • Findingown data

    For 150 mg aspirin, the number needed to treat was 39.

    “The number needed to treat with 150 mg of aspirin was 39.”
    Quote in the paperSubstantial claim
  • Findingown data

    In the same trial, salt substitute use lowered major adverse cardiovascular events (RR 0.87).

    “major adverse cardiovascular event (RR, 0.87)”
    Quote in the paperSubstantial claim
  • Findingown data

    National Readmission Database delivery hospitalizations showed a hypertensive disorders of pregnancy rate of 912.4 per 10,000 in 2014 versus 528.9 per 10,000 in 1993 in the United States.

    “Analysis of delivery hospitalizations from the National Readmission Database reported a rate of hypertensive disorders of pregnancy of 912.4 per 10 000 delivery hospitalizations in 2014 compared with 528.9 in 1993 in the United States.”
    Quote in the paperNot a substantial claim
  • Findingown data

    A cluster-randomized open-label trial in 600 rural Chinese villages (20,995 participants) found that replacing regular salt (100% sodium chloride) with a substitute (75% sodium chloride, 25% potassium chloride) reduced stroke incidence (RR 0.86).

    “In an open-label, cluster-randomized trial involving 20995 individuals from 600 villages in rural China, the use of a salt substitute (75% sodium chloride and 25% potassium chloride by mass) compared with the use of regular salt (100% sodium chloride) resulted in a lower incidence of stroke (RR, 0.86)”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 22
  • May combine two claims. 50
  • The quote only partly states this claim. 2

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Among Medicare fee-for-service beneficiaries with end-stage renal disease in 2019, hospitalization costs totaled $12.2 billion and outpatient costs $13.1 billion.

    “Total hospitalization expenditures in Medicare fee-for-service beneficiaries with end-stage renal disease was $12.2 billion in 2019, and outpatient spending was $13.1 billion in 2019.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    A 2021 umbrella review reported that for every 5-kg/m2 higher body mass index, risks rose by 15% for coronary heart disease, 23% for atrial fibrillation, 41% for heart failure, and 49% for hypertension.

    “A large umbrella review in 2021 found that every 5–kg/m2 increase in body mass index was associated with a 15% increased risk for CHD, 23% increased risk for atrial fibrillation (AF), 41% increased risk for HF, and 49% increased risk for hypertension.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Hypertension was more common in males than females through age 64 years, but after age 65 years it was more common in females.

    “A higher percentage of males than females had hypertension up to 64 years of age, but for those ≥65 years of age, the percentage of females with hypertension was higher than for males.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    In US metropolitan areas, the cumulative COVID-19 death rate was about 292 per 100,000, compared with about 392 per 100,000 in nonmetropolitan areas.

    “In metropolitan areas in the United States, the cumulative COVID-19 death rate was ≈292 deaths per 100 000 compared with ≈392 deaths per 100 000 in nonmetropolitan areas.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    By July 1, 2022, the United States had recorded 1,014,620 cumulative COVID-19 deaths, roughly 306 per 100,000 people.

    “As of July 1, 2022, the cumulative number of COVID-19 (coronavirus disease 2019) deaths in the United States was 1 014 620, which equates to ≈306 deaths per 100 000 people.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In 2017-2020, 5.0% of US male adolescents and 4.6% of female adolescents had LDL-C ≥130 mg/dL.

    “Among adolescents in 2017 to 2020, low-density lipoprotein cholesterol (LDL-C) levels ≥130 mg/dL occurred in 5.0% of male adolescents and 4.6% of female adolescents”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    US end-stage renal disease prevalence in 2019 was 2302 per million after adjustment for age, race, and sex, up 1.4% from 2018.

    “In 2019, the age-, race-, and sex-adjusted prevalence of end-stage renal disease in the United States was 2302 per 1 million people, an increase of 1.4% over 2018.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Data from 2017-2020 indicated that 29.3 million US adults, or 10.6%, had diagnosed diabetes.

    “Overall, on the basis of 2017 to 2020 data, 29.3 million adults (10.6%) in the United States had diagnosed diabetes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In 2017-2020, 7.2% of US male adolescents and 6.2% of female adolescents had triglycerides ≥130 mg/dL.

