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Cited by 5,292Cardiovascular Health and Risk FactorsHealthcare Systems and Public HealthHealth Promotion and Cardiovascular Prevention

Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association

Open access
Go, Alan S., Mozaffarian, Dariush, Roger, Véronique L., Benjamin, Emelia J., Berry, Jarett D., Borden, William B., Bravata, Dawn M., Dai, Shifan +32 more·2013·Circulation
DOI 10.1161/cir.0b013e31828124adPMC PMC5408511
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Abstract

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update*The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on heart disease, stroke, and other cardiovascular disease-related morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document*Indeed, since 1999, the Statistical Update has been cited >10 500 times in the literature, based on citations of all annual versions*In 2011 alone, the various Statistical Updates were cited ≈1500 times (data from ISI Web of Science)*In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas, as well as increasing the number of ways to access and use the information assembled*For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year*This year's edition also implements a new chapter organization to reflect the spectrum of cardiovascular health behaviors and health factors and risks, as well as subsequent complicating conditions, disease states, and outcomes*Also, the 2013 Statistical Update contains new data on the monitoring and benefits of cardiovascular health in the population, with additional new focus on evidence-based approaches to changing behaviors, implementation strategies, and implications of the AHA's 2020 Impact Goals*Below are a few highlights from this year's Update . © 2013 American Heart Association, Inc.

Integrity signals

Registry

Crossref · 10.1161/cir.0b013e31828124ad

Cites

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Statistics

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Claims the paper makes

0 of 843 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    For cardiovascular disease mortality, the adjusted population attributable fraction for high blood pressure was 40.6% (95% CI 24.5-54.6).

    “40.6% (95% confidence interval [CI], 24.5–54.6) for high blood pressure”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • Findingcitation

    For cardiovascular disease mortality, the adjusted population attributable fraction for smoking was 13.7% (95% CI 4.8-22.3).

    “13.7% (95% CI, 4.8–22.3) for smoking”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • Findingnone given

    The percentage of the nonsmoking US population with detectable serum cotinine declined from 52.5% in 1999-2000 to 40.1% in 2007-2008.

    “The percentage of the nonsmoking population with detectable serum cotinine (indicating exposure to secondhand smoke) declined from 52.5% in 1999 to 2000 to 40.1% in 2007 to 2008”
    Quote in the paperNot a substantial claim
  • Findingown data

    Between 1971 and 2004, average total energy consumption among US women increased by 22%, from 1542 to 1886 kcal/d.

    “between 1971 and 2004, average total energy consumption among US adults increased by 22% in women (from 1542 to 1886 kcal/d)”
    Quote in the paperNot a substantial claim
  • Findingown data

    In 2011, 21.3% of US men aged 18 years or older were current cigarette smokers.

    “in 2011, among Americans ≥18 years of age, 21.3% of men and 16.7% of women continued to be cigarette smokers”
    Quote in the paperNot a substantial claim
  • May combine two claims. 308
  • Classified as probably not a substantial claim. 152
  • The quote only partly states this claim. 6

  • May combine two claims.

    Findingown data

    Approximately 2.5% of US adults have 0 of the 7 criteria at ideal levels, and another 15% meet only 1 of 7 criteria.

    “Approximately 2.5% of US adults have 0 of the 7 criteria at ideal levels, and another 15% meet only 1 of 7 criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    64.5% of those with cardiovascular disease and 47.3% of those without cardiovascular disease report engaging in no moderate or vigorous activity at all.

    “Furthermore, 64.5% of those with CVD and 47.3% of those without CVD report engaging in no moderate or vigorous activity at all.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of those with hypertension, nearly all with cardiovascular disease are aware of their hypertension (98.6%) and are receiving treatment (97.4%), but a much smaller proportion of those without cardiovascular disease are aware (70.6%) or receiving treatment (61.4%).

    “Of these, nearly all with CVD are aware of their hypertension (98.6%) and are receiving treatment (97.4%), but a much smaller proportion of those without CVD are aware (70.6%) or receiving treatment (61.4%).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The number of any-mention deaths attributable to heart failure was approximately as high in 1995 (287,000) as in 2009 (275,000).

    “The number of any-mention deaths attributable to heart failure was approximately as high in 1995 (287 000) as it was in 2009 (275 000).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 2009, the age-standardized death rate from all cardiovascular diseases was 237.1 per 100,000, down 6% from 252.4 per 100,000 in 2007.

    “In 2009, the age-standardized death rate attributable to all CVDs was 237.1 per 100 000 (Chart 2-11), down 6% from 252.4 per 100 000 in 2007”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Coronary heart disease alone caused about 1 of every 6 deaths in the United States in 2009.

    “Coronary heart disease alone caused ≈1 of every 6 deaths in the United States in 2009.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The exceptions to the pattern of higher ideal levels in children are diet and physical activity, for which ideal levels in children are similar for physical activity or worse for diet than in adults.

    “The major exceptions are diet and PA, for which the prevalence of ideal levels in children is similar (for PA) or worse (for diet) than in adults.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among adults, meeting the smoking metric showed a positive trend, while meeting the BMI and glucose metrics showed negative trends; other metrics were fairly flat.

    “Among adults, there appears to be a positive trend for meeting the smoking metric and negative trends for meeting the BMI and glucose metrics. Trends for other metrics appear fairly flat.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Based on 2007-2010 data, 33.0% of US adults aged 20 years or older have hypertension, representing 78 million adults.

    “Based on 2007 to 2010 data, 33.0% of US adults ≥20 years of age have hypertension. This represents 78 million US adults with hypertension.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Among US children aged 2 to 19 years, 31.8% were overweight and obese, representing 23.9 million children.

    “Among children 2 to 19 years of age, 31.8% are overweight and obese (which represents 23.9 million children)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Approximately 40% of US children aged 12 to 19 years have 5 or more metrics at ideal levels, with lower levels in boys (36%) than in girls (45%).

    “Approximately 40% of US children 12 to 19 years of age have 5 or more metrics at ideal levels, with lower levels in boys (36%) than in girls (45%).”
    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 2009, cardiovascular disease death rates were 281.4 per 100,000 for white males, 387.0 for black males, 190.4 for white females, and 267.9 for black females.

    “The rates were 281.4 per 100 000 for white males, 387.0 per 100 000 for black males, 190.4 per 100 000 for white females, and 267.9 per 100 000 for black females.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 2010, 38.2% of Americans had prediabetes with abnormal fasting glucose levels.

    “and 38.2% had prediabetes, with abnormal fasting glucose levels.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Approximately 610,000 of these strokes are first attacks.

    “Approximately 610 000 of these are first attacks”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among children, meeting the BMI metric showed a negative trend, while meeting the smoking and total cholesterol metrics showed positive trends; other metrics had no consistent trends.

    “Among children, there appears to be a negative trend for meeting the body mass index (BMI) metric and positive trends for meeting the smoking and total cholesterol metrics. Other metrics do not show consistent trends.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Heart failure was the underlying cause in 56,410 of those deaths in 2009.

    “Heart failure was the underlying cause in 56 410 of those deaths in 2009.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In 2010, an estimated 19.7 million Americans had diagnosed diabetes mellitus, representing 8.3% of the adult population.

    “In 2010, an estimated 19.7 million Americans had diagnosed diabetes mellitus, representing 8.3% of the adult population.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Two thirds of US adults are overweight, with little difference by prevalent cardiovascular disease.

    “Two thirds of US adults are overweight, with little difference by prevalent CVD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Younger US adults are more likely to meet greater numbers of ideal metrics, and older adults are much less likely.

    “Younger adults are more likely to meet greater numbers of ideal metrics, and older adults are much less likely.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingnone given

    The prevalence of diabetes mellitus is increasing dramatically over time, in parallel with increases in the prevalence of overweight and obesity.

    “The prevalence of diabetes mellitus is increasing dramatically over time, in parallel with the increases in prevalence of overweight and obesity.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Hospital discharges for heart failure remained essentially unchanged from 2000 to 2010, with first-listed discharges of 1,008,000 and 1,023,000, respectively.

    “Additionally, hospital discharges for heart failure remained essentially unchanged from 2000 to 2010, with first-listed discharges of 1 008 000 and 1 023 000, respectively.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In 2010, an additional 8.2 million Americans had undiagnosed diabetes mellitus.

    “An additional 8.2 million had undiagnosed diabetes mellitus”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Approximately 12% of US adults meet 5 metrics, 4% meet 6 metrics, and 0% meet 7 metrics at ideal levels.

    “Approximately 12% meet 5 metrics, 4% meet 6 metrics, and 0% meet 7 metrics at ideal levels.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Half of all US adults with cardiovascular disease and one third without cardiovascular disease are obese.

    “Half of all US adults with CVD and one third without CVD are obese.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Each year, an estimated 280,000 Americans have a recurrent coronary attack.

    “and ≈280 000 have a recurrent attack.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    On the basis of 2009 death rate data, more than 2150 Americans die of cardiovascular disease each day, an average of 1 death every 40 seconds.

    “On the basis of 2009 death rate data, >2150 Americans die of CVD each day, an average of 1 death every 40 seconds.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    An estimated additional 150,000 silent first myocardial infarctions occur each year.

    “It is estimated that an additional 150 000 silent first myocardial infarctions occur each year.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    African American adults have among the highest prevalence of hypertension in the world, at 44%.

    “African American adults have among the highest prevalence of hypertension (44%) in the world.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Other changes related to increased caloric intake in the United States include larger portion sizes, greater food quantity and calories per meal, and increased consumption of sugar-sweetened beverages, snacks, fast food, and higher energy-density foods.

    “Other specific changes related to increased caloric intake in the United States include larger portion sizes, greater food quantity and calories per meal, and increased consumption of sugar-sweetened beverages, snacks, commercially prepared (especially fast food) meals, and higher energy-density foods.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 2009, 1 in 9 death certificates in the United States, or 274,601 deaths, mentioned heart failure.

    “In 2009, 1 in 9 death certificates (274 601 deaths) in the United States mentioned heart failure.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    The total direct and indirect cost of cardiovascular disease and stroke in the United States for 2009 is estimated to be $312.6 billion.

    “The total direct and indirect cost of CVD and stroke in the United States for 2009 is estimated to be $312.6 billion.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    The prevalence of hypertension is nearly equal between US men and women.

    “The prevalence of hypertension is nearly equal between men and women.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In 2009, stroke caused about 1 of every 19 deaths in the United States.

    “In 2009, stroke caused ≈1 of every 19 deaths in the United States.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Each year, an estimated 635,000 Americans have a new coronary attack, defined as a first hospitalized myocardial infarction or coronary heart disease death.

    “Each year, an estimated ≈635 000 Americans have a new coronary attack (defined as first hospitalized myocardial infarction or coronary heart disease death)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The 2009 overall rate of death attributable to cardiovascular disease was 236.1 per 100,000.

    “The 2009 overall rate of death attributable to CVD (International Classification of Diseases, 10th Revision, codes I00–I99) was 236.1 per 100 000.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only 16% of US adults have 5 or more metrics at ideal levels, with lower prevalence in men (12%) than in women (21%).

    “In comparison, only 16% of US adults have 5 or more metrics with ideal levels, with lower prevalence in men (12%) than in women (21%).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Approximately 185,000 of these strokes are recurrent attacks.

    “and 185 000 are recurrent attacks.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Hypertension is present in 28.5% of US adults without cardiovascular disease and 51.0% of US adults with cardiovascular disease.

    “Hypertension is present in 28.5% of US adults without CVD and 51.0% of US adults with CVD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    As measured by self-report, 74.1% of Americans with cardiovascular disease have intermediate or poor levels of physical activity, compared with 58.4% of those without cardiovascular disease.

    “As measured by self-reported data, Americans with CVD are very likely to have intermediate or poor levels of PA (74.1%), whereas Americans without CVD still commonly have such levels (58.4%).”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    On average, every 40 seconds someone in the United States has a stroke and dies of one approximately every 4 minutes.

    “On average, every 40 seconds, someone in the United States has a stroke and dies of one approximately every 4 minutes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Based on NHANES 2003-2006 data, the age-adjusted prevalence of metabolic syndrome is about 34%, with 35.1% among men and 32.6% among women.

    “On the basis of NHANES 2003–2006 data, the age-adjusted prevalence of metabolic syndrome, a cluster of major cardiovascular risk factors related to overweight/obesity and insulin resistance, is ≈34% (35.1% among men and 32.6% among women).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Obesity, defined as body mass index at least 30 kg/m2, is associated with marked excess mortality in the US population.

    “Obesity (body mass index ≥30 kg/m2) is associated with marked excess mortality in the US population.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 2009, 386,324 Americans died of coronary heart disease.

    “In 2009, 386 324 Americans died of coronary heart disease.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    About 153,000 Americans who died of cardiovascular disease in 2009 were younger than 65 years of age.

    “About 153 000 Americans who died of CVD (I00–I99) in 2009 were <65 years of age.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Overweight and obesity are associated with excess morbidity, including risk factor development, diabetes incidence, cardiovascular disease endpoints such as coronary heart disease, stroke, and heart failure, and other conditions including asthma, cancer, end-stage renal disease, and degenerative joint disease.

    “Even more notable is the excess morbidity associated with overweight and obesity in terms of risk factor development and incidence of diabetes mellitus, CVD end points (including coronary heart disease, stroke, and heart failure), and numerous other health conditions, including asthma, cancer, end-stage renal disease, degenerative joint disease, and many others.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 2009, cardiovascular disease accounted for 32.3% of all deaths in the United States, or 787,931 of 2,437,163 deaths, about 1 of every 3 deaths.

    “Yet in 2009, CVD (I00–I99; Q20–Q28) still accounted for 32.3% (787 931) of all 2 437 163 deaths, or 1 of every 3 deaths in the United States.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    An estimated 31.9 million US adults aged 20 years or older have total serum cholesterol levels of at least 240 mg/dL, a prevalence of 13.8%.

    “An estimated 31.9 million adults ≥20 years of age have total serum cholesterol levels ≥240 mg/dL, with a prevalence of 13.8%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    From 1999 to 2009, the relative rate of stroke death fell by 36.9% and the actual number of stroke deaths declined by 23.0%.

    “From 1999 to 2009, the relative rate of stroke death fell by 36.9% and the actual number of stroke deaths declined by 23.0%.”
    Quote in the paperSubstantial claim

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

    Findingnone given

    Among US children aged 2 to 19 years, 16.9% were obese, representing 12.7 million children.

    “and 16.9% are obese (12.7 million children).”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Each year, about 795,000 people in the United States experience a new or recurrent stroke, either ischemic or hemorrhagic.

    “Yet each year, ≈795 000 people continue to experience a new or recurrent stroke (ischemic or hemorrhagic).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Projections based on NHANES 1988-2008 indicate that if current trends continue, estimated cardiovascular health will improve by 6% by 2020, short of the AHA goal of 20%.

    “If current trends continue, estimated cardiovascular health will improve by 6%, short of the AHA’s goal of 20%.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    About half of US children meet 3 or 4 criteria for ideal cardiovascular health, and about half meet 5 or 6 criteria.

    “About half of US children meet 3 or 4 fewer criteria for ideal cardiovascular health, and about half meet 5 or 6 criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most US adults, about 60%, have 2, 3, or 4 criteria at ideal cardiovascular health, with approximately 1 in 5 adults within each of these categories.

    “Most US adults (≈60%) have 2, 3, or 4 criteria at ideal cardiovascular health, with approximately 1 in 5 adults within each of these categories.”
    Quote in the paperNot a substantial claim

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

    Findingreasoning

    Approximately every 34 seconds, 1 American has a coronary event, and approximately every 1 minute, an American dies of one.

    “Approximately every 34 seconds, 1 American has a coronary event, and approximately every 1 minute, an American will die of one.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    African Americans, Mexican Americans, Hispanic/Latino individuals, and other ethnic minorities bear a disproportionately high burden of diabetes mellitus in the United States.