    “triglycerides ≥130 mg/dL occurred in 7.2% of male adolescents and 6.2% of female adolescents.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    A meta-analysis of 38 prospective cohorts reported that, comparing highest with lowest Mediterranean diet adherence, relative risks were 0.79 for total cardiovascular mortality, 0.73 for coronary heart disease incidence, 0.83 for coronary heart disease mortality, 0.80 for stroke incidence, 0.87 for stroke mortality, and 0.73 for myocardial infarction incidence.

    “A meta-analysis of 38 prospective cohort studies showed that the relative risk (RR) for the highest versus the lowest categories of Mediterranean diet adherence was 0.79 for total CVD mortality, 0.73 for CHD incidence, 0.83 for CHD mortality, 0.80 for stroke incidence, 0.87 for stroke mortality, and 0.73 for myocardial infarction incidence.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In 2021, 1.0% of US middle school students and 1.9% of high school students reported smoking cigarettes in the previous 30 days.

    “The prevalence of cigarette use in the past 30 days among middle and high school students in the United States was 1.0% and 1.9%, respectively, in 2021.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among adolescent e-cigarette users, flavored products were used by 85.8% of high schoolers and 79.2% of middle schoolers.

    “with the majority of adolescent users using flavored electronic cigarettes (85.8% of high school students and 79.2% of middle school students).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In 2017-2020, 24.9% of US adult males and 9.3% of adult females had HDL cholesterol <40 mg/dL.

    “high-density lipoprotein cholesterol <40 mg/dL occurred in 24.9% of males and 9.3% of females.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    NHANES data from 2017 through March 2020 indicated that 71.2% of US adults aged ≥20 years had overweight or obesity, and 41.4% had obesity, after age adjustment.

    “According to data from NHANES from 2017 until March 2020, the age-adjusted prevalence of overweight or obesity among adults ≥20 years of age in the United States was 71.2%, and the prevalence of obesity was 41.4%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    NHANES 1999-2018 data showed metabolic syndrome prevalence among US youths aged 12-19 years of 4.34% in non-Hispanic White, 3.66% in non-Hispanic Black, 7.70% in Mexican American, 4.84% in other Hispanic, and 1.84% in other race youths.

    “According to the data from NHANES 1999 to 2018, the prevalence of metabolic syndrome among youths 12 to 19 years of age was 4.34% for NH White, 3.66% for NH Black, 7.70% for Mexican American, 4.84% for other Hispanic, and 1.84 for other race youths.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Cigarette smoking among US adults and youths has fallen steadily over the last 20 years, yet large disparities continue.

    “Although there has been a consistent decline in adult and youth cigarette use in the United States in the past 2 decades, significant disparities persist.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In 2017-2020, 19.3% of US male adolescents and 8.6% of female adolescents had LDL-C <40 mg/dL.

    “LDL-C levels <40 mg/dL occurred in 19.3% of male adolescents and 8.6% of female adolescents”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the same period, mean overall CVH score for US children was 78.4 for non-Hispanic Asian, 74.1 for non-Hispanic White, and 71.3 for non-Hispanic Black children.

    “The corresponding mean overall CVH score was 78.4 for NH Asian, 74.1 for NH White, and 71.3 for NH Black children.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In 2020, heart disease and stroke together caused more deaths annually than cancer and chronic lower respiratory disease combined, and the death rate from heart disease and stroke was 207.1 per 100,000 people.

    “On the basis of 2020 mortality data, HD and stroke currently claim more lives each year than cancer and chronic lower respiratory disease combined. In 2020, 207.1 of 100 000 people died of HD and stroke.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 2020 mortality data

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingown data

    Mean overall CVH score for US adults was 69.6 for non-Hispanic Asian, 66.0 for non-Hispanic White, and 59.7 for non-Hispanic Black adults.

    “with a mean score of 69.6 for NH Asian, 66.0 for NH White, and 59.7 for NH Black adults.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    In 2015-2018, chronic kidney disease-defined by estimated glomerular filtration rate below 60 mL·min−1·1.73 m−2 or albumin-to-creatinine ratio at least 30 mg/g-had an overall prevalence of 14.9%.

    “The overall prevalence of chronic kidney disease (estimated glomerular filtration rate <60 mL·min−1·1.73 m−2 or albumin-to-creatinine ratio ≥30 mg/g) in 2015 to 2018 was 14.9%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    This represented about 122.4 million US adults aged ≥20 years with high blood pressure, including 62.8 million males and 59.6 million females.

    “This equates to an estimated 122.4 million adults ≥20 years of age who have high blood pressure (62.8 million males and 59.6 million females).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among 74,393 adults with diabetes in the US Diabetes Collaborative Registry, 74% had HbA1c <7%, 40% had blood pressure <130/80 mm Hg, and 49% had LDL-C <100 mg/dL (<70 mg/dL with atherosclerotic cardiovascular disease), but only 15% met all three targets.

    “Data from the US Diabetes Collaborative Registry of 74 393 adults with diabetes demonstrate a prevalence of 74% with hemoglobin A1c <7%, 40% with blood pressure <130/80 mm Hg, and 49% with LDL-C <100 mg/dL (<70 mg/dL if with atherosclerotic cardiovascular disease), but only 15% at target for all 3 factors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In 2021, 2.8% of US middle school students and 11.3% of high school students used e-cigarettes in the previous 30 days.

    “the prevalence of use in the past 30 days among middle and high school students in the United States was 2.8% and 11.3%, respectively”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    NHANES data from 2017 through March 2020 showed that 36.8% of US children and adolescents aged 2-19 years were overweight or obese, including 19.8% with obesity.

    “According to data from NHANES from 2017 until March 2020, among US children and adolescents 2 to 19 years of age, the prevalence of being either overweight or obese was 36.8%, with obesity prevalence of 19.8%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In US adults aged 20 and older, the prevalence of cardiovascular disease (including coronary heart disease, heart failure, stroke, and hypertension) was 48.6% overall, corresponding to 127.9 million people in 2020, and it rises with age in both sexes.

    “On the basis of NHANES 2017 to March 2020 data, the prevalence of CVD (comprising CHD, HF, stroke, and hypertension) in adults ≥20 years of age was 48.6% overall (127.9 million in 2020) and increases with age in both males and females.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites NHANES 2017 to March 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingown data

    The largest share of adults sleeping under 7 hours nightly was among non-Hispanic Black adults (43.5%); the smallest shares were among non-Hispanic Asian (30.5%) and non-Hispanic White (30.7%) adults.

    “NH Black adults had the highest percentage of respondents reporting sleeping <7 h/night (43.5%), whereas NH Asian adults (30.5%) and NH White adults (30.7%) had the lowest percentage of respondents reporting sleeping <7 hours.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Based on NHANES 2017-2020, about 6.7 million Americans aged 20 and older had heart failure, an increase from about 6.0 million in NHANES 2015-2018.

    “On the basis of data from NHANES 2017 to 2020, ≈6.7 million Americans ≥20 years of age had HF, which is increased from ≈6.0 million according to NHANES 2015 to 2018.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites NHANES

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    In a meta-analysis of 66 SBP-lowering trials (324,812 participants, 11,437 strokes, mean follow-up 3.3 years), SBP lowering was associated with 21% lower odds of stroke versus control; by stroke type, it was associated with 14% lower odds of ischemic stroke, 28% lower odds of hemorrhagic stroke, and 28% lower odds of fatal or disabling stroke.

    “In a meta-analysis of 66 trials of SBP-lowering interventions including 324 812 participants and 11 437 strokes over an average follow-up of 3.3 years, SBP lowering was associated with 21% lower odds of stroke compared with control. In meta-analyses of stroke types, SBP lowering was associated with 14% lower odds of ischemic stroke (6 trials), 28% lower odds of hemorrhagic stroke (6 trials), and 2”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites meta-analysis of 66 trials

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    According to 2018 Healthcare Cost and Utilization Project data, 481,780 percutaneous coronary interventions were performed on an inpatient basis in the United States.

    “According to Healthcare Cost and Utilization Project data from the Agency for Healthcare Research and Quality for the year 2018, 481 780 percutaneous coronary interventions were performed on an inpatient basis in the United States.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites HCUP

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    In a Korea National Health Insurance Service analysis (N=66,692), people who maintained exercise after AF diagnosis were less likely than those who continued to abstain to have ischemic stroke (HR 0.86), heart failure (HR 0.92), or mortality (HR 0.61).