    “African Americans, Mexican Americans, Hispanic/Latino individuals, and other ethnic minorities bear a strikingly disproportionate burden of diabetes mellitus in the United States.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In 2008, the estimated cost of all cancer and benign neoplasms was $228 billion.

    “By comparison, in 2008, the estimated cost of all cancer and benign neoplasms was $228 billion”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    YRBS data for grades 9-12 show that the percentage ever trying cigarettes remained stable from 1991 to 1999 and then declined from 70.4% in 1999 to 44.7% in 2011.

    “The percentage of students who reported ever trying cigarettes remained stable from 1991 to 1999 and then declined from 70.4% in 1999 to 44.7% in 2011.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    NHANES 2009-2010 data show that 7.2% of Americans self-reported some type of cardiovascular disease, including 3.2% with coronary heart disease, 2.7% with stroke, and 2.0% with congestive heart failure.

    “Data from NHANES 2009–2010 reveal that overall, 7.2% of Americans self-reported having some type of CVD (Table 2-3), including 3.2% with coronary heart disease (CHD), 2.7% with stroke, and 2.0% with congestive heart failure (CHF)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    NHANES 1999-2002 data show only modest intercorrelations between different cardiovascular health metrics, ranging from -0.12 between physical activity and HbA1c to 0.29 between BMI and HbA1c; the metrics appear interrelated but only modestly, with substantial independent variation.

    “Interestingly, based on NHANES 1999–2002, only modest intercorrelations are present between different cardiovascular health metrics. For example, these ranged from a correlation of −0.12 between PA and hemoglobin A1c (HbA1c) to a correlation of 0.29 between BMI and HbA1c. Thus, the 7 AHA cardiovascular health metrics appear interrelated, but only modestly, with substantial independent variation in”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7]

      Not checked in the free run.

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

    Findingown data

    In 2009, death rates from stroke, heart diseases, and other cardiovascular causes were 38.9, 116.1, and 81.0 per 100,000, respectively.

    “Death rates in 2009 attributable to stroke, HDs, and other cardiovascular causes were 38.9, 116.1, and 81.0 per 100 000, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Adjusted population attributable fractions for ischemic heart disease mortality were 34.7% for high blood pressure, 16.7% for smoking, 20.6% for poor diet, 7.8% for insufficient physical activity, and 7.5% for abnormal glucose levels.

    “Adjusted population attributable fractions for ischemic HD mortality were as follows6:34.7% (95% CI, 6.6%–57.7%) for HBP16.7% (95% CI, 6.4%–26.6%) for smoking20.6% (95% CI, 1.2%–38.6%) for poor diet7.8% (95% CI, 0%–22.2%) for insufficient PA7.5% (95% CI, 3.0%–14.7%) for abnormal glucose levels”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Among youths 12-17 in 2010, 2.6 million (10.7%) used a tobacco product in the past month, and 2.0 million (8.3%) used cigarettes.

    “Among youths 12 to 17 years of age in 2010, 2.6 million (10.7%) used a tobacco product (cigarettes, cigars, or smokeless tobacco) in the past month, and 2.0 million (8.3%) used cigarettes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

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

    Findingcitation

    Ford et al demonstrated similar relationships.

    “Ford et al7 demonstrated similar relationships.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The states with the highest percentage of current cigarette smokers were Kentucky (29.0%), West Virginia (28.6%), and Arkansas (27.0%); Utah had the lowest percentage (11.8%).

    “The states with the highest percentage of current cigarette smokers were Kentucky (29.0%), West Virginia (28.6%), and Arkansas (27.0%). Utah has the lowest percentage of smokers (11.8%) (BRFSS).4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Both ideal health behaviors and ideal health factors were independently associated with lower cardiovascular disease risk in a stepwise fashion.

    “Importantly, both ideal health behaviors and ideal health factors were independently associated with lower CVD risk in a stepwise fashion (Chart 2-12).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4]

      Not checked in the free run.

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

    Findingcitation

    AHA cardiovascular health metrics predict future cardiometabolic risk when assessed in youth; in the Young Finns Study, a stepwise inverse association was found between the number of ideal metrics in adolescence and risk of hypertension, dyslipidemia, or high carotid intima-media thickness in adulthood after 21 years, with odds ratios per additional metric of 0.66 for hypertension, 0.66 for high-L

    “The AHA cardiovascular health metrics predict future cardiometabolic risk when assessed in youth. In the Young Finns Study, a stepwise, inverse association was found between the number of ideal cardiovascular health metrics in adolescence (12–18 years of age) and risk of developing hypertension, dyslipidemia, or high carotid intima-media thickness (IMT) in adulthood after 21 years of follow-up (”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Adjusted population attributable fractions for cardiovascular disease mortality were 40.6% for high blood pressure, 13.7% for smoking, 13.2% for poor diet, 11.9% for insufficient physical activity, and 8.8% for abnormal glucose levels.

    “Adjusted population attributable fractions for CVD mortality were as follows6:40.6% (95% CI, 24.5%–54.6%) for HBP13.7% (95% CI, 4.8%–22.3%) for smoking13.2% (95% CI, 3.5%–29.2%) for poor diet11.9% (95% CI, 1.3%–22.3%) for insufficient PA8.8% (95% CI, 2.1%–15.4%) for abnormal glucose levels”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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  • May combine two claims.

    Findingcitation

    YRBS data for grades 9-12 show that current cigarette use increased between 1991 and 1997 and then declined from 36.4% in 1997 to 18.1% in 2011.

    “The percentage who reported current cigarette use (on at least 1 day in the 30 days before the survey) increased between 1991 and 1997 and then declined from 36.4% in 1997 to 18.1% in 2011.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    YRBS data for grades 9-12 show that current frequent cigarette use increased from 1991 to 1999 and then declined from 16.8% in 1999 to 6.4% in 2011.

    “The percentage who reported current frequent cigarette use (smoked on ≥20 of the 30 days before the survey) increased from 1991 to 1999 and then declined from 16.8% in 1999 to 6.4% in 2011.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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  • May combine two claims.

    Findingcitation

    From 1998 to 2007, cigarette smoking prevalence among adults 18 years and older decreased in 44 states and the District of Columbia; six states had no substantial changes after controlling for age, sex, and race/ethnicity.

    “From 1998 to 2007, cigarette smoking prevalence among adults ≥18 years of age decreased in 44 states and the District of Columbia. Six states had no substantial changes in prevalence after controlling for age, sex, and race/ethnicity (BRFSS).8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8]

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

    Findingcitation

    The 2010 Surgeon General report concludes that there is a sharp increase in cardiovascular disease risk with low levels of exposure to cigarette smoke, including secondhand smoke, and a less rapid further increase as the number of cigarettes per day increases.

    “There is a sharp increase in CVD risk with low levels of exposure to cigarette smoke, including secondhand smoke, and a less rapid further increase in risk as the number of cigarettes per day increases.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Each year from 2000 to 2004, smoking caused 3.1 million years of potential life lost for males and 2.0 million years for females, excluding certain deaths.

    “Each year from 2000 to 2004, smoking caused 3.1 million years of potential life lost for males and 2.0 million years for females, excluding deaths attributable to smoking-attributable residential fires and adult deaths attributable to secondhand smoke.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

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

    Findingcitation

    In 2008, $9.94 billion was spent on marketing cigarettes in the United States.

    “In 2008, $9.94 billion was spent on marketing cigarettes in the United States.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In a study of 12,812 youth 9-18 years of age, physical activity level in boys and girls declined starting at age 13, with a significantly greater decline among girls.

    “In a study of 12 812 youth 9 to 18 years of age, the PA level in boys and girls declined starting at the age of 13, with a significantly greater decline in activity among girls.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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  • May combine two claims.

    Findingcitation

    As of December 31, 2010, 25 states and the District of Columbia had laws prohibiting smoking in indoor areas of worksites, restaurants, and bars; no states had such laws in 2000.

    “As of December 31, 2010, 25 states and the District of Columbia had laws that prohibited smoking in indoor areas of worksites, restaurants, and bars; no states had such laws in 2000.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22]

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

    Findingcitation

    During 2000-2004, approximately 49,000 (11.1%) of cigarette smoking-related deaths were attributable to secondhand smoke.

    “During 2000 to 2004, ≈49 000 (11.1%) of cigarette smoking–related deaths were attributable to secondhand smoke.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

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  • May combine two claims.

    Findingcitation

    On average, male smokers die 13.2 years earlier than male nonsmokers, and female smokers die 14.5 years earlier than female nonsmokers.

    “On average, male smokers die 13.2 years earlier than male nonsmokers, and female smokers die 14.5 years earlier than female nonsmokers.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17]

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  • May combine two claims.

    Findingcitation

    Among people 12-49 years of age who had started smoking within the past 12 months, the average age of first cigarette use was 17.3 years, similar to the average in 2009 (17.5 years).

    “Among people ages 12 to 49 years of age who had started smoking within the past 12 months, the average age of first cigarette use was 17.3 years, similar to the average in 2009 (17.5 years).2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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

    Findingcitation

    During 2000-2004, cigarette smoking resulted in an estimated 269,655 deaths annually among males and 173,940 deaths annually among females.

    “During 2000 to 2004, cigarette smoking resulted in an estimated 269 655 deaths annually among males and 173 940 deaths annually among females.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Short exposures to secondhand smoke can cause blood platelets to become stickier, damage the lining of blood vessels, and decrease coronary flow velocity reserves, potentially increasing the risk of acute myocardial infarction.

    “Short exposures to secondhand smoke can cause blood platelets to become stickier, damage the lining of blood vessels, and decrease coronary flow velocity reserves, potentially increasing the risk of an acute MI (AMI).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20]

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Increased television time has significant nutritional associations with weight gain.

    “Increased television time has significant nutritional associations with weight gain (refer to Chapter 5, Nutrition).”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    From 2000 to 2004, smoking during pregnancy resulted in an estimated 776 infant deaths annually.

    “From 2000 to 2004, smoking during pregnancy resulted in an estimated 776 infant deaths annually.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

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  • May combine two claims.

    Findingcitation

    During 2007-2008, the percentage of nonsmokers with detectable serum cotinine was higher for those 3-11 years (53.6%) and 12-19 years (46.5%) than for those 20 years and older (36.7%); it was also higher for non-Hispanic blacks (55.9%) than for non-Hispanic whites (40.1%) and Mexican Americans (28.5%).

    “During 2007 to 2008, the percentage of nonsmokers with detectable serum cotinine was higher for those 3 to 11 years of age (53.6%) and those 12 to 19 years of age (46.5%) than for those ≥20 years of age (36.7%); the percentage was also higher for non-Hispanic blacks (55.9%) than for non-Hispanic whites (40.1%) and Mexican Americans (28.5%; NHANES).24”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

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

    Findingreasoning

    The 2010 estimate averages out to approximately 6500 new cigarette smokers every day.

    “The 2010 estimate averages out to ≈6500 new cigarette smokers every day.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The prevalence of watching television 3 or more hours per day was highest among black girls (54.9%) and boys (54.4%), followed by Hispanic boys (38.4%) and girls (37.2%), and white boys (27.3%) and girls (23.9%).

    “The prevalence of watching television ≥3 hours per day was highest among black girls (54.9%) and boys (54.4%), followed by Hispanic boys (38.4%) and girls (37.2%) and white boys (27.3%) and girls (23.9%).1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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

    Findingcitation

    Direct medical costs ($96 billion) and lost productivity costs ($97 billion) associated with smoking totaled an estimated $193 billion per year between 2000 and 2004.

    “Direct medical costs ($96 billion) and lost productivity costs ($97 billion) associated with smoking totaled an estimated $193 billion per year between 2000 and 2004.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The percentage of the US nonsmoking population with detectable serum cotinine declined from 52.5% in 1999-2000 to 40.1% in 2007-2008, with declines occurring for children and adults.

    “The percentage of the US nonsmoking population with detectable serum cotinine declined from 52.5% in 1999 to 2000 to 40.1% in 2007 to 2008, with declines occurring for children and adults.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

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  • May combine two claims.

    Findingcitation

    A study of 3068 youths 14-24 years of age from 1999 to 2006 found that the prevalence of inactivity increased with age for both boys and girls; across ages, girls had a higher prevalence of physical inactivity than boys.

    “A study of 3068 youths between 14 and 24 years of age from 1999 to 2006 found that the prevalence of inactivity went up with age for both boys and girls. Across ages, girls had a higher prevalence of physical inactivity than boys.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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

    Findingcitation

    Cigarette prices increased 283% between the early 1980s and 2011, resulting in decreased sales from approximately 30 million packs in 1982 to approximately 14 million packs in 2011.

    “Cigarette prices have increased 283% between the early 1980s and 2011, resulting in decreased sales from ≈30 million packs sold in 1982 to ≈14 million packs sold in 2011.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25]

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  • May combine two claims.

    Findingcitation

    In 2008, 64.5% of adult current smokers 18 years and older with a checkup during the preceding year reported being advised to quit, not significantly different from 2002 (63.1%).

    “In 2008, 64.5% of adult current smokers ≥18 years of age with a checkup during the preceding year reported that they had been advised to quit, which was not significantly different from 2002 (63.1%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19]

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

    Findingcitation

    In 2005, tobacco smoking caused approximately 467,000 adult deaths (19.1%) in the United States; about one third of these deaths were related to cardiovascular disease.

    “In 2005, tobacco smoking was the cause of ≈467 000 adult deaths (19.1%) in the United States. Approximately one third of these deaths were related to CVD.15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

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  • May combine two claims.

    Findingcitation

    The number of new smokers younger than 18 (1.4 million) was similar to that in 2002 (1.3 million); new smokers 18 years and older increased from approximately 600,000 in 2002 to 1 million in 2010.

    “The number of new smokers <18 years of age (1.4 million) is similar to that in 2002 (1.3 million); however, new smokers ≥18 years of age increased from ≈600 000 in 2002 to 1 million in 2010 (NSDUH).2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In 2010, approximately 2.4 million people 12 years and older smoked cigarettes for the first time within the past 12 months, similar to the estimate in 2009 (2.5 million).

    “In 2010:≈2.4 million people ≥12 years of age smoked cigarettes for the first time within the past 12 months, which was similar to the estimate in 2009 (2.5 million).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingcitation

    In 2011, the proportion of students meeting activity recommendations of at least 60 minutes of physical activity on 7 days of the week was 28.7% nationwide and declined from 9th (30.7%) to 12th (25.1%) grades; at each grade level, the proportion was higher in boys than in girls.

    “In 2011, the proportion of students who met activity recommendations of at least 60 minutes of PA on 7 days of the week was 28.7% nationwide and declined from 9th (30.7%) to 12th (25.1%) grades. At each grade level, the proportion was higher in boys than in girls.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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  • May combine two claims.

    Findingcitation

    Inactivity was higher among women than men (33.2% vs 29.9%, age-adjusted) and increased with age from 26.1% to 33.4%, 40.0%, and 52.4% among adults 18-44, 45-64, 65-74, and 75 years and older, respectively.

    “Inactivity was higher among women than men (33.2% versus 29.9%, age-adjusted) and increased with age from 26.1% to 33.4%, 40.0%, and 52.4% among adults 18 to 44, 45 to 64, 65 to 74, and ≥75 years of age, respectively.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Findingcitation

    The proportion of adults reporting physical activity levels consistent with the 2008 Physical Activity Guidelines for Americans remains low and decreases with age.

    “The proportion of adults reporting levels of PA consistent with the 2008 Physical Activity Guidelines for Americans remains low and decreases with age.8,9”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8]

      Not checked in the free run.

    • cites [9]

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  • May combine two claims.

    Findingcitation

    Despite recommendations from the National Association for Sport and Physical Education that schools require daily physical education for students in kindergarten through 12th grade, only 51.8% of students attended physical education classes daily (56.7% of boys and 46.7% of girls).

    “Despite recommendations from the National Association for Sport and Physical Education that schools should require daily physical education for students in kindergarten through 12th grade,6 only 51.8% of students attended physical education classes in school daily (56.7% of boys and 46.7% of girls).1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The percentage of men engaged in both leisure-time aerobic and strengthening activities decreased with age from 39.8% at 18-24 years to 11.1% at 75 years and older; the percentage of women decreased from 20.7% to 5.3%.

    “The percentage of men who engaged in both leisure-time aerobic and strengthening activities decreased with age, from 39.8% at age 18 to 24 years to 11.1% at ≥75 years of age. The percentage of women who engaged in both leisure-time aerobic and strengthening activities also decreased with age, from 20.7% at age 18 to 24 years to 5.3% at ≥75 years of age, on the basis of the 2011 NHIS.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

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  • May combine two claims.

    Findingcitation

    On the basis of accelerometer counts per minute greater than 2020, 42% of 6-11 year olds accumulated at least 260 minutes of moderate-to-vigorous physical activity on 5 or more days per week, whereas only 8% of 12-15 year olds and 7.6% of 16-19 year olds achieved similar counts.

    “On the basis of accelerometer counts per minute >2020, 42% of 6- to 11-year-olds accumulated ≥260 minutes of moderate-to-vigorous PA on ≥5 days per week, whereas only 8% of 12-to 15-year-olds and 7.6% of 16- to 19-year-olds achieved similar counts.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5]

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  • May combine two claims.

    Findingcitation

    Little more than half (58.4%) of high school students played on at least 1 school or community sports team in the previous year; the prevalence declined with increasing grade level, from 61.4% in 9th grade to 52.5% in 12th grade.

    “Little more than half (58.4%) of high school students played on at least 1 school or community sports team in the previous year; however, the prevalence declined with increasing grade level, from 61.4% in the 9th grade to 52.5% in the 12th grade.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In 2011, more high school boys (38.3%) than girls (18.5%) self-reported being physically active at least 60 minutes per day on all 7 days; self-reported rates were higher in white (30.4%) than in black (26.0%) or Hispanic (26.5%) adolescents.

    “In 2011, more high school boys (38.3%) than girls (18.5%) self-reported having been physically active at least 60 minutes per day on all_7 days; self-reported rates of activity were higher in white (30.4%) than in black (26.0%) or Hispanic (26.5%) adolescents.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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  • May combine two claims.

    Findingcitation

    The 2010 National Youth Physical Activity and Nutrition Study showed that 15.3% of high school students met aerobic activity recommendations, 51.0% met muscle-strengthening recommendations, and 12.2% met both.

    “The 2010 National Youth Physical Activity and Nutrition Study showed that a total of 15.3% of high school students met the recommendations for aerobic activity, 51.0% met the recommendations for muscle-strengthening activity, and 12.2% met the recommendations for both aerobic and muscle-strengthening activities.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4]

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

    Findingcitation

    High dietary trans fatty acid consumption was estimated to be responsible for 82,000 annual deaths in the United States.

    “high dietary trans fatty acids for 82 000 annual deaths”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [110] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    A 1.2 g/d reduction in dietary sodium was projected to reduce US annual incident CHD by 60,000 to 120,000, stroke by 32,000 to 66,000, and total mortality by 44,000 to 92,000.

    “a 1.2 g/d reduction in dietary sodium was projected to reduce US annual cases of incident CHD by 60 000 to 120 000, stroke by 32 000 to 66 000, and total mortality by 44 000 to 92 000.119”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [119]

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  • May combine two claims.

    Findingcitation

    Estimated costs per year of life gained for primary CVD prevention strategies were between $9800 and $18,000 for statin therapy, at least $1500 for nurse screening and lifestyle advice, $500 to $1250 for smoking cessation, and $20 to $900 for population-based healthy eating.

    “estimated costs per year of life gained were between $9800 and $18 000 for statin therapy, ≥$1500 for nurse screening and lifestyle advice, $500 to $1250 for smoking cessation, and $20 to $900 for population-based healthy eating.112”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [112]

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

    Findingcitation

    High dietary salt consumption was estimated to be responsible for 102,000 annual deaths in the United States.

    “High dietary salt consumption was estimated to be responsible for 102 000 annual deaths”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [110] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Sodium restriction increased total mortality in trials of patients with congestive heart failure, but the data were based on very few events.

    “Sodium restriction increased total mortality in trials of patients with CHF (RR, 2.59; 95% CI, 1.04–6.44), but these data were based on very few events (n=21 deaths).96”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [96] source

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

    Findingcitation

    The Consumer Price Index for food increased 3.7% in 2011.

    “The Consumer Price Index for food increased 3.7% in 2011.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [111] source

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

    Findingcitation

    Prices for foods eaten at home increased 4.8% in 2011, while prices for foods eaten away from home increased 1.9%.

    “Prices for foods eaten at home increased 4.8% in 2011, whereas prices for foods eaten away from home increased by 1.9%.111”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [111] source

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  • May combine two claims.

    Findingcitation

    The associations between sodium consumption and CVD outcomes were greater with larger differences in sodium intake and longer follow-up.

    “These associations were greater with larger differences in sodium intake and longer follow-up.97”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [97]

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

    Findingcitation

    Low dietary omega-3 fatty acid consumption was estimated to be responsible for 84,000 annual deaths in the United States.

    “low dietary omega-3 fatty acids for 84 000 annual deaths”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [110] source

      Not checked in the free run.

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

    Findingcitation

    Each year, more than $33 billion in medical costs and $9 billion in lost productivity from heart disease, cancer, stroke, and diabetes are attributed to poor nutrition.

    “Each year, >$33 billion in medical costs and $9 billion in lost productivity resulting from HD, cancer, stroke, and DM are attributed to poor nutrition.113–117”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [113]

      Not checked in the free run.

    • cites [114]

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    • cites [115]

      Not checked in the free run.

    • cites [116]

      Not checked in the free run.

    • cites [117]

      Not checked in the free run.

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

    Findingcitation

    Low consumption of fruits and vegetables was estimated to be responsible for 55,000 annual deaths in the United States.

    “and low consumption of fruits and vegetables for 55 000 annual deaths.110”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [110] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Average price per portion of fruits and vegetables was 31 cents with 57 calories per portion, compared with 33 cents and 183 calories per portion for snack foods.

    “Average price per portion of fruits and vegetables was 31 cents with an average of 57 calories per portion, compared with 33 cents and 183 calories per portion for snack foods.111”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [111] source

      Not checked in the free run.

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

    Findingcitation

    For any given year, the share of disposable income spent on food is inversely proportional to absolute income.

    “For any given year, the share of disposable income spent on food is inversely proportional to absolute income.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [111] source

      Not checked in the free run.

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

    Findingcitation

    As a share of personal disposable income, average total food expenditures by families and individuals decreased from 22.3% in 1949 to 11.3% in 2011.

    “average (mean) total food expenditures by families and individuals have decreased from 22.3% (1949) to 18.1% (1961) to 14.9% (1981) to 11.3% (2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [111] source

      Not checked in the free run.

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

    Findingcitation

    The proportion of total US food expenditures for meals outside the home increased from 27% in 1961 to 40% in 1981 to 49% in 2011.

    “The proportion of total US food expenditures for meals outside the home, as a share of total food dollars, increased from 27% in 1961 to 40% in 1981 to 49% in 2011.59”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59]

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  • May combine two claims.

    Findingcitation

    Blacks aged 18 years or older (38.9%) and American Indians or Alaska Natives (40.8%) were more likely to be obese than whites (27.2%) and Asians (9.3%).

    “Blacks ≥18 years of age (38.9%) and American Indians or Alaska Natives (40.8%) were more likely to be obese than were whites (27.2%) and Asians (9.3%).12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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  • May combine two claims.

    Findingcitation

    In 2009-2010 NHANES, obesity prevalence based on BMI-for-age at or above the 95th percentile among children 2 to 5 years was 12% for non-Hispanic white boys, 6% for non-Hispanic white girls, 21% for non-Hispanic black boys, 17% for non-Hispanic black girls, 19% for Mexican American boys, and 12% for Mexican American girls.

    “The prevalence of obesity in children 2 to 5 years of age, based on BMI-for-age values ≥95th percentile of the 2000 CDC growth charts, was 12% for non-Hispanic white boys and 6% for non-Hispanic white girls, 21% for non-Hispanic black boys and 17% for non-Hispanic black girls, and 19% for Mexican American boys and 12% for Mexican American girls according to 2009–2010 data from NHANES (NCHS).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In children 12 to 19 years, overweight/obesity prevalence was 32% for non-Hispanic white boys, 28% for non-Hispanic white girls, 37% for non-Hispanic black boys, 45% for non-Hispanic black girls, 46% for Mexican American boys, and 41% for Mexican American girls.

    “In children 12 to 19 years of age, the prevalence was 32% for non-Hispanic white boys and 28% for non-His-panic white girls, 37% for non-Hispanic black boys and 45% for non-Hispanic black girls, and 46% for Mexican American boys and 41% for Mexican American girls.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    By 2002, 21.4% of Medicare beneficiaries and 39.3% of disabled beneficiaries were obese compared with 16.4% and 32.5%, respectively, in 1997.

    “By 2002, 21.4% of beneficiaries and 39.3% of disabled beneficiaries were obese compared with 16.4% and 32.5%, respectively, in 1997.21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    A comparison of NHANES 2009-2010 with 1999-2000 data demonstrates an increase in obesity prevalence in male youth (OR 1.05; 95% CI 1.01-1.10) but not in female youth (OR 1.02; 95% CI 0.98-1.07).

    “A comparison of NHANES 2009–2010 data with 1999–2000 data demonstrates an increase in obesity prevalence in male youth of 5% (OR, 1.05; 95% CI, 1.01–1.10) but not in female youth (OR, 1.02; 95% CI, 0.98–1.07).2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • May combine two claims.

    Findingcitation

    NHANES 2009-2010 found that 16.9% of youth aged 2 to 19 years were obese, unchanged from 2007-2008.

    “NHANES 2009–2010 found that 16.9% (15.4%–18.4%) of youth aged 2 to 19 years were obese, which was unchanged from 2007–2008.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingcitation

    In children 12 to 19 years, obesity prevalence was 18% for non-Hispanic white boys, 15% for non-Hispanic white girls, 23% for non-Hispanic black boys, 25% for non-Hispanic black girls, 29% for Mexican American boys, and 19% for Mexican American girls.

    “In children 12 to 19 years of age, the prevalence was 18% for non-Hispanic white boys and 15% for non-Hispanic white girls, 23% for non-Hispanic black boys and 25% for non-Hispanic black girls, and 29% for Mexican American boys and 19% for Mexican American girls.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingcitation

    Almost 13% of Asian children, 16% of white children, nearly 21% of black children, 22% of Hispanic children, and 31% of American Indian children were obese.

    “Almost 13% of Asian children, 16% of white children, nearly 21% of black children, 22% of Hispanic children, and 31% of American Indian children were obese.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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  • May combine two claims.

    Findingcitation

    According to 1999-2008 NHANES data, lowest-income girls had an obesity prevalence of 17.9% compared with 13.1% among higher-income girls, and similar observations were seen for boys (20.6% versus 15.6%).

    “According to 1999–2008 NHANES survey data, lowest-income girls had an obesity prevalence of 17.9% compared with 13.1% among those with higher income; similar observations were observed for boys (20.6% versus 15.6%, respectively).7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Findingcitation

    On the basis of 2009 self-reported BRFSS data, overall obesity prevalence was 26.7% in the United States, with rates of 27.4% in men and 26.0% in women.

    “overall obesity prevalence was 26.7% in the United States, with rates of 27.4% in men and 26.0% in women.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20]

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  • May combine two claims.

    Findingcitation

    By race/ethnicity, obesity prevalence was 25.2% among non-Hispanic whites, 36.8% among non-Hispanic blacks, and 30.7% among Hispanics.

    “the prevalence of obesity among non-Hispanic whites was 25.2%, whereas it.8% among non-Hispanic blackswas 36 and 30.7% among Hispanics.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20]

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  • May combine two claims.

    Findingcitation

    In 1996, 1.0% of adolescents were severely obese, and 70.5% maintained this weight status into adulthood.

    “According to the US National Longitudinal Study of Adolescent Health, 1.0% of adolescents were severely obese in 1996 (defined as age <20 years and BMI ≥95th sex-specific BMI-for-age growth chart or BMI ≥30 kg/m2); the majority (70.5%) maintained this weight status into adulthood.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8]

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  • May combine two claims.

    Findingcitation

    The sex gap in obesity among blacks was largest in those with low parental education and smallest in those with high parental education.

    “The sex gap was largest in those with low parental education (16.7% of men compared with 45.4% of women were obese) and smallest in those with high parental education (28.5% of men compared with 31.4% of women were obese).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4]

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  • May combine two claims.

    Findingcitation

    In children 6 to 11 years, overweight/obesity prevalence was 30% for non-Hispanic white boys, 25% for non-Hispanic white girls, 41% for non-Hispanic black boys, 44% for non-Hispanic black girls, 39% for Mexican American boys, and 40% for Mexican American girls.

    “In children 6 to 11 years of age, the prevalence was 30% for non-Hispanic white boys and 25% for non-Hispanic white girls, 41% for non-Hispanic black boys and 44% for non-Hispanic black girls, and 39% for Mexican American boys and 40% for Mexican American girls.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingcitation

    In children 6 to 11 years, obesity prevalence was 17% for non-Hispanic white boys, 11% for non-Hispanic white girls, 30% for non-Hispanic black boys, 28% for non-Hispanic black girls, 22% for Mexican American boys, and 22% for Mexican American girls.

    “In children 6 to 11 years of age, the prevalence was 17% for non-Hispanic white boys and 11% for non-Hispanic white girls, 30% for non-Hispanic black boys and 28% for non-Hispanic black girls, and 22% for Mexican American boys and 22% for Mexican American girls.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingcitation

    The proportion of obese adults told they were overweight was significantly lower for non-Hispanic blacks (60.5%) and Mexican Americans (57.1%) than for non-Hispanic whites (66.4%), for middle-income than high-income people (62.4% versus 70.6%), and for adults with less than a high school education than for those with any college education (59.2% versus 70.3%).

    “The proportion of obese adults told that they were overweight was significantly lower for non-Hispanic blacks (60.5%) and Mexican Americans (57.1%) than for non-Hispanic whites (66.4%), for middle-income people than for high-income people (62.4% versus 70.6%), and for adults with less than a high school education than for those with any college education (59.2% versus 70.3%).14”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

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  • May combine two claims.

    Findingcitation

    In 2011, American Indian/Alaskan Native youth had an obesity rate of 17.7%, Hispanics 14.7%, non-Hispanic blacks 10.6%, non-Hispanic whites 10.3%, and Asian/Pacific Islanders 9.3%.

    “Data from 2011 show that American Indian/Alaskan Native youth have an obesity rate of 17.7%, whereas rates are 14.7% for Hispanics, 10.6% for non-Hispanic blacks, 10.3% for non-Hispanic whites, and 9.3% for Asian/Pacific Islanders.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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  • May combine two claims.

    Findingcitation

    Rates of overweight and obesity at or above the 85th BMI percentile were 39.1% for Hispanics, 39.4% for Mexican Americans, 27.9% for non-Hispanic whites, and 39.1% for non-Hispanic blacks.

    “Rates of overweight and obesity (≥85th BMI percentile) were 39.1% for Hispanics, 39.4% for Mexican Americans, 27.9% for non-Hispanic whites, and 39.1% for non-Hispanic blacks.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingown data

    Among US adults, 35% were obese (35% of men and 36% of women).

    “Among US adults, 35% were obese (35% of men and 36% of women).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In MESA, a large proportion of white, black, and Hispanic participants were overweight (60%-85%) or obese (30%-50%), whereas fewer Chinese American participants were overweight (33%) or obese (5%).