    “An analysis of the Korea National Health Insurance Service (N=66 692) classified individuals by exercise status before and after AF diagnosis. Those who maintained exercise were significantly less likely to have ischemic stroke (HR, 0.86), HF (HR, 0.92), or mortality (HR, 0.61) than those who continued to abstain from exercise after AF diagnosis.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Korea National Health Insurance Service

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Globally from 1990 to 2017, dementia prevalent cases rose 119%, incident cases rose 113%, DALYs rose 115%, and deaths rose 146%; however, age-standardized prevalence fell 4%, age-standardized incidence fell 5%, age-standardized DALYs fell 6%, and age-standardized mortality fell 4%.

    “Globally, prevalent cases increased by 119%, annual incident cases increased by 113%, DALYs increased by 115%, and annual deaths increased by 146%.”
    • Also stated in: § Brain Health (Chapter 16) · plain
      “However, global age-standardized prevalence decreased by 4%, age-standardized annual incidence decreased by 5%, age-standardized DALYs decreased by 6%, and age-standardized annual mortality decreased by 4%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites GBD study

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    In a meta-analysis of 11 clinical trials (1970-2021, 20,163 stroke patients), intensive LDL-C-lowering statin therapy reduced recurrent ischemic stroke risk compared with less intensive therapy (RR 0.88), and the reduction was stronger in populations with atherosclerosis (RR 0.79).

    “A meta-analysis of 11 clinical trials from 1970 to 2021 with 20 163 patients with stroke found that intensive LDL-C–lowering statin-based therapies reduced the risk of recurrent ischemic stroke (RR, 0.88) compared with less intensive LDL-C–lowering statin-based therapies. This relationship was even stronger in populations with atherosclerosis (RR, 0.79).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites meta-analysis of 11 clinical trials

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingown data

    In 2020, CHD age-adjusted death rates per 100,000 were 128.5 for non-Hispanic White males, 153.6 for non-Hispanic Black males, and 102.2 for Hispanic males; for females, rates were 63.8 for non-Hispanic White, 85.9 for non-Hispanic Black, and 54.2 for Hispanic.

    “In 2020, CHD age-adjusted death rates per 100 000 were 128.5 for NH White males, 153.6 for NH Black males, and 102.2 for Hispanic males. For NH White females, the rate was 63.8; for NH Black females, it was 85.9; and for Hispanic females, it was 54.2.”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingcitation

    In the Health and Retirement Study, cognitive impairment-free life expectancy at age 55 was 23.0 years with none of hypertension, heart disease, diabetes, or stroke; 21.2 years with any one; 18.1 years with any two; and 14.0 years with any three or all four; the association of greater CVD burden with lower cognitive impairment-free life expectancy was also seen at ages 65, 75, and 85.

    “In the HRS (Health and Retirement Study), cognitive impairment-free life expectancy at 55 years of age was estimated as 23.0 years for participants with no hypertension, HD, diabetes, or stroke; 21.2 years for those with any 1 of those conditions; 18.1 years for those with any 2 conditions; and 14.0 years for those with any 3 or all 4 conditions.”
    • Also stated in: § Brain Health (Chapter 16) · plain
      “The association of CVD burden with lower cognitive impairment-free life expectancy was also observed at 65, 75, and 85 years of age, with lower absolute life expectancies.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites HRS

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingown data

    In 18,262 adults with hypertension, the age-adjusted proportion with controlled blood pressure improved from 31.8% in 1999-2000 to 48.5% in 2007-2008, was similar in 2013-2014 (53.8%), and then declined to 43.7% in 2017-2018.

    “In 18 262 adults with hypertension, the age-adjusted estimated proportion with controlled blood pressure (blood pressure <140/90 mm Hg) improved from 31.8% in 1999 to 2000 to 48.5% in 2007 to 2008, was similar in 2013 to 2014 (53.8%), and then declined to 43.7% in 2017 to 2018.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The average annual direct and indirect cost of cardiovascular disease in the United States was an estimated $407.3 billion in 2018-2019.

    “The average annual direct and indirect cost of CVD in the United States was an estimated $407.3 billion in 2018 to 2019.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database indicate that 161,816 procedures involved isolated coronary artery bypass graft in 2019.

    “Data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database, which voluntarily collects data from ≈80% of all hospitals that perform coronary artery bypass grafts in the United States, indicate that a total of 161 816 procedures involved isolated coronary artery bypass graft in 2019.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites STS Adult Cardiac Surgery Database

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    MarketScan and Medicare data showed that 33.9% of peripheral artery disease patients were prescribed statins versus 51.7% of coronary artery disease patients, and only 24.5% of peripheral artery disease patients in MarketScan achieved LDL-C <70 mg/dL.