    “a large proportion of white, black, and Hispanic participants were overweight (60%–85%) or obese (30%–50%), whereas fewer Chinese American participants were overweight (33%) or obese (5%).15”
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    • cites [15] source

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

    Findingcitation

    Approximately 64.8% of obese adults were told by a doctor or health professional that they were overweight.

    “Approximately 64.8% of obese adults were told by a doctor or health professional that they were overweight.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

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

    Findingcitation

    Among adults, obesity was associated with nearly 112,000 excess deaths relative to normal weight in 2000.

    “obesity was associated with nearly 112 000 excess deaths (95% CI, 53 754–170 064) relative to normal weight in 2000.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37]

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  • May combine two claims.

    Findingcitation

    Overweight children and adolescents are at increased risk for poor school performance, tobacco use, alcohol use, premature sexual behavior, and poor diet.

    “Poor school performance, tobacco use, alcohol use, premature sexual behavior, and poor diet.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

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  • May combine two claims.

    Findingcitation

    Data from the Framingham Heart Study indicate a doubling in the incidence of diabetes mellitus over the past 30 years, most dramatically during the 1990s and primarily among individuals with a BMI above 30 kg/m2.

    “Data from the FHS indicate a doubling in the incidence of DM over the past 30 years, most dramatically during the 1990s and primarily among individuals with a BMI >30 kg/m2.26”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26]

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  • May combine two claims.

    Findingcitation

    A recent meta-analysis of 15 prospective studies found that the increased risk for Alzheimer disease or vascular dementia and any dementia was 1.35 and 1.26 for overweight, respectively, and 2.04 and 1.64 for obesity, respectively.

    “A recent meta-analysis of 15 prospective studies demonstrated the increased risk for Alzheimer disease or vascular dementia and any dementia was 1.35 and 1.26 for overweight, respectively, and 2.04 and 1.64 for obesity, respectively.29”
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    • cites [29]

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  • May combine two claims.

    Findingcitation

    These stroke risks were graded with increasing BMI and were independent of age, lifestyle, and other cardiovascular risk factors.

    “These risks were graded with increasing BMI and were independent of age, lifestyle, and other cardiovascular risk factors.34”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34]

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  • May combine two claims.

    Findingcitation

    Obesity is a strong predictor of sleep-disordered breathing, which is strongly associated with the development of CVD and with other conditions including numerous cancers, nonalcoholic fatty liver disease, gallbladder disease, musculoskeletal disorders, and reproductive abnormalities.

    “Obesity is also a strong predictor of sleep-disordered breathing, itself strongly associated with the development of CVD, as well as with myriad other health conditions, including numerous cancers, nonalcoholic fatty liver disease, gallbladder disease, musculoskeletal disorders, and reproductive abnormalities.28”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28]

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  • May combine two claims.

    Findingcitation

    Adolescents with high BMI in the overweight or obese range are at a 2.5-fold increased risk of developing metabolic syndrome, a 2.2-fold increased risk of high carotid intima-media thickness, and a 3.4-fold increased risk of diabetes mellitus in adulthood.

    “adolescents with high BMI in the overweight or obese range are at a 2.5-fold increased risk of developing metabolic syndrome, a 2.2-fold increased risk of high carotid IMT, and a 3.4-fold increased risk of DM in adulthood.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25]

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  • May combine two claims.

    Findingcitation

    Compared with a BMI of 22.5 to 24.9 kg/m2, the hazard ratios for death were 1.47 for BMI 15.0-18.4, 1.14 for 18.5-19.9, 1.0 for 20.0-22.4, 1.13 for 25.0-29.9, 1.44 for 30.0-34.9, 1.88 for 35.0-39.9, and 2.51 for 40.0-49.9 kg/m2.

    “the HRs for death were as follows: BMI 15.0 to 18.4 kg/m2, 1.47; 18.5 to 19.9 kg/m2, 1.14; 20.0 to 22.4 kg/m2, 1.0; 25.0 to 29.925 kg/m2, 1.13; 30.0 to 34.9 kg/m2, 1.44; 35.0 to 39.9 kg/m2, 1.88; and 40.0 to 49.9 kg/m2, 2.51.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40]

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  • May combine two claims.

    Findingcitation

    A systematic review found an adjusted relative risk for ischemic stroke of 1.22 in overweight individuals and 1.64 for obese individuals relative to normal-weight individuals.

    “an adjusted RR for ischemic stroke of 1.22 (1.05–1.41) in overweight individuals and an RR of 1.64 (1.36–1.99) for obese individuals relative to normal-weight individuals.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34]

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  • May combine two claims.

    Findingcitation

    The population attributable fraction for CHD associated with reducing current population mean BMI to 21 kg/m2 in the Asia-Pacific region ranged from 2% in India to 58% in American Samoa; for ischemic stroke it ranged from 3% in India to 64% in American Samoa.

    “The population attributable fraction for CHD associated with reducing current population mean BMI to 21 kg/m2 in the Asia-Pacific region ranged from 2% in India to 58% in American Samoa; the population attributable fraction for ischemic stroke ranged from 3% in India to 64% in American Samoa.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 22a

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  • May combine two claims.

    Findingcitation

    Below 22.5 to 25 kg/m2, the overall inverse association with BMI was predominantly related to strong inverse associations for smoking-related respiratory disease, and the only clearly positive association was for ischemic heart disease.

    “Below 22.5 to 25 kg/m2, the overall inverse association with BMI was predominantly related to strong inverse associations for smoking-related respiratory disease, and the only clearly positive association was for ischemic heart disease.39”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39]

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  • May combine two claims.

    Findingcitation

    Obesity was associated with significantly increased mortality caused by CVD, some cancers, and diabetes mellitus or kidney disease.

    “Obesity was associated with significantly increased mortality caused by CVD, some cancers, and DM or kidney disease.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38]

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  • May combine two claims.

    Findingcitation

    Recent estimates suggest that reductions in smoking, cholesterol, blood pressure, and physical activity resulted in a gain of 2,770,500 life-years, but these gains were reduced by a loss of 715,000 life-years caused by increased prevalence of obesity and diabetes mellitus.

    “reductions in smoking, cholesterol, BP, and PA levels resulted in a gain of 2 770 500 life-years; however, these gains were reduced by a loss of 715 000 life-years caused by the increased prevalence of obesity and DM.43”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43]

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  • May combine two claims.

    Findingcitation

    Above this range, each 5-kg/m2 higher BMI was associated with approximately 30% higher all-cause mortality, and no specific cause of death was inversely associated with BMI.

    “Above this range, each 5-kg/m2-higher BMI was associated with ≈30% higher all-cause mortality, and no specific cause of death was inversely associated with BMI.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39]

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  • May combine two claims.

    Findingcitation

    Overweight children and adolescents are at increased risk for asthma, hepatic steatosis, sleep apnea, stroke, some cancers, musculoskeletal disorders, and gallbladder disease.

    “Other associated health conditions, such as asthma, hepatic steatosis, sleep apnea, stroke, some cancers (breast, colon, and kidney), musculoskeletal disorders, and gallbladder disease.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

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  • May combine two claims.

    Findingcitation

    A randomized clinical trial of 130 severely obese adults randomized to either 12 months of diet and physical activity or only 6 months of physical activity resulted in 12.1 and 9.9 kg of weight loss at 1 year, with improvements in waist circumference, visceral fat, blood pressure, and insulin resistance.

    “A randomized clinical trial of 130 severely obese adult individuals randomized to either 12 months of diet and PA or only 6 months of PA resulted in 12.1 and 9.9 kg, respectively, of weight loss at 1 year, with improvements in waist circumference, visceral fat, BP, and insulin resistance.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17]

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  • May combine two claims.

    Findingcitation

    Overweight was associated with significantly increased mortality from diabetes mellitus or kidney disease and was not associated with increased mortality from cancer or CVD in an analysis of 2004 NHANES data.

    “Overweight was associated with significantly increased mortality resulting from DM or kidney disease and was not associated with increased mortality resulting from cancer or CVD in an analysis of 2004 data from NHANES.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38]

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  • May combine two claims.

    Findingcitation

    Overweight and obese participants had lower multivariable-adjusted scores on the physical component summary score but not on the mental component summary score.

    “overweight and obese participants had lower multivariable-adjusted scores on the physical component summary score but not on the mental component summary score.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22]

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  • May combine two claims.

    Findingcitation

    Forecasts through 2030 using the BRFSS 1990-2008 data set suggest that by 2030, 51% of the population will be obese, with 11% with severe obesity, an increase of 33% for obesity and 130% for severe obesity.

    “Forecasts through 2030 using the BRFSS 1990–2008 data set suggest that by 2030, 51% of the population will be obese, with 11% with severe obesity, an increase of 33% for obesity and 130% for severe obesity.23”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Grade II to III obesity was associated with more than 82,000 excess deaths.

    “and grade II to III obesity (BMI ≥35 kg/m2) with >82 000 (95% CI, 44 843–119 289).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37]

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

    Findingcitation

    An obesity paradox has been reported, with obese patients demonstrating favorable outcomes in congestive heart failure, hypertension, peripheral vascular disease, and coronary artery disease.

    “An obesity paradox has been reported, with obese patients demonstrating favorable outcomes in CHF, hypertension, peripheral vascular disease, and coronary artery disease (CAD).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33]

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

    Findingcitation

    The annual medical burden of obesity has increased to almost 10% of all medical spending and could amount to $147 billion per year in 2008.

    “the annual medical burden of obesity has increased to almost 10% of all medical spending and could amount to $147 billion per year in 2008 (in 2008 dollars).50”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50]

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  • May combine two claims.

    Findingcitation

    Using self-reported NHIS data with linked mortality files through 2006, the hazard ratio for all-cause mortality was 1.07 for overweight individuals, 1.41 for obese individuals, and 2.46 for extremely obese individuals.

    “the HR for all-cause mortality was 1.07 (95% CI, 0.91–1.26) for overweight individuals, 1.41 (95% CI, 1.16–1.73) for obese individuals, and 2.46 for extremely obese individuals (95% CI, 1.91–3.16).44”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44]

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  • May combine two claims.

    Findingcitation

    In the HUNT 2 study, the risk of death per standard deviation increase was 1.02 for BMI, 1.10 for waist circumference, 1.01 for hip circumference, 1.15 for waist-to-hip ratio, and 1.12 for waist-to-height ratio.

    “the risk of death per SD increase in each measure was 1.02 (95% CI, 0.99–1.06) for BMI, 1.10 (95% CI, 1.06–1.14) for waist circumference, 1.01 (95% CI, 0.97–1.05) for hip circumference, 1.15 (95% CI, 1.11–1.19) for waist-to-hip ratio, and 1.12 (95% CI, 1.08–1.16) for waist-to-height ratio.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45]

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  • May combine two claims.

    Findingcitation

    History of heart attack in both parents increases the risk of heart attack, especially when one parent had a premature heart attack.

    “History of a heart attack in both parents increases the risk of heart attack, especially when 1 parent had a premature heart attack4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4]

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

    Findingcitation

    According to the 2006 NHDS, the incidence of bariatric surgery was estimated at 113,000 cases per year, with costs of approximately 1.5 billion dollars annually.

    “the incidence of bariatric surgery was estimated at 113 000 cases per year, with costs of ≈1.5 billion dollars annually.56”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56]

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  • May combine two claims.

    Findingcitation

    Obese people have 46% higher inpatient costs, 27% more outpatient visits, and spend 80% more on prescription drugs.

    “obese people have 46% higher inpatient costs and 27% more outpatient visits and spend 80% more on prescription drugs.50”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50]

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  • May combine two claims.

    Findingown data

    The breakdown of reported family history of heart attack by age was 8.4% for men and 10.3% for women aged 20-39, 12.8% for men and 15.3% for women aged 40-59, 13.7% for men and 17.5% for women aged 60-79, and 9.8% for men and 13.7% for women aged 80 or older.

    “Age 20 to 39 years, 8.4% for men, 10.3% for womenAge 40 to 59 years, 12.8% for men, 15.3% for womenAge 60 to 79 years, 13.7% for men, 17.5% for womenAge ≥80 years, 9.8% for men, 13.7% for women”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    According to 2006 MEPS and 2006 BRFSS data, annual medical expenditures would be 6.7% to 10.7% lower in the absence of obesity.

    “annual medical expenditures would be 6.7% to 10.7% lower in the absence of obesity.54”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] source

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  • May combine two claims.

    Findingcitation

    The second trial randomized 60 patients to bariatric surgery versus medical therapy and conducted follow-up for 24 months; diabetes mellitus remission occurred in 75% of the gastric bypass group compared with 0% of the medical treatment arm.

    “DM remission occurred in 75% of the group that underwent gastric bypass surgery compared with 0% of those in the medical treatment arm, with HbA1c values of 6.35% in the surgical arm compared with 7.69% in the medical treatment arm.63”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] source

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

    Findingcitation

    If current trends in obesity growth continue, total healthcare costs attributable to obesity could reach $861 to $957 billion by 2030, accounting for 16% to 18% of US health expenditures.

    “total healthcare costs attributable to obesity could reach $861 to $957 billion by 2030, which would account for 16% to 18% of US health expenditures.51”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] source

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  • May combine two claims.

    Findingcitation

    Cancer mortality was reduced by 60%, diabetes mellitus mortality by 92%, and coronary artery disease mortality by 56% in the surgery group.

    “Specifically, cancer mortality was reduced by 60%, DM mortality by 92%, and CAD mortality by 56%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] source

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  • May combine two claims.

    Findingcitation

    Bariatric surgery was associated with fewer CVD deaths and fewer strokes than in the control group.

    “bariatric surgery was associated with fewer CVD deaths (HR, 0.47; 95% CI, 0.29–0.76) and fewer strokes (HR, 0.67; 95% CI, 0.54–0.83) than in the control group.58”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [58] source

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  • May combine two claims.

    Findingcitation

    Among 641 patients followed up for 10 years compared with 627 matched control subjects, after 2 years 72% of surgically treated patients versus 21% of control patients had remission of diabetes mellitus; at 10 years, results were 36% and 13%, respectively.

    “after 2 years of follow-up, 72% of the surgically treated patients versus 21% of the control patients had remission of their DM; at 10 years of follow-up, results were 36% and 13%, respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59]

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  • May combine two claims.

    Findingcitation

    For CVD mortality in HUNT 2, the risk of death per standard deviation increase was 1.12 for BMI, 1.19 for waist circumference, 1.06 for hip circumference, 1.23 for waist-to-hip ratio, and 1.24 for waist-to-height ratio.

    “For CVD mortality, the risk of death per SD increase was 1.12 (95% 1.06–1.20) for BMI, 1.19 (1.12–1.26) for waist circumference, 1.06 (1.00–1.13) for hip circumference, 1.23 (95% CI, 1.16–1.30) for waist-to-hip ratio, and 1.24 (95% CI, 1.16–1.31) for waist-to-height ratio.45”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45]

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

    Findingcitation

    Among children and adolescents, annual hospital costs related to obesity were $127 million between 1997 and 1999.

    “annual hospital costs related to obesity were $127 million between 1997 and women, 1999.49”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49]

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  • May combine two claims.

    Findingcitation

    A recent cost-effectiveness study of laparoscopic adjustable gastric banding showed that after 5 years, $4970 was saved in medical expenses; if indirect costs were included, savings increased to $6180 and $10,960.

    “after 5 years, $4970 was saved in medical expenses; if indirect costs were included (absenteeism and presenteeism), savings increased to $6180 and $10 960, respectively.64”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64]

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  • May combine two claims.

    Findingcitation

    Premature paternal history of heart attack approximately doubles the risk of heart attack in men and increases the risk in women by approximately 70%.

    “Premature paternal history of a heart attack has been shown to approximately double the risk of a heart attack in men and increase the risk in women by ≈70%.2,3”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2]

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    • cites [3]

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  • May combine two claims.

    Findingcitation

    For obese beneficiaries, Medicare pays $1723 more, Medicaid pays $1021 more, and private insurance pays $1140 more than for normal-weight beneficiaries.

    “For obese beneficiaries, Medicare pays $1723 more, Medicaid pays $1021 more, and private insurances pay $1140 more than for beneficiaries who are at normal weight.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50]

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  • May combine two claims.

    Findingcitation

    The first randomized controlled trial randomized 150 patients to bariatric surgery versus intensive medical treatment and conducted 12-month follow-up; it showed that glycemic control improved and weight loss was greater in the surgical arm.

    “this study showed that glycemic control improved (6.4%) and weight loss was greater (29.4 versus 5.4 kg) in the surgical arm.62”
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    • cites [62]

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

    Findingcitation

    The total excess cost related to the current prevalence of adolescent overweight and obesity is estimated to be $254 billion, including $208 billion in lost productivity and $46 billion in direct medical costs.

    “The total excess cost related to the current prevalence of adolescent overweight and obesity is estimated to be $254 billion ($208 billion in lost productivity secondary to premature morbidity and mortality and $46 billion in direct medical costs).53”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53]

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  • May combine two claims.

    Findingcitation

    Data from NHANES 2005-2006 indicate that among those with elevated LDL cholesterol levels, 35.5% had not been screened previously, 24.9% were screened but not told they had elevated cholesterol, and 39.6% were treated inadequately.

    “Data from NHANES 2005–2006 indicate that among those with elevated LDL cholesterol levels, 35.5% had not been screened previously, 24.9% were screened but not told they had elevated cholesterol, and 39.6% were treated inadequately.8”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8]

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  • May combine two claims.

    Findingcitation

    For a 65-year-old man with 2 risk alleles at 9p21.3 and no other traditional risk factors, 10-year heart disease risk is about 13.2%, compared with about 9.2% for a similar man with 0 alleles.

    “The 10-year HD risk for a 65-year-old man with 2 risk alleles at 9p21.3 and no other traditional risk factors is ≈13.2%, whereas a similar man with 0 alleles would have a 10-year risk of ≈9.2%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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  • May combine two claims.

    Findingcitation

    At the 9p21.3 single-nucleotide polymorphism, about 27% of the white population is estimated to have 0 risk alleles, 50% to have 1, and 23% to have 2.

    “At this single-nucleotide polymorphism, ≈27% of the white population is estimated to have 0 risk alleles, 50% is estimated to have 1 risk allele, and the remaining 23% is estimated to have 2 risk alleles.12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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    Findingcitation

    During 1999-2006, 26.0% of US adults had hypercholesterolemia, 9% had both hypercholesterolemia and hypertension, 1.5% had diabetes and hypercholesterolemia, and 3% had all three conditions.

    “During the period from 1999 to 2006, 26.0% of adults had hypercholesterolemia, 9% of adults had both hypercholesterolemia and hypertension, 1.5% of adults had DM and hypercholesterolemia, and 3% of adults had all 3 conditions.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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  • May combine two claims.

    Findingcitation

    Among US youths 12 to 19 years of age, 14.2% of normal-weight, 22.3% of overweight, and 42.9% of obese youths have at least one abnormal lipid level.

    “The prevalence of abnormal lipid levels among youths 12 to 19 years of age is 20.3%; 14.2% of normal-weight youths, 22.3% of overweight youths, and 42.9% of obese youths have at least 1 abnormal lipid level (NHANES 1999–2006, NCHS).1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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  • May combine two claims.

    Findingown data

    An estimated 31.9 million US adults 20 years of age or older have total serum cholesterol levels of 240 mg/dL or higher, a prevalence of 13.8%.

    “An estimated 31.9 million adults ≥20 years of age have total serum cholesterol levels ≥240 mg/dL (extrapolated to 2010 by use of NCHS/NHANES 2007–2010 data), with a prevalence of 13.8% (Table 8-1; unpublished NHLBI tabulation).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The decline in mean total cholesterol was observed for men 40 years of age or older and women 60 years of age or older, with little change for other sex and age groups.

    “This decline was observed for men ≥40 years of age and for women ≥60 years of age. There was little change over this time period for other sex/age groups.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Findingcitation

    Awareness, treatment, and control of hypercholesterolemia have increased, but more than half of those at borderline-high risk remain unaware of their condition.

    “Awareness, treatment, and control of hypercholesterolemia have increased; however, more than half of those at borderline-high risk remain unaware of their condition.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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  • May combine two claims.

    Findingcitation

    For a 40-year-old woman with 2 risk alleles at 9p21.3 and no other traditional risk factors, 10-year heart disease risk is about 2.4%, compared with about 1.7% for a similar woman with 0 alleles.

    “The 10-year HD risk for a 40-year-old woman with 2 alleles and no other traditional risk factors is ≈2.4%, whereas a similar woman with 0 alleles would have a 10-year risk of ≈1.7%.12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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  • May combine two claims.

    Findingcitation

    In 2005-2006, about 65% of men and 70% of women had been screened for high cholesterol in the past 5 years, and 16% of adults had serum total cholesterol levels of 240 mg/dL or higher.

    “In 2005 to 2006, ≈65% of men and 70% of women had been screened for high cholesterol in the past 5 years, and 16% of adults had serum total cholesterol levels ≥240 mg/dL.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Findingcitation

    In 2011, among US adults screened for high blood cholesterol, the percentage who had been told they had high blood cholesterol ranged from 33.5% in Colorado to 42.3% in Mississippi, with a median among states of 38.4%.

    “Data from the BRFSS (CDC) survey in 2011 showed that among adults screened for high blood cholesterol, the percentage who had been told that they had high blood cholesterol ranged from 33.5% in Colorado to 42.3% in Mississippi. The median percentage among states was 38.4%.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

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  • May combine two claims.

    Findingown data

    The decline in total cholesterol was not uniform across age groups; middle-aged to older people had substantial decreases, while younger people had little overall change and recently increased total cholesterol values.

    “however, the decline was not uniform across all age groups. Middle-aged to older people have shown substantial decreases, but younger people have shown little overall change and recently had increased total cholesterol values.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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  • May combine two claims.

    Findingcitation

    Only about one third of treated patients achieve their LDL goal, and fewer than 20% of patients with coronary heart disease are at their LDL goal.

    “Only approximately one third of treated patients are achieving their LDL goal; <20% of patients with CHD are at their LDL goal.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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  • May combine two claims.

    Findingcitation

    During 2005-2008, 33.2% of US adults achieved LDL cholesterol goals; among adults without health insurance, 22.6% achieved LDL cholesterol goals; 82.8% of adults with uncontrolled LDL cholesterol had some form of health insurance.

    “There were 33.2% of adults overall during 2005–2008 in NHANES who achieved LDL cholesterol goals. Among adults without health insurance, only 22.6% achieved LDL cholesterol goals; however, 82.8% of those adults with uncontrolled LDL cholesterol did have some form of health insurance.11”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

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  • May combine two claims.

    Findingnone given

    Compared with whites, blacks develop high blood pressure earlier in life and have much higher average blood pressures.

    “Compared with whites, blacks develop HBP earlier in life, and their average BPs are much higher.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    According to NHANES 1988-1994 and 2007-2008, high blood pressure control rates improved from 27.3% to 50.1%, treatment improved from 54.0% to 73.5%, and control/treated rates improved from 50.6% to 72.3%.

    “According to data from NHANES 1988–1994 and 2007–2008, HBP control rates improved from 27.3% to 50.1%, treatment improved from 54.0% to 73.5%, and the control/treated rates improved from 50.6% to 72.3%.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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  • May combine two claims.

    Findingcitation

    A study of high school students in Houston, Texas, found that about 30% had at least one elevated blood pressure measurement, and elevated blood pressure was significantly influenced by obesity.

    “A study of high school students in Houston, TX (mean age 15.4 years; 45.2% male, 49.3% Hispanic, 25.2% Caucasian, and 16.1% African American) found ≈30% of the students had at least 1 elevated BP measurement; elevated BP was significantly influenced by obesity.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

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  • May combine two claims.

    Findingreasoning

    Compared with whites, blacks have a 1.3-times greater rate of nonfatal stroke, a 1.8-times greater rate of fatal stroke, a 1.5-times greater rate of death from heart disease, and a 4.2-times greater rate of end-stage kidney disease.

    “As a result, compared with whites, blacks have a 1.3-times greater rate of nonfatal stroke, a 1.8-times greater rate of fatal stroke, a 1.5-times greater rate of death attributable to HD, and a 4.2-times greater rate of end-stage kidney disease (fifth and sixth reports of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Among Mexican Americans, girls' systolic blood pressure increased 1.0 mm Hg and boys' systolic blood pressure increased 2.7 mm Hg compared with non-Hispanic whites.

    “Among Mexican Americans, girls’ SBP increased 1.0 mm Hg and boys’ SBP increased 2.7 mm Hg compared with non-Hispanic whites.14”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

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  • May combine two claims.

    Findingcitation

    Mean LDL cholesterol decreased from 126.1 mg/dL during 1999-2000 to 116.1 mg/dL during 2009-2010, and the prevalence of high LDL cholesterol decreased from 31.5% to 28.2%.

    “Mean levels of LDL cholesterol decreased from 126.1 mg/dL during 1999 to 2000 to 116.1 mg/dL during 2009 to 2010. The prevalence of high LDL cholesterol decreased from 31.5% during 1999 to 2000 to 28.2% during 2009 to 20108”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8]

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  • May combine two claims.

    Findingcitation

    In that Ohio study, 3% of those with hypertension had stage 2 hypertension, and 41% of those with stage 2 hypertension were undiagnosed.

    “In addition, 3% of those with hypertension had stage 2 hypertension, and 41% of those with stage 2 hypertension were undiagnosed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13]

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  • May combine two claims.

    Findingcitation

    The prevalence of hypertension in US blacks is among the highest in the world and is increasing.

    “The prevalence of hypertension in blacks in the United States is among the highest in the world, and it is increasing.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18]

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  • May combine two claims.

    Findingown data

    NHANES data show that a higher percentage of men than women have hypertension until 45 years of age; from 45 to 54 and 55 to 64 years the percentages are similar; after that a higher percentage of women have hypertension than men.

    “NHANES data show that a higher percentage of men than women have hypertension until 45 years of age. From 45 to 54 and from 55 to 64 years of age, the percentages of men and women with hypertension are similar. After that, a higher percentage of women have hypertension than men (Chart 9-1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    According to NHANES 2003-2008, among US adults with hypertension, 8.9% met criteria for resistant hypertension, representing 12.8% of the population taking antihypertensive medication.

    “According to NHANES data 2003–2008, among US adults with hypertension, 8.9% met the criteria for resistant hypertension (BP was ≥140/90 mm Hg, and they reported using antihypertensive medications from 3 different drug classes or drugs from ≥4 antihypertensive drug classes regardless of BP). This represents 12.8% of the population taking antihypertensive medication.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5]

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  • May combine two claims.

    Findingcitation

    Between 1988-1994 and 1999-2004, awareness of high LDL cholesterol increased from 39.2% to 63.0%, use of pharmacological lipid-lowering treatment increased from 11.7% to 40.8%, and LDL cholesterol control increased from 4.0% to 25.1% among those with high LDL cholesterol.

    “Between 1988 to 1994 and 1999 to 2004, awareness increased from 39.2% to 63.0%, and use of pharmacological lipid-lowering treatment increased from 11.7% to 40.8%. LDL cholesterol control increased from 4.0% to 25.1% among those with high LDL cholesterol.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13]

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  • May combine two claims.

    Findingcitation

    A study in Ohio of more than 14,000 children and adolescents 3 to 18 years of age observed at least 3 times between 1999 and 2006 found that 3.6% had hypertension; of these, 26% had been diagnosed and 74% were undiagnosed.

    “A study in Ohio of >14 000 children and adolescents 3 to 18 years of age who were observed at least 3 times between 1999 and 2006 found that 3.6% had hypertension.13 Of these, 26% had been diagnosed and 74% were undiagnosed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13]

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  • May combine two claims.

    Findingcitation

    Data from NHANES 2005-2006 found that 29% of US adults 18 years of age or older were hypertensive; prevalence was nearly equal between men and women; 7% had high blood pressure but had never been told; among hypertensive adults, 78% were aware, 68% were using antihypertensive medication, and 64% of those treated had their hypertension controlled.

    “Data from NHANES 2005–2006 found that 29% of US adults ≥18 years of age were hypertensive. The prevalence of hypertension was nearly equal between men and women; 7% of adults had HBP but had never been told that they had hypertension. Among hypertensive adults, 78% were aware of their condition, 68% were using antihypertensive medication, and 64% of those treated had their hypertensioncontrolled.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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  • May combine two claims.

    Findingcitation

    Among US adults 65 years of age or older in NHANES 1999-2004, prevalence of hypertension was 70.8%, awareness was 75.9%, treatment was 69.3%, and control was 48.8%.

    “Among US adults ≥65 years of age (NHANES 1999–2004), prevalence of hypertension was 70.8%, awareness of hypertension was 75.9%, treatment for hypertension was 69.3%, and control of hypertension was 48.8%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

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  • May combine two claims.

    Findingcitation

    In 1999-2004, LDL cholesterol control rates were lower among adults 20 to 49 years of age than among those 65 years or older, among non-Hispanic blacks and Mexican Americans than among non-Hispanic whites, and among men than among women.

    “In 1999 to 2004, rates of LDL cholesterol control were lower among adults 20 to 49 years of age than among those ≥65 years of age (13.9% versus 30.3%, respectively), among non-Hispanic blacks and Mexican Americans than among non-Hispanic whites (17.2% and 16.5% versus 26.9%, respectively), and among men than among women (22.6% versus 26.9%, respectively).13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13]

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  • May combine two claims.

    Findingcitation

    Longitudinal blood pressure outcomes from the National Childhood Blood Pressure database for ages 13-15, after a single blood pressure measurement, showed that among those with prehypertension, 14% of boys and 12% of girls had hypertension 2 years later; the overall progression rate from prehypertension to hypertension was about 7%.

    “Longitudinal BP outcomes from the National Childhood Blood Pressure database (ages 13–15 years) were examined after a single BP measurement. Among those determined to have prehypertension, 14% of boys and 12% of girls had hypertension 2 years later; the overall rate of progression from prehypertension to hypertension was ≈7%.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17]

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

    Findingcitation

    Pre-high blood pressure and high blood pressure increased 2.3% and 1%, respectively, between 1988 and 1999.

    “Pre-HBP and HBP increased 2.3% and 1%, respectively, between 1988 and 1999.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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  • May combine two claims.

    Findingcitation

    From 1988-1994 through 1999-2002, the prevalence of high blood pressure in US adults increased from 35.8% to 41.4% among blacks, and it was particularly high among black women at 44.0%.

    “From 1988 to 1994 through 1999 to 2002, the prevalence of HBP in adults increased from 35.8% to 41.4% among blacks, and it was particularly high among black women at 44.0%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18]

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  • May combine two claims.

    Findingcitation

    The SEARCH study found the prevalence of elevated blood pressure to be 5.9% among children 3 to 17 years of age with type 1 diabetes and 23.7% among those with type 2 diabetes.

    “Analysis of data from the Search for Diabetes in Youth Study (SEARCH), which included children 3 to 17 years of age with type 1 and type 2 DM, found the prevalence of elevated BP to be 5.9% among those with type 1 DM and 23.7% among those with type 2 DM.15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

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  • May combine two claims.

    Findingcitation

    In NHANES 1999-2000, people with prehypertension were more likely than those with normal blood pressure to have above-normal cholesterol and to be overweight or obese, while the probability of current smoking was lower.

    “In a study of NHANES 1999–2000 (NCHS), people with prehypertension were more likely than those with normal BP levels to have above-normal cholesterol levels (≥200 mg/dL) and to be overweight or obese, whereas the probability of current smoking was lower.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52]

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  • May combine two claims.