    “Data from MarketScan and Medicare databases showed that only 33.9% of patients with peripheral artery disease were prescribed statins compared with 51.7% of patients with coronary artery disease, and only 24.5% of patients with peripheral artery disease in the MarketScan database achieved a target LDL-C <70 mg/dL.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites MarketScan

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Medicare

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    In an NIS analysis of 7,026,432 acute myocardial infarction hospitalizations from 2004-2015, females were less likely than males to undergo coronary angiography (adjusted OR 0.92) and percutaneous coronary intervention (adjusted OR 0.82), and had a higher mortality risk (adjusted OR 1.03).

    “An NIS (National Inpatient Sample) analysis of sex differences spanning 2004 to 2015 identified 7 026 432 hospitalizations for acute myocardial infarction. Compared with males, females were less likely to undergo coronary angiography (adjusted OR, 0.92) and percutaneous coronary intervention (adjusted OR, 0.82), Females had a higher risk of mortality (adjusted OR, 1.03) compared with males.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites NIS

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Globally in 2020, there were an estimated 19.05 million CVD deaths, an 8.71% increase from 2010; the age-standardized CVD death rate was 239.80 per 100,000, a 12.19% decrease from 2010; crude CVD prevalence was 607.64 million cases, a 29.01% increase from 2010; and the age-standardized CVD prevalence rate was 7354.05 per 100,000, a 0.73% increase from 2010.

    “In 2020, 19.05 million deaths were estimated for CVD globally, which amounted to an increase of 8.71% from 2010.”
    • Also stated in: § Total Cardiovascular Disease (Chapter 14) · plain
      “The age-standardized death rate per 100 000 population was 239.80, which represents a decrease of 12.19% from 2010.”
    • Also stated in: § Total Cardiovascular Disease (Chapter 14) · plain
      “Overall, the crude prevalence of CVD was 607.64 million cases in 2020, an increase of 29.01% compared with 2010. However, the age-standardized prevalence rate was 7354.05 per 100 000, an increase of 0.73% from 2010.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In 2018, there were 578,000 outpatient visits with pulmonary hypertension as the principal diagnosis and 14,000 hospital discharges with pulmonary hypertension as the principal diagnosis.

    “In 2018, there were 578 000 outpatient visits for pulmonary hypertension as the principal diagnosis. In addition, there were 14 000 hospital discharges with pulmonary hypertension as the principal diagnosis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Rochester Epidemiology Project data showed improved survival after heart failure diagnosis from 1979 to 2000, but estimated 5-year mortality did not decline from 2000 to 2010 and remained high (52.6% overall, 24.4% at age 60, and 54.4% at age 80).

    “Data from the Rochester Epidemiology Project in Olmsted County, Minnesota, showed improved survival after HF diagnosis between 1979 and 2000; however, estimated 5-year mortality for those with HF did not decline from 2000 to 2010 and remained high (52.6% overall; 24.4% for those 60 years of age; and 54.4% for those 80 years of age).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rochester Epidemiology Project

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    In 2021, 3,817 heart transplantations were performed in the United States, the most ever; the highest numbers were in California (529), Texas (359), New York (307), and Florida (263).

    “In 2021, 3817 heart transplantations were performed in the United States, the most ever. The highest numbers of heart transplantations were performed in California (529), Texas (359), New York (307), and Florida (263).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Among 229,976 UK Biobank participants with 2,143 incident dementia cases over a median 9-year follow-up, each 1-point increase in Life's Simple 7 score was associated with an 11% lower dementia hazard (HR 0.89); each 1-point increase in the biological component score was associated with a 7% lower hazard (HR 0.93); but a 1-point increase in the lifestyle component score was not associated with痴呆 (

    “Among 229 976 participants in the UK Biobank, with 2143 cases of incident dementia over a median follow-up of 9 years, each 1-point increment in Life's Simple 7 score was associated with an 11% lower hazard of dementia (HR, 0.89). Each 1-point increment in the biological component score (based on blood pressure, cholesterol, and glucose) was associated with a 7% lower hazard of dementia (HR, 0.93”
    • Also stated in: § Brain Health (Chapter 16) · plain
      “However, a 1-point increment in the lifestyle component score (based on smoking, body mass index, diet, and physical activity) was not associated with dementia (HR, 0.99).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites UK Biobank

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    In high-income countries from 1990 to 2017, dementia prevalent cases rose 93%, incident cases rose 87%, DALYs rose 90%, and deaths rose 126%; age-standardized prevalence fell 5%, age-standardized incidence fell 6%, age-standardized DALYs fell 7%, and age-standardized mortality fell 4%.

    “For high-income countries, percent increases in absolute burden measures were smaller than globally: Prevalent cases increased by 93%, annual incident cases increased by 87%, DALYs increased by 90%, and annual deaths increased by 126%. The age-standardized prevalence in high-income countries decreased by 5%, age-standardized annual incidence rate decreased by 6%, age-standardized DALYs decreased”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites GBD study

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    In 2019, the United States had an estimated 393,000 pulmonary embolism cases, 643,000 deep vein thrombosis cases, and 1,036,000 total venous thromboembolism cases.

    “In 2019, there were an estimated ≈393 000 cases of pulmonary embolism, ≈643 000 cases of deep vein thrombosis, and ≈1 036 000 total venous thromboembolism cases in the United States.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In 2020, congenital cardiovascular defects were related to 2,817 deaths in the United States, an 11.9% decrease from 2010.

    “2020 mortality related to congenital cardiovascular defects was 2817 deaths in the United States, an 11.9% decrease from the number of deaths in 2010.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    A simulation model from 7 decision analysis studies projected that the number of elderly patients with calcific aortic stenosis will more than double by 2050 in the United States and Europe; pooled prevalence of all aortic stenosis in the elderly was 12.4%, and severe aortic stenosis prevalence was 3.4%.

    “The number of elderly patients with calcific aortic stenosis is projected to more than double by 2050 in both the United States and Europe according to a simulation model in 7 decision analysis studies. The pooled prevalence of all aortic stenosis in the elderly was 12.4%, and the prevalence of severe aortic stenosis was 3.4%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    In patients with COVID-19, venous thromboembolism is associated with double the risk of death; among those admitted to the ICU the risk is 2.63 times higher, and among those on mechanical ventilation it is 3-fold higher.

    “In patients with COVID-19, there is a double risk of death after venous thromboembolism. In those admitted to the intensive care unit, this risk is 2.63 times higher, with a 3-fold increase in patients on mechanical ventilation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In the PARTNER 3 trial of 1,000 low-surgical-risk patients with severe aortic stenosis, the primary composite end point (death, stroke, or rehospitalization) was lower with TAVR than surgery (8.5% vs 15.1%; HR 0.54); at 2 years it remained lower (11.5% vs 17.4%; HR 0.63), but TAVR valve thrombosis was higher (2.6% vs 0.7%).

    “In 1000 patients with severe aortic stenosis at low surgical risk randomized in the PARTNER 3 trial (Placement of Aortic Transcatheter Valve 3) to either balloon-expandable transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement, the primary composite end point (death, stroke, or rehospitalization) rate was significantly lower in the TAVR versus surgical aortic valve”
    • Also stated in: § Valvular Diseases (Chapter 23) · plain
      “At 2 years, the primary end point was significantly reduced after TAVR compared with surgical aortic valve replacement (11.5% versus 17.4%; HR, 0.63), although TAVR valve thrombosis at 2 years was increased (2.6%; 13 events) compared with surgery (0.7%; 3 events).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites PARTNER 3

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Estimated direct costs of cardiovascular disease in the United States increased from $103.5 billion in 1996-1997 to $251.4 billion in 2018-2019.

    “The estimated direct costs of CVD in the United States increased from $103.5 billion in 1996 to 1997 to $251.4 billion in 2018 to 2019.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    From 1990 to 2019, the absolute number of incident strokes increased by 70.0, while the age-standardized incidence rate for total stroke fell by 17.0%; the age-standardized incidence rate decreased by 10% for ischemic stroke and by 29% for intracerebral hemorrhage.