    Findingcitation

    The prevalence of diagnosed diabetes in adults aged 65 years or older was 26.9% in 2010, and an additional 50% (more than 20 million) had prediabetes; NHANES 2005-2006 data show that 46% of diabetes cases remain undiagnosed in this age group.

    “The prevalence of diagnosed DM in adults ≥65 years of age was 26.9% in 2010, and an additional 50% (>20 million) had prediabetes based on fasting glucose, oral glucose tolerance testing, or HbA1c. In addition, data from NHANES 2005–2006 show that 46% of DM cases remain undiagnosed in this group aged ≥65 years.11”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

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  • May combine two claims.

    Findingown data

    Among younger children, type 1 diabetes accounted for at least 80% of diabetes; among older youths, the proportion of type 2 diabetes ranged from 6% to 76%.

    “Among younger children, type 1 DM accounted for ≥80% of DM; among older youths, the proportion of type 2 DM ranged from 6% (0.19 per 1000 for non-Hispanic white youths) to 76% (1.74 per 1000 for American Indian youths).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Based on NHANES 2007-2010, an estimated 19.7 million Americans aged 20 years or older have physician-diagnosed diabetes mellitus.

    “On the basis of data from NHANES 2007–2010 (unpublished NHLBI tabulation), an estimated 19.7 million Americans ≥20 years of age have physician-diagnosed DM.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    An additional 8.2 million adults have undiagnosed diabetes mellitus, and about 87.3 million adults have prediabetes; the prevalence of prediabetes in the US adult population is 38%.

    “An additional 8.2 million adults have undiagnosed DM, and ≈87.3 million adults have prediabetes (eg, fasting blood glucose of 100 to <126 mg/dL). The prevalence of prediabetes in the US adult population is 38%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In NHANES 1998-2008 for adults with diabetes, hypertension prevalence increased while awareness, treatment, and control improved, but for adults aged 20 to 44 there was no evidence of improvement.

    “According to data from NHANES 1998–2008 for adults with DM, prevalence of hypertension increased, whereas awareness, treatment, and control improved during these time periods; however, for adults 20 to 44 years of age, there was no evidence of improvement.48”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [48]

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  • May combine two claims.

    Findingcitation

    Of 1514 SEARCH participants, 95% reported having blood pressure checks, 88% reported lipid-level checks, 68% reported HbA1c testing, and 66% reported eye examinations.

    “Of 1514 SEARCH participants, 95% reported having undergone BP checks and 88% reported lipid-level checks, whereas slightly more than two thirds (68%) reported having had HbA1c testing or eye examinations (66%).10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

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  • May combine two claims.

    Findingcitation

    In FHS/NHLBI follow-up of 9845 men and women examined from 1978 to 1994, the 4-year incidence of hypertension at ages 35 to 64 was 5.3% for baseline BP below 120/80 mm Hg, 17.6% for SBP 120-129 or DBP 80-84 mm Hg, and 37.3% for SBP 130-139 or DBP 85-89 mm Hg.

    “Follow-up of 9845 men and women in the FHS/NHLBI who attended examinations from 1978 to 1994 revealed that at 35 to 64 years of age, the 4-year incidence of hypertension was 5.3% for those with baseline BP <120/80 mm Hg, 17.6% for those with SBP of 120 to 129 mm Hg or DBP of 80 to 84 mm Hg, and 37.3% for those with SBP of 130 to 139 mm Hg or DBP of 85 to 89 mm Hg.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [51] source

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

    Findingcitation

    Each year, approximately 15,000 people younger than 20 years are diagnosed with type 1 diabetes mellitus.

    “Each year, ≈15 000 people <20 years of age are diagnosed with type 1 DM.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Findingcitation

    The association between prehypertension and stroke risk was particularly noted in nonelderly persons and in those with blood pressure values in the higher prehypertension range.

    “The risk was particularly noted in nonelderly persons and for those with BP values in the higher prehypertension range.54”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] source

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

    Findingcitation

    Projections indicate that by 2030 the total cost of high blood pressure will increase to an estimated $343 billion.

    “Projections show that by 2030, total cost of HBP will increase to an estimated $343 billion (unpublished AHA computation, based on methodology described in Heidenreich et al7).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Heidenreich et al7

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

    Findingcitation

    Men aged 20 years or older have a slightly higher prevalence of diabetes mellitus (11.8%) than women (10.8%).

    “Men ≥20 years of age have a slightly higher prevalence of DM (11.8%) than women (10.8%).6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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  • May combine two claims.

    Findingcitation

    In SEARCH, the prevalence of diabetes mellitus in US youths younger than 20 years in 2001 was 1.82 cases per 1000 youths, with 0.79 per 1000 among youths aged 0-9 and 2.80 per 1000 among those aged 10-19.

    “In SEARCH, the prevalence of DM in youths <20 years of age in 2001 in the United States was 1.82 cases per 1000 youths (0.79 per 1000 among youths 0–9 years of age and 2.80 per 1000 among youths 10–19 years of age).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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  • May combine two claims.

    Findingcitation

    Among respondents told they had high blood pressure, 70.9% changed eating habits, 79.5% reduced or stopped salt use, 79.2% reduced or eliminated alcohol, 68.8% exercised, and 73.4% took antihypertensive medication.

    “Of these, 70.9% reported changing their eating habits; 79.5% reduced the use of or were not using salt; 79.2% reduced the use of or eliminated alcohol; 68.8% were exercising; and 73.4% were taking antihypertensive medication.45”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45]

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

    Findingreasoning

    This translates to 154,369 youths with physician-diagnosed diabetes mellitus in the United States in 2001, an overall prevalence estimate of about 0.18% in children and adolescents.

    “This translates to 154 369 youths with physician-diagnosed DM in 2001 in the United States, for an overall prevalence estimate for DM in children and adolescents of ≈0.18%.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • May combine two claims.

    Findingcitation

    Compared with non-Hispanic white adults, the risk of diagnosed diabetes was 18% higher among Asian Americans, 66% higher among Hispanics/Latinos, and 77% higher among non-Hispanic blacks.

    “Compared with non-Hispanic white adults, the risk of diagnosed DM was 18% higher among Asian Americans, 66% higher among Hispanics/Latinos, and 77% higher among non-Hispanic blacks.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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

    Findingcitation

    Approximately 186,000 people younger than 20 years have diabetes mellitus.

    “Approximately 186 000 people <20 years of age have DM.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

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

    Findingcitation

    Type 2 diabetes accounts for 90% to 95% of all diagnosed cases of diabetes in adults.

    “Type 2 DM accounts for 90% to 95% of all diagnosed cases of DM in adults.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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  • May combine two claims.

    Findingcitation

    Among youths with type 2 diabetes, 10.4% are overweight and 79.4% are obese.

    “Among youths with type 2 DM, 10.4% are overweight and 79.4% are obese.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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

    Findingcitation

    The estimated direct and indirect cost of high blood pressure for 2009 was $51.0 billion.

    “The estimated direct and indirect cost of HBP for 2009 is $51.0 billion (MEPS, NHLBI tabulation).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In the TODAY trial, only half of the children maintained durable glycemic control with monotherapy, a higher rate of treatment failure than observed in adult cohorts.

    “The results of the clinical trial demonstrated that only half of the children maintained durable glycemic control with monotherapy,9 a higher rate of treatment failure than observed in adult cohorts.”
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    • cites [9]

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    Findingcitation

    Within the black community, rates of hypertension vary substantially; those with the highest rates are more likely to be middle-aged or older, less educated, overweight or obese, physically inactive, and to have diabetes.

    “Within the black community, rates of hypertension vary substantially.18,19Those with the highest rates are more likely to be middle-aged or older, less educated, overweight or obese, and physically inactive and are more likely to have DM.”
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    • cites [18]

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    • cites [19]

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    Findingcitation

    During 2002 to 2005, 3600 youth younger than 20 years were diagnosed with type 2 diabetes mellitus annually.

    “During the period from 2002 to 2005, 3600 youth (age <20 years) were diagnosed with type 2 DM annually.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

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    Findingcitation

    In a collaborative meta-analysis of 820,900 individuals from 97 prospective studies, diabetes was associated with all-cause mortality (HR 1.80; 95% CI 1.71-1.90), cancer death (HR 1.25; 95% CI 1.19-1.31), and vascular death (HR 2.32; 95% CI 2.11-2.56).

    “In a collaborative meta-analysis of 820 900 individuals from 97 prospective studies, DM was associated with the following risks: all-cause mortality, HR 1.80 (95% CI, 1.71–1.90); cancer death, HR 1.25 (95% CI, 1.19–1.31); and vascular death, HR 2.32 (95% CI, 2.11–2.56).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

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    Findingcitation

    According to NHIS 1997-2006, the rate of cardiovascular disease death among adults with diabetes decreased by 40% (95% CI 23%-54%) and all-cause mortality decreased by 23% (95% CI 10%-35%); compared with adults without diabetes, the CVD mortality rate decreased by 60% and the all-cause mortality rate decreased by 44%.

    “According to NHIS data from 1997 to 2006, the rate of CVD death among adults with DM decreased by 40% (95% CI, 23%–54%). Similarly, all-cause mortality decreased by 23% (95% CI, 10%–35%). Compared with adults without DM, the CVD mortality rate decreased by 60% and the allcause mortality rate decreased by 44%.29”
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    • cites [29]

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  • May combine two claims.

    Findingcitation

    Age-adjusted CVD prevalence was higher among men than women, among whites than blacks, and among non-Hispanics than Hispanics.

    “Age-adjusted CVD prevalence was higher among men than women, among whites than blacks, and among non-Hispanics than Hispanics.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33]

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  • May combine two claims.

    Findingcitation

    During 1979 to 2004, diabetes death rates for black youths aged 1 to 19 were approximately twice those for white youths; during 2003 to 2004, the annual average diabetes death rate per 1 million youths was 2.46 for black youths and 0.91 for white youths.

    “During 1979 to 2004, DM death rates for black youths 1 to 19 years of age were approximately twice those for white youths. During 2003 to 2004, the annual average DM death rate per 1 million youths was 2.46 for black youths and 0.91 for white youths.27”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27]

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    Findingcitation

    Among women, age-adjusted prevalence of self-reported CVD decreased by 11.2%; among men it did not decrease significantly; among blacks it decreased by 25.3%; among whites no significant decrease occurred; among non-Hispanics the rate decreased by 12%; no clear trends were detected among Hispanics.

    “Among women, the age-adjusted prevalence decreased by 11.2%; among men, it did not decrease significantly. Among blacks, the age-adjusted prevalence of self-reported CVD decreased by 25.3%; among whites, no significant decrease occurred; among non-Hispanics, the rate decreased by 12%. No clear trends were detected among Hispanics.”
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    • cites [33]

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

    Findingcitation

    International survey and epidemiologic data from 2.7 million participants show that adult diabetes prevalence increased from 8.3% in men and 7.5% in women in 1980 to 9.8% in men and 9.2% in women in 2008; the number affected increased from 153 million in 1980 to 347 million in 2008.

    “According to international survey and epidemiologic data from 2.7 million participants, the prevalence of DM in adults increased from 8.3% in men and 7.5% in women in 1980 to 9.8% in men and 9.2% in women in 2008. The number of individuals affected with DM increased from 153 million in 1980 to 347 million in 2008.18”
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    • cites [18]

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    Findingown data

    NHANES/NCHS 2005-2008 data indicated a diabetes prevalence of 8.2% among people aged 20 years or older; of an estimated 18.3 million adults with diabetes, 73.3% were told they had diabetes or were undergoing treatment and 26.7% (5.7 million) were unaware; of 7.9 million treated (37.3% of the diabetic population), one third (2.6 million) had diabetes under control and 25.0% (5.3 million) were being

    “Analysis of NHANES/NCHS data collected during 2005–2008 indicated that the prevalence of DM was 8.2% among people ≥20 years of age. Prevalence of DM was defined as people who were told by a physician or other health professional that they have DM. Of the estimated 18.3 million adults with DM, 73.3% were told they had DM or were undergoing treatment, and 26.7% (5.7 million) were unaware of the”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Of 2291 individuals younger than 20 years with newly diagnosed diabetes, 54.5% had autoimmune insulin-sensitive diabetes and 15.9% had nonautoimmune insulin-resistant diabetes.

    “Of 2291 individuals <20 years of age with newly diagnosed DM, slightly more than half (54.5%) had autoimmune, insulin-sensitive DM, and 15.9% had nonautoimmune, insulin-resistant DM.19”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19]

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    Findingcitation

    Over 5 years of follow-up in 45- to 84-year-olds in MESA, 8.2% of the cohort developed diabetes; cumulative incidence was highest in Hispanics (11.3%), followed by black (9.5%), Chinese (7.7%), and white (6.3%) participants.

    “Over 5 years of follow-up in 45- to 84-year-olds in MESA, 8.2% of the cohort developed DM. The cumulative incidence was highest in Hispanics (11.3%), followed by black (9.5%), Chinese (7.7%), and white (6.3%) participants.21”
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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Gestational diabetes complicates 2% to 10% of pregnancies and increases the risk of developing type 2 diabetes by 35% to 60%.

    “Gestational diabetes complicates 2% to 10% of pregnancies and increases the risk of developing type 2 DM by 35% to 60%.3”
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    • cites [3]

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    Findingcitation

    FHS data indicate a doubling in the incidence of diabetes over the past 30 years, most dramatically during the 1990s; among adults aged 40 to 55 in the 1970s, 1980s, and 1990s, age-adjusted 8-year incidence rates were 2.0%, 3.0%, and 3.7% among women and 2.7%, 3.6%, and 5.8% among men, respectively.

    “Data from the FHS indicate a doubling in the incidence of DM over the past 30 years, most dramatically during the 1990s. Among adults 40 to 55 years of age in each decade of the 1970s, 1980s, and 1990s, the age-adjusted 8-year incidence rates of DM were 2.0%, 3.0%, and 3.7% among women and 2.7%, 3.6%, and 5.8% among men, respectively.”
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    Findingcitation

    FHS/NHLBI data show that diabetes significantly increased the risk of developing cardiovascular disease (HR 2.5 for women and 2.4 for men) and of dying when cardiovascular disease was present (HR 2.2 for women and 1.7 for men); diabetic men and women aged 50 or older lived an average of 7.5 and 8.2 years less than their nondiabetic equivalents, with differences in life expectancy free of CVD of 7.

    “FHS/NHLBI data show that having DM significantly increased the risk of developing CVD (HR 2.5 for women and 2.4 for men) and of dying when CVD was present (HR 2.2 for women and 1.7 for men). Diabetic men and women ≥50 years of age lived an average of 7.5 and 8.2 years less than their nondiabetic equivalents. The differences in life expectancy free of CVD were 7.8 and 8.4 years, respectively.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25]

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  • May combine two claims.

    Findingcitation

    Although the prevalence of diagnosed diabetes increased significantly over the past decade, the prevalence of undiagnosed diabetes and impaired fasting glucose remained relatively stable, and minority groups remain disproportionately affected.

    “Although the prevalence of diagnosed DM has increased significantly over the past decade, the prevalence of undiagnosed DM and impaired fasting glucose has remained relatively stable. Minority groups remain disproportionately affected.31”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31]

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  • May combine two claims.

    Findingcitation

    Although there was a 50% reduction in the rate of incident CVD events among adults with diabetes, the absolute risk of CVD remained 2-fold greater than among people without diabetes.

    “Thus, although there was a 50% reduction in the rate of incident CVD events among adults with DM, the absolute risk of CVD remained 2-fold greater than among people without DM.34”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34]

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    Findingcitation

    Among children younger than 10 years, most had type 1 diabetes regardless of race/ethnicity; the highest rates of incident type 1 diabetes were observed in non-Hispanic white youths (18.6, 28.1, and 32.9 per 100,000 person-years for ages 0-4, 5-9, and 10-14, respectively).