    “An analysis of data from the GBD 2019 study found that from 1990 to 2019, the absolute number of incident strokes increased by 70.0, whereas the age-standardized incidence rate for total stroke decreased by 17.0%. The age-standardized incidence rate for ischemic stroke decreased by 10% and intracerebral hemorrhage decreased by 29% during the same period.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites GBD 2019

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    From 2005-2014 ARIC data, the estimated annual incidence of myocardial infarction was 605,000 new attacks and 200,000 recurrent attacks; of the 805,000 total first and recurrent events, an estimated 170,000 were silent.

    “According to data from the 2005 to 2014 ARIC study, the estimated annual incidence of myocardial infarction is 605 000 new attacks and 200 000 recurrent attacks. Of these 805 000 first and recurrent events, it is estimated that 170 000 are silent.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites ARIC study

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    In the Rotterdam Study of older adults, intraplaque hemorrhage detected by high-resolution MRI was associated with incident stroke (HR 2.42) and coronary heart disease (HR 1.95), whereas calcification and lipid-rich core were not.

    “In the Rotterdam Study of older adults, the presence of intraplaque hemorrhage (but not calcification or lipid-rich core) by high-resolution magnetic resonance imaging demonstrated an association with incident stroke and CHD (HR, 2.42 and 1.95, respectively).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rotterdam Study

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Among 390,692 patients at 586 hospitals from July 2008 to December 2013, those in lower-SES neighborhoods had longer median arrival-to-angiography times (8.0 vs 3.4 hours) and higher fibrinolysis rates for STEMI (23.1% vs 5.9%) than higher-SES patients, and had greater independent risk of in-hospital mortality and major bleeding and lower discharge care quality.

    “In 390 692 patients receiving care at 586 hospitals from July 2008 to December 2013, patients residing in lower-SES neighborhoods had longer median arrival-to-angiography time (lowest quintile of SES, 8.0 hours; highest quintile of SES, 3.4 hours) and a higher rate of fibrinolysis (versus primary angioplasty) for ST-segment–elevation myocardial infarction (lowest quintile of SES, 23.1%; highest”
    • Also stated in: § Quality of Care (Chapter 26) · plain
      “Patients from lower-SES neighborhoods had greater independent risk of in-hospital mortality and major bleeding and a lower quality of discharge care.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Among patients in the Get With The Guidelines Registry hospitalized for heart failure in 2021, 91.7% received ACE inhibitors/ARBs or ARNIs at discharge, 93.4% received evidence-based specific beta-blockers, 99.2% had left ventricular function measured, and 85.5% had a scheduled postdischarge appointment.

    “Despite substantial disruptions to cardiovascular care delivery during the COVID-19 pandemic, among patients in the GWTG Registry (Get With The Guidelines) who were hospitalized for HF in 2021, 91.7% received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers or angiotensin receptor-neprilysin inhibitors at discharge; 93.4% received evidence-based specific β-blockers; 99.2% had”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites GWTG Registry

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    As of March 1, 2022, 7,459 cases of multisystem inflammatory syndrome in children and 63 attributable deaths (0.84%) had been reported; median age was 9 years, 58% of cases were in Hispanic or Latino or Black children, 98% tested positive for SARS-2, and 60% were male.

    “As of March 1, 2022, 7459 cases and 63 attributable deaths (0.84%) have been reported. Median age of cases was 9 years; 58% of cases have occurred in children who are Hispanic or Latino (1846 cases) or Black (2206 cases); 98% tested positive for SARS-2 (severe acute respiratory syndrome coronavirus 2; reverse transcriptase–polymerase chain reaction, serology, or antigen test); and 60% of reported”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites CDC

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationcitation

    In the United States, people from underrepresented racial and ethnic groups face substantially higher sudden cardiac arrest risk and worse survival and neurological outcomes than White individuals; in ARIC, the sex-adjusted hazard ratio for sudden cardiac death comparing Black with White participants was 2.12 and the fully adjusted hazard ratio was 1.38, and in San Francisco Black females had a 2.

    “In the United States, individuals from underrepresented racial and ethnic groups are at substantially higher risk of sudden cardiac arrest and experience worse survival and neurological outcomes after sudden cardiac arrest compared with White individuals.”
    • Also stated in: § Sudden Cardiac Arrest, Ventricular Arrhythmias, and Inherited Channelopathies (Chapter 19) · plain
      “In the ARIC study (Atherosclerosis Risk in Communities), the sex-adjusted HR for sudden cardiac death comparing Black with White participants was 2.12, and the fully adjusted HR was 1.38. In San Francisco, Black females had a 2.55 higher incidence of sudden arrhythmic death than White females.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites ARIC study

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

59 of 59

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Between 5% and 14% of patients with systemic lupus erythematosus also present with myocarditis.