    “Among children <10 years of age, most had type 1 DM, regardless of race/ethnicity. The highest rates of incident type 1 DM were observed in non-Hispanic white youths (18.6, 28.1, and 32.9 per 100 000 person-years for age groups of 0–4, 5–9, and 10–14 years, respectively).”
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    Findingcitation

    FHS data over a 30-year period show that CVD among women with diabetes was 54.8% among normal-weight women but 78.8% among obese women; among normal-weight men with diabetes, the lifetime risk of CVD was 78.6%, whereas it was 86.9% among obese men.

    “Other data from FHS show that over a 30-year period, CVD among women with DM was 54.8% among normal-weight women but 78.8% among obese women. Among normal-weight men with DM, the lifetime risk of CVD was 78.6%, whereas it was 86.9% among obese men.36”
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    • cites [36] source

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    Findingcitation

    Compared with the 1970s, the age- and sex-adjusted odds ratio for diabetes was 1.40 in the 1980s and 2.05 in the 1990s (P for trend = 0.0006).

    “Compared with the 1970s, the age-and sex-adjusted OR for DM was 1.40 in the 1980s and 2.05 in the 1990s (P for trend=0.0006).”
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    • cites [20]

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    Findingcitation

    Worldwide diabetes prevalence for all age groups was estimated at 2.8% in 2000 and is projected to be 4.4% in 2030; the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030.

    “The prevalence of DM for all age groups worldwide was estimated to be 2.8% in 2000 and is projected to be 4.4% in 2030. The total number of people with DM is projected to rise from 171 million in 2000 to 366 million in 2030.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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    Findingcitation

    Overall, type 2 diabetes was relatively infrequent, with the highest rates (17.0-49.4 per 100,000 person-years) seen among 15- to 19-year-old minority groups.

    “Overall, type 2 DM was relatively infrequent, with the highest rates (17.0–49.4 per 100 000 person-years) seen among 15- to 19-year-old minority groups.4”
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    Findingcitation

    Diabetes mortality in 2009 was 68,705, and any-mention mortality in 2009 was 230,642.

    “DM mortality in 2009 was 68 705. Any-mention mortality in 2009 was 230 642.23”
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    • cites [23]

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    Findingcitation

    The 2009 overall underlying-cause death rate attributable to diabetes was 20.9 per 100,000; rates were 23.3 for white males, 44.2 for black males, 15.7 for white females, and 35.9 for black females.

    “The 2009 overall underlying-cause death rate attributable to DM was 20.9. Death rates per 100 000 people were 23.3 for white males, 44.2 for black males, 15.7 for white females, and 35.9 for black females.23”
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  • May combine two claims.

    Findingcitation

    Analysis of FHS data from 1950 to 2005 found reductions in all-cause and cardiovascular disease mortality among men and women with and without diabetes; however, all-cause and CVD mortality rates among individuals with diabetes remain about 2-fold higher than for individuals without diabetes.

    “Analysis of data from the FHS from 1950 to 2005 found reductions in all-cause and CVD mortality among men and women with and without DM. However, all-cause and CVD mortality rates among individuals with DM remain ≈2-fold higher than for individuals without DM.28”
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  • May combine two claims.

    Findingcitation

    Based on NCHS/NHIS 1997-2005 data, the estimated number of people aged 35 years or older with diabetes and a self-reported cardiovascular condition increased 36%, from 4.2 million in 1997 to 5.7 million in 2005; however, the age-adjusted prevalence of self-reported CVD conditions among people with diagnosed diabetes aged 35 or older decreased 11.2%, from 36.6% to 32.5%.

    “On the basis of data from the NCHS/NHIS, 1997–200533The estimated number of people ≥35 years of age with DM with a self-reported cardiovascular condition increased 36%, from 4.2 million in 1997 to 5.7 million in 2005; however, the age-adjusted prevalence of self-reported CVD conditions among people with diagnosed DM who were ≥35 years of age decreased 11.2%, from 36.6% in 1997 to 32.5% in 2005.”
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    Findingcitation

    At least 68% of people older than 65 years with diabetes die of some form of heart disease, and 16% die of stroke; heart disease death rates among adults with diabetes are 2 to 4 times higher than among adults without diabetes.

    “At least 68% of people >65 years of age with DM die of some form of HD; 16% die of stroke.HD death rates among adults with DM are 2 to 4 times higher than the rates for adults without DM.3”
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    Findingcitation

    The age- and sex-adjusted hazard ratio for diabetes as a CVD risk factor was 3.0 in the earlier time period and 2.5 in the later time period.

    “The age- and sex-adjusted HR for DM as a CVD risk factor was 3.0 in the earlier time period and 2.5 in the later time period.”
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    Findingcitation

    A total of 1.9 million new cases of diabetes (type 1 or type 2) were diagnosed in US adults aged 20 years or older in 2010.

    “A total of 1.9 million new cases of DM (type 1 or type 2) were diagnosed in US adults ≥20 years of age in 2010.3”
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    Findingcitation

    Diabetes prevalence is projected to increase by 99% among non-Hispanic whites, 107% among non-Hispanic blacks, and 127% among Hispanics.

    “DM prevalence is projected to increase by 99% among non-Hispanic whites, by 107% among non-Hispanic blacks, and by 127% among Hispanics.”
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    • cites [15] source

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    Findingcitation

    Increasing duration of diabetes diagnosis is associated with increasing cardiovascular disease risk; FHS longitudinal data suggest that the risk factor-adjusted relative risk of coronary heart disease is 1.38 (95% CI 0.99-1.92) times higher and the risk for CHD death is 1.86 (95% CI 1.17-2.93) times higher for each 10-year increase in diabetes duration.

    “Although the exact date of DM onset can be difficult to determine, increasing duration of DM diagnosis is associated with increasing CVD risk. Longitudinal data from FHS suggest that the risk factor–adjusted RR of CHD is 1.38 (95% CI, 0.99–1.92) times higher and the risk for CHD death is 1.86 (95% CI, 1.17–2.93) times higher for each 10-year increase in duration of DM.32”
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    Findingcitation

    Analysis of NHANES 1971-2000 found that men with diabetes experienced a 43% relative reduction in age-adjusted mortality rate, similar to nondiabetic men; among women with diabetes, mortality rates did not decrease, and the difference in mortality rates between diabetic and nondiabetic women doubled.

    “Analysis of data from NHANES 1971–2000 found that men with DM experienced a 43% relative reduction in the age-adjusted mortality rate, which was similar to that of nondiabetic men. Among women with DM, however, mortality rates did not decrease, and the difference in mortality rates between diabetic and nondiabetic women doubled.26”
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    Findingcitation

    Increases are projected to be largest for the oldest age groups, with a 220% increase among those aged 65-74 and a 449% increase among those aged 75 or older.

    “Increases are projected to be largest for the oldest age groups (for instance, projected to increase by 220% among those 65–74 years of age and by 449% among those ≥75 years of age).”
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    Findingcitation

    Nationwide Inpatient Sample data from 1993 to 2004 for individuals aged 0 to 29 with a diabetes diagnosis showed that hospitalization rates increased by 38%; rates were higher for females (42%) than males (29%), and inflation-adjusted total charges for diabetes hospitalizations increased 130%, from $1.05 billion in 1993 to $2.42 billion in 2004.

    “Nationwide Inpatient Sample data from 1993 to 2004 were analyzed for individuals 0 to 29 years of age with a diagnosis of DM. Rates of hospitalizations increased by 38%. Hospitalization rates were higher for females (42%) than for males (29%). Inflation-adjusted total charges for DM hospitalizations increased 130%, from $1.05 billion in 1993 to $2.42 billion in 2004.56”
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    Findingcitation

    Diabetes accounted for 44% of new cases of end-stage renal disease in 2007; according to US Renal Data System and BRFSS data from 1996 to 2007, the incidence rate of ESRD attributed to diabetes decreased from 304.5 per 100,000 to 199.1 per 100,000.

    “DM accounted for 44% of the new cases of end-stage renal disease (ESRD) in 2007. According to data from the US Renal Data System and BRFSS from 1996 to 2007, the incidence rate of ESRD attributed to DM decreased from 304.5 per 100 000 to 199.1 per 100 000.43”
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    Findingcitation

    In North America, diverse data show lower rates of CVD among diabetic people, but as diabetes prevalence increased, the absolute burden of CVD increased, especially among middle-aged and older individuals.

    “In North America, diverse data show lower rates of CVD among diabetic people, but as the prevalence of DM has increased, so has the absolute burden of CVD, especially among middle-aged and older individuals.42”
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    Findingcitation

    Analysis of CHS data found that lifestyle risk factors including physical activity level, dietary habits, smoking habits, alcohol use, and adiposity measures, assessed late in life, were each independently associated with risk of new-onset diabetes; participants whose physical activity and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes,

    “Analysis of data from the CHS of the NHLBI found that lifestyle risk factors, including PA level, dietary habits, smoking habits, alcohol use, and adiposity measures, assessed late in life, were each independently associated with risk of new-onset DM. Participants whose PA level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of DM than all other”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [54] source

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  • May combine two claims.

    Findingcitation

    Diabetes is associated with increased ischemic stroke incidence at all ages, with the incremental risk most prominent before 55 years of age in blacks and before 65 years of age in whites.

    “DM is associated with increased ischemic stroke incidence at all ages, with the incremental risk associated with DM being most prominent before 55 years of age in blacks and before 65 years of age in whites.37”
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    • cites [37]

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    Findingcitation

    In the same data set, the transition to a high-risk category occurred at a younger age for men and women with diabetes than for those without diabetes (mean difference 14.6 years); for the outcome of AMI, stroke, or death from any cause, diabetic men and women entered the high-risk category at 47.9 and 54.3 years of age, respectively.

    “In the same data set, the transition to a high-risk category (an event rate equivalent to a 10-year risk of 20% or an event rate equivalent to that associated with previous MI) occurred at a younger age for men and women with DM than for those without DM (mean difference 14.6 years). For the outcome of AMI, stroke, or death resulting from any cause, diabetic men and women entered the high-risk”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [42]

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    Findingcitation

    Diabetic patients experienced reductions in case fatality rates related to acute myocardial infarction and stroke similar to those without diabetes (−44.1% vs −33.2%, P=0.1; −17.1% vs −16.6%, P=0.9) and similarly comparable decreases in all-cause mortality.

    “Diabetic patients experienced reductions in case fatality rates related to AMI and stroke similar to those without DM (−44.1% versus −33.2%, P=0.1; −17.1% versus −16.6%, P=0.9, respectively) and similarly comparable decreases in all-cause mortality.”
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    • cites [41]

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  • May combine two claims.

    Findingcitation

    Ischemic stroke patients with diabetes are younger, more likely to be black, and more likely to have hypertension, prior myocardial infarction, and high cholesterol than nondiabetic patients.

    “Ischemic stroke patients with DM are younger, more likely to be black, and more likely to have hypertension, prior MI, and high cholesterol than nondiabetic patients.37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37]

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  • May combine two claims.

    Findingcitation

    During this decade, all-cause and cause-specific mortality rates declined, although not for patients with diabetes; rates increased 61% and 52% for diabetic men and women, respectively, as did hospitalization rates for diabetes and its complications.

    “During this decade, all-cause and cause-specific mortality rates declined, although not for patients with DM; rates increased 61% and 52% for diabetic men and women, respectively, as did hospitalization rates for DM and its complications.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40]

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  • May combine two claims.

    Findingcitation

    Risk factors for hypoglycemia included older age, diabetes duration, worse renal function, lower BMI, lower cognitive function, multiple glucose-lowering medications, and randomization to the intensive glucose control arm.

    “Risk factors for hypoglycemia included older age, DM duration, worse renal function, lower BMI, lower cognitive function, multiple glucose-lowering medications, and randomization to the intensive glucose control arm.58”
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    • cites [58] source

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  • May combine two claims.

    Findingcitation

    In multivariable models controlling for age, sex, income, education, insurance, and residence location, blacks were 38% less likely and Hispanics 33% less likely than their respective comparison groups to receive all recommended risk factor interventions in 2001.

    “In multivariable models that controlled for age, sex, income, education, insurance, and residence location, blacks were 38% less likely and Hispanics were 33% less likely than their respective comparison groups to receive all recommended risk factor interventions in 2001.51”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] source

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  • May combine two claims.

    Findingcitation

    Diabetes, especially type 2 diabetes, is associated with clustered risk factors for coronary heart disease, with prevalence of 75% to 85% for hypertension among adults with diabetes, 70% to 80% for elevated LDL, and 60% to 70% for obesity.

    “DM, especially type 2 DM, is associated with clustered risk factors for CHD, with a prevalence of 75% to 85% for hypertension among adults with DM, 70% to 80% for elevated LDL, and 60% to 70% for obesity.47”
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  • May combine two claims.

    Findingcitation

    The 2004 National Healthcare Disparities Report found that only about one third of adults with diabetes received all 5 interventions to reduce risk factors recommended for comprehensive diabetes care in 2001; the proportion receiving all 5 was lower among blacks than whites and among Hispanics than non-Hispanic whites.

    “Data from the 2004 National Healthcare Disparities Report (Agency for Healthcare Research and Quality, US Department of Health and Human Services) found that only approximately one third of adults with DM received all 5 interventions to reduce risk factors recommended for comprehensive DM care in 2001. The proportion receiving all 5 interventions was lower among blacks than whites and among Hispan”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] source

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  • May combine two claims.

    Findingcitation

    Between NHANES III (1984-1992) and NHANES 1999-2004, the proportion of patients with diabetes whose blood pressure was treated increased from 76.5% to 87.8%, and the proportion whose blood pressure was controlled nearly doubled, from 15.9% to 29.6%.

    “Between NHANES III (1984–1992) and NHANES 1999–2004, the proportion of patients with DM whose BP was treated increased from 76.5% to 87.8%, and the proportion whose BP was controlled nearly doubled (15.9% to 29.6%).48”
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    • cites [48]

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  • May combine two claims.

    Findingcitation

    Over the same period, the number of diabetes cases increased by 165%, translating to a marked increase in the proportion of CVD events occurring among patients with diabetes: AMI 44.6%, stroke 26.1%, AMI deaths 17.2%, and stroke deaths 13.2%.

    “Over the same period, the number of DM cases increased by 165%, which translates to a marked increase in the proportion of CVD events occurring among patients with DM: AMI, 44.6%; stroke, 26.1%; AMI deaths, 17.2%; and stroke deaths, 13.2%.41”
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    • cites [41]

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

    Findingcitation

    In a subgroup analysis of 62,036 patients with diabetes enrolled in randomized clinical trials of acute coronary syndrome therapies, 17.1% had diabetes; modeling showed that 30-day mortality was significantly higher among patients with diabetes than without diabetes who presented with UA/NSTEMI (2.1% vs 1.1%; P≤0.001) and STEMI (8.5% vs 5.4%; P=0.001), with adjusted risks for 30-day mortality of 1

    “A subgroup analysis was conducted of patients with DM enrolled in randomized clinical trials that evaluated acute coronary syndrome (ACS) therapies. The data included 62 036 patients from Thrombolysis in Myocardial Infarction studies (46 577 with STEMI and 15 459 with unstable angina [UA]/non–ST-segment–elevation myocardial infarction [NSTEMI]). Of these, 17.1% had DM. Modeling showed that”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    CHD risk factors among patients with diabetes remain suboptimally treated, although improvements have been observed over the past decade; between 1999 and 2008, in up to 2623 adult participants with diabetes, NHANES showed improvements in achieved targets for HbA1c (37.0% to 55.2%), blood pressure (35.2% to 51.0%), and LDL cholesterol (32.5% to 52.9%).

    “CHD risk factors among patients with DM remain suboptimally treated, although improvements have been observed over the past decade. Between 1999 and 2008, in up to 2623 adult participants with DM, data from NHANES showed that improvements were observed for the achieved targets for control of HbA1c (from 37.0% to 55.2%), BP (from 35.2% to 51.0%), and LDL cholesterol (from 32.5% to 52.9%).50”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50]

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  • May combine two claims.