    “between 5% and 14% of patients diagnosed with systemic lupus erythematosus also present with myocarditis”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [28]

    The Summary’s Cardiomyopathy and Heart Failure section (Chapter 22; page unavailable) reports heart-failure statistics but does not address myocarditis in patients with systemic lupus erythematosus. Searches for lupus, myocarditis, and the 5%–14% range found no passage in our copy supporting that prevalence estimate. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • Myocarditis exhibits a notable association with systemic autoimmune diseases.

    “Myocarditis exhibits a notable association with systemic autoimmune diseases.”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [28]

    The Summary’s Cardiomyopathy and Heart Failure section (Chapter 22; page unavailable) reports heart-failure statistics, not an association between myocarditis and systemic autoimmune diseases. Searches for myocarditis, systemic autoimmune diseases, lupus, and autoimmune cardiomyopathy found no passage in our copy addressing that association. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Three-month cardiac-arrest risk conflicts with the annualized rate

    Minor

    A rate of 116 per 100 000 person-years is 0.116% per year, already less than the stated 0.29% risk over just three months. At a constant rate, the three-month risk would be approximately 0.029%.

    Reported 0.29 · recomputed 0.116

1 of 1

Cited works that were retracted

Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.

  • Cites a retracted work: 10.1016/s2213-8587(19)30074-9

    Major

    The cited work was retracted on 2016-08-01 (notice 10.1016/s2213-8587(16)30085-7), before this paper was published (2023-02-21). Its authors could have known.

    Cited work 10.1016/s2213-8587(19)30074-9 · retracted 2016-08-01 · notice 10.1016/s2213-8587(16)30085-7 · this paper published 2023-02-21

  • Cites a retracted work: 10.1056/nejmc1806491

    Info

    The cited work was retracted; the date of the notice is not on record.

    Cited work 10.1056/nejmc1806491 · retraction date not known · this paper published 2023-02-21

2 of 2

Cites

2 retracted

Flagged first, then by citations

21 of the 3524 references couldn’t be matched to a known paper.

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Related

Authors
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., Commodore-Mensah, Y., Elkind, M. S. V., Evenson, K. R., Eze-Nliam, C., Fugar, S., Generoso, G., Heard, D. G., Hiremath, S., Ho, J. E., Kalani, R., Kazi, D. S., Ko, D., Levine, D. A., Liu, J., Ma, J., Magnani, J. W., Michos, E. D., Mussolino, M. E., Navaneethan, S. D., Parikh, N. I., Poudel, R., Rezk-Hanna, M., Roth, G. A., Shah, N. S., St-Onge, M.-P., Thacker, E. L., Virani, S. S., Voeks, J. H., Wang, N.-Y., Wong, N. D., Wong, S. S., Yaffe, K., Martin, S. S., & on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2023-02-21
Volume
147
Issue
8
Pages
e93-e621
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/cir.0000000000001123
PMC
PMC12135016
OpenAlex
W4211191293
Semantic Scholar
833f7bd8f145bf3ead5e206b47578f54a90e14c9
Cited by
8,300
References
3,524
Citations by year
2026: 807 · 2025: 1510 · 2024: 1852 · 2023: 846 · 2022: 189 · 2021: 147 · 2020: 153 · 2019: 185 · 2018: 175 · 2017: 231 · 2016: 278 · 2015: 382 · 2014: 477 · 2013: 591 · 2012: 357
FWCI
263.14
Type
journal article
Language
en
Update notices
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
Funders
  • National Heart, Lung, and Blood Institute (R01HL140224, R01HL134893, R01HL142648, K24HL153669, R35HL155670)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK128154)
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 risk factors, cardiovascular health, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary artery disease, heart failure, valvular heart disease, venous disease, peripheral arterial disease, health equity, structural racism, health disparities, COVID-19 pandemic, cardiovascular outcomes, quality of care, economic costs
MeSH terms
COVID-19, American Heart Association, Cardiovascular Diseases, Heart Diseases, Humans, United States, 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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Statistics and arithmetic are recomputed, not judged.

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