    Findingcitation

    In a large academic medical center, outpatients with type 2 diabetes were less likely to have cholesterol levels measured (76%) than HbA1c levels (92%) or blood pressure (99%; P<0.0001 for either comparison); the proportion receiving any drug therapy was greater for above-goal HbA1c (92%) than for above-goal systolic blood pressure (78%) or LDL cholesterol (38%; P<0.0001 for each comparison).

    “Patients were less likely to have cholesterol levels measured (76%) than HbA1c levels (92%) or BP (99%; P<0.0001 for either comparison). The proportion of patients who received any drug therapy was greater for above-goal HbA1c (92%) than for above-goal SBP (78%) or LDL cholesterol (38%; P<0.0001 for each comparison).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [52]

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  • May combine two claims.

    Findingcitation

    Data from the same academic medical center showed that CVD risk factors among women with diabetes were managed less aggressively than among men with diabetes; women were less likely than men to have HbA1c <7% (without CHD: adjusted OR 0.84, P=0.005; with CHD: 0.63, P<0.0001).

    “Data from the same academic medical center also showed that CVD risk factors among women with DM were managed less aggressively than among men with DM. Women were less likely than men to have HbA1c <7% (without CHD: adjusted OR for women versus men 0.84, P=0.005; with CHD: 0.63, P<0.0001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53]

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  • May combine two claims.

    Findingcitation

    Diabetes was also associated with significantly higher mortality 1 year after UA/NSTEMI or STEMI; by 1 year after ACS, patients with diabetes presenting with UA/NSTEMI had a risk of death that approached that of patients without diabetes presenting with STEMI (7.2% vs 8.1%).

    “DM was also associated with significantly higher mortality 1 year after UA/NSTEMI or STEMI. By 1 year after ACS, patients with DM presenting with UA/NSTEMI had a risk of death that approached that of patients without DM presenting with STEMI (7.2% versus 8.1%).39”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Although hospital days for acute myocardial infarction fell overall, for those with diabetes they increased 51%, from 34,188 to 51,566.

    “Although hospital days for AMI fell overall, for those with DM, they increased 51% (from 34 188 to 51 566).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40]

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  • May combine two claims.

    Findingcitation

    In the ADVANCE trial, 2.1% of patients had an episode of severe hypoglycemia; severe hypoglycemia was associated with increased risk of major macrovascular events (HR 2.88; 95% CI 2.01-4.12), cardiovascular death (HR 2.68; 95% CI 1.72-4.19), and all-cause death (HR 2.69; 95% CI 1.97-3.67), including nonvascular outcomes.

    “In the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial, 2.1% of patients had an episode of severe hypoglycemia. Severe hypoglycemia was associated with an increased risk of major macrovascular events (HR, 2.88; 95% CI, 2.01–4.12), cardiovascular death (HR, 2.68; 95% CI, 1.72–4.19), and all-cause death (HR, 2.69; 95% CI, 1.97–3.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] source

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  • May combine two claims.

    Findingcitation

    According to NHDS data reported by the CDC for 2009, diabetes was a listed diagnosis in about 15% of US adult hospital discharges; circulatory diseases were the most common first-listed diagnosis (26.2%; 1.4 million discharges) and diabetes the second most common (12.0%; 655,000 discharges).

    “According to NHDS data reported by the CDC in an analysis of data from 2009, DM was a listed diagnosis in ≈15% of US adult hospital discharges, among which circulatory diseases was the most common first-listed diagnosis (26.2%; 1.4 million discharges) and DM the second most common (12.0%; 655 000 discharges).57”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57]

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  • May combine two claims.

    Findingcitation

    According to NHANES data, the prevalence of diabetic kidney disease increased from 2.2% in NHANES III to 3.3% in NHANES 2005-2008; these increases were observed in direct proportion to increases in diabetes.

    “According to NHANES data, the prevalence of diabetic kidney disease has increased from 2.2% in NHANES III to 3.3% in NHANES 2005–2008. These increases were observed in direct proportion to increases in DM.44”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44]

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  • May combine two claims.

    Findingcitation

    The percentage of all acute myocardial infarctions occurring in patients with diabetes increased from 21% to 36%, and the absolute number more than doubled, from 2951 to 6048.

    “The percentage of all AMIs occurring in patients with DM increased from 21% to 36%, and the absolute number more than doubled, from 2951 to 6048.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40]

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

    Findingcitation

    According to 2004-2008 MarketScan data for type 2 diabetes consisting of 536,581 individuals, the incidence rate of hypoglycemia was 153.8 per 10,000 person-years and was highest in adults aged 18 to 34 years (218.8 per 10,000 person-years).

    “According to data from the 2004 to 2008 MarketScan database of type 2 DM, which consisted of 536 581 individuals, the incidence rate of hypoglycemia was 153.8 per 10 000 person-years and was highest in adults aged 18 to 34 years (218.8 per 10 000 person-years).59”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59]

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  • May combine two claims.

    Findingcitation

    New York City death certificate data for 1989-1991 and 1999-2001 and hospital discharge data for 1988-2002 show increases in all-cause and cause-specific mortality between 1990 and 2000, as well as in annual hospitalization rates for diabetes and its complications among patients hospitalized with acute myocardial infarction and/or diabetes.

    “New York City death certificate data for 1989 to 1991 and 1999 to 2001 and hospital discharge data for 1988 to 2002 show increases in all-cause and cause-specific mortality between 1990 and 2000, as well as in annual hospitalization rates for DM and its complications among patients hospitalized with AMI and/or DM.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40]

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  • May combine two claims.

    Findingcitation

    HbA1c levels of 6.5% or higher can be used to diagnose diabetes; in the population-based ARIC study, HbA1c ≥6.5% had a 14-year follow-up multivariable-adjusted hazard ratio of 16.5 (95% CI 14.2-19.1) for diagnosed diabetes and 1.95 (95% CI 1.53-2.48) for coronary heart disease relative to HbA1c <5.0%.

    “HbA1c levels ≥6.5% can be used to diagnose DM.45 In the population-based ARIC study, HbA1c levels ≥6.5% had a 14-year follow-up, multivariable-adjusted HR of 16.5 (95% CI, 14.2–19.1) for diagnosed DM and 1.95 (95% CI, 1.53–2.48) for CHD relative to those with HbA1c <5.0%.46”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [45]

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    • cites [46]

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

    Findingcitation

    The prevalence of CKD stages I-V in 1999-2004 was 13.1%.

    “The prevalence of CKD in 1999–2004 (stages I to V)9 is 13.1%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

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  • May combine two claims.

    Findingcitation

    In 2010, the median age of the ESRD population was 57.9 years for Native Americans, 58.1 for blacks, 59.7 for Asians, and 61.2 for whites.

    “The median age of the population with ESRD in 2010 varied across different racial/ethnic groups: 57.9 years for Native Americans, 58.1 years for blacks, 59.7 years for Asians, and 61.2 years for whites.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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

    Findingcitation

    The prevalence of stage III CKD was 7.7%.

    “The prevalence of stage III CKD (eGFR 30–59 mL·min−1·1.73 m−2) is 7.7%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

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

    Findingcitation

    More than 26 million people in the US, about 13%, have CKD, and most are undiagnosed.

    “More than 26 million people (13%) in the United States have CKD, and most are undiagnosed.8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8]

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

    Findingcitation

    The prevalence of stage I CKD was 1.8%.

    “The prevalence of stage I CKD (estimated GFR [eGFR] ≥90 mL·min−1·1.73 m−2 with kidney damage, ie, presence of albuminuria) is 1.8%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

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  • May combine two claims.

    Findingcitation

    CKD severity by eGFR and urine albumin each show strong links to progression from CKD to ESRD.

    “In addition, both the degree of CKD (ie, eGFR) and urine albumin are strongly associated with the progression from CKD to ESRD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13]

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

    Findingcitation

    The prevalence of stage II CKD was 3.2%.

    “The prevalence of stage II CKD (eGFR 60–89 mL·min−1·1.73 m−2 with kidney damage) is 3.2%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingcitation

    CKD prevalence increased from 10.0% in NHANES 1988-1994 to 13.1% in 1999-2004.

    “This represents an increase from the 10.0% prevalence estimate from NHANES 1988–1994 (NCHS).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8]

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

    Findingcitation

    The total annual cost of treating ESRD in the US was $26.8 billion in 2008, nearly 6% of the total Medicare budget.

    “The total annual cost of treating ESRD in the United States was $26.8 billion in 2008, which represents nearly 6% of the total Medicare budget.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

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

    Findingcitation

    The prevalence of stages IV and V CKD was 0.4%.

    “The prevalence of stages IV and V CKD (eGFR<29 mL·min−1·1.73 m−2) is 0.4%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

      Not checked in the free run.

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

    Findingcitation

    An additional 20 million people are at increased risk for CKD.

    “Another 20 million are at increased risk for CKD.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    For stage I CKD, prevalence was 4.2% in non-Hispanic whites, 10.2% in Mexican Americans, and 9.4% in non-Hispanic blacks.

    “This disparity was most evident for those with stage I CKD; non-Hispanic whites had a CKD prevalence of 4.2% compared with prevalences among Mexican Americans and non-Hispanic blacks of 10.2% and 9.4%, respectively.11”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

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

    Findingcitation

    On the basis of 2009 mortality data, CVD caused about 1 death per minute among females, or 401,495 deaths.

    “On the basis of 2009 mortality data, CVD caused ≈1 death per minute among females, or 401 495 deaths.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In 2009, cancer caused 567,628 deaths; chronic lower respiratory disease 137,353; accidents 118,021; and Alzheimer disease 79,003.

    “Among other causes of death in 2009, cancer caused 567 628 deaths; CLRD, 137 353; accidents, 118 021; and Alzheimer disease, 79 003.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In 2009, CVD death rates were 281.4 for white males, 387.0 for black males, 190.4 for white females, and 267.9 for black females.

    “The rates were 281.4 for white males, 387.0 for black males, 190.4 for white females, and 267.9 for black females.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In 2009, CVD death rates were 287.2 for males and 196.1 for females.

    “The 2009 CVD (I00–I99) death rates were 287.2 for males and 196.1 for females.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    The number of female CVD deaths in 2009 was approximately the same as the combined female deaths from cancer, chronic lower respiratory disease, and Alzheimer disease.

    “That represents approximately the same number of female lives that were claimed by cancer, CLRD, and Alzheimer disease combined (unpublished AHA tabulation).7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Findingcitation

    In a large national cohort, higher cystatin C values were associated with prevalent stroke, angina, and MI, and with higher BMI.

    “Data from a large national cohort found higher values of cystatin C to be associated with prevalent stroke, angina, and MI,43 as well as higher BMI.44”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [43]

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    • cites [44]

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  • May combine two claims.

    Findingcitation

    Cystatin C elevation independently predicted HF, PAD events, clinical atherosclerosis, and subclinical CVD measures in older adults.

    “Elevated cystatin C was an independent risk factor for HF,45,46 PAD events,47 clinical atherosclerosis, and subclinical measures of CVD in older adults,48”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [45]

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    • cites [46]

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    • cites [47]

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    • cites [48]

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

    Findingcitation

    CVD currently claims more lives each year than cancer and chronic lower respiratory disease combined.

    “CVD currently claims more lives each year than cancer and CLRD combined.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In every year since 1900 except 1918, CVD accounted for more deaths than any other major cause of death in the United States.

    “In every year since 1900 except 1918, CVD accounted for more deaths than any other major cause of death in the United States.8,9”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8]

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    • cites [9]

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

    Findingcitation

    In 2009, female death rates were 22.3 for breast cancer and 38.5 for lung cancer.

    “Death rates for females were 22.3 for breast cancer and 38.5 for lung cancer.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In 2009, CVD as the listed underlying cause of death accounted for 32.3% (787,931) of all 2,437,163 US deaths, about 1 in every 3 deaths.

    “Mortality data show that CVD (I00–I99, Q20–Q28) as the listed underlying cause of death (including congenital cardiovascular defects) accounted for 32.3% (787 931) of all 2 437 163 deaths in 2009, or ≈1 of every 3 deaths in the United States.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In 2009, CVD any-mentions (1,330,137 deaths) constituted 54.6% of all US deaths that year.

    “CVD any-mentions (1 330 137 deaths in 2009) constituted 54.6% of all deaths that year (NHLBI; NCHS public use data files).7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingown data

    Of those with CVD, an estimated 42.2 million are aged 60 years or older.

    “Of these, 42.2 million are estimated to be ≥60 years of age.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    The 2009 CVD death rate was 236.1 per 100,000, excluding congenital cardiovascular defects.

    “The 2009 death rate attributable to CVD (I00–I99) was 236.1 (excluding congenital cardiovascular defects) (NCHS).7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    In 2009, the leading causes of death in men aged 65 and older were heart disease, cancer, chronic lower respiratory disease, and stroke, in that order.

    “In older men, they were diseases of the heart (No. 1), cancer (No. 2), CLRD (No. 3), and stroke (No. 4).7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    On average, more than 2150 Americans die of CVD each day, about 1 death every 40 seconds.

    “On average, >2150 Americans die of CVD each day, an average of 1 death every 40 seconds.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    One in 4.5 females died of cancer, whereas 1 in 3.0 died of CVD.

    “For comparison, 1 in 4.5 females died of cancer, whereas 1 in 3.0 died of CVD (I0–I99, Q20– Q28).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    If all forms of cancer were eliminated, the estimated life expectancy gain could be 3 years.

    “If all forms of cancer were eliminated, the estimated gain could be 3 years.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

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  • May combine two claims.

    Findingcitation

    In the Framingham Heart Study, lifetime risk for all CVD at age 45 among those starting free of known disease is almost 2 in 3 for men and more than 1 in 2 for women.

    “Data from the FHS indicate that the subsequent lifetime risk for all CVD in recipients starting free of known disease is almost 2 in 3 for men and >1 in 2 for women at 45 years of age (Table 13-4).5a”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 5a

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

    Findingcitation

    One in 30 female deaths was attributable to breast cancer, whereas 1 in 6.9 was attributable to coronary heart disease.

    “One in 30 deaths of females was attributable to breast cancer, whereas 1 in 6.9 was attributable to CHD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    If all forms of major CVD were eliminated, life expectancy could rise by almost 7 years.

    “According to the NCHS, if all forms of major CVD were eliminated, life expectancy could rise by almost 7 years.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

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

    Findingcitation

    Approximately 150,000 Americans under 65 years of age died of CVD in 2009.

    “Approximately 150 000 Americans died of CVD (I00–I99) in 2009 who were <65 years of age”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingown data

    An estimated 83.6 million American adults, more than one in three, have at least one type of CVD.

    “An estimated 83.6 million American adults (>1 in 3) have 1 or more types of CVD.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    In 2009, the leading causes of death in women aged 65 and older were heart disease, cancer, stroke, and chronic lower respiratory disease, in that order.

    “In 2009, the leading causes of death in women ≥65 years of age were diseases of the heart (No. 1), cancer (No. 2), stroke (No. 3), and CLRD (No. 4).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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  • May combine two claims.

    Findingcitation

    Among American Indian men aged 45-74, CVD incidence ranges from 15 to 28 per 1000; among women it ranges from 9 to 15 per 1000.

    “Among American Indian men 45 to 74 years of age, the incidence of CVD ranges from 15 to 28 per 1000 population. Among women, it ranges from 9 to 15 per 1000.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5]

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

    Findingcitation

    34% of deaths attributed to CVD occurred before age 75.

    “34% of deaths attributed to CVD occurred before the age of 75 years,7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

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

    Findingcitation

    The probability at birth of eventually dying of major CVD is 47%, and the chance of dying of cancer is 22%.

    “According to the same study, the probability at birth of eventually dying of major CVD (I00–I78) is 47%, and the chance of dying of cancer is 22%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

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

    Findingcitation

    In 2009, breast cancer caused 40,678 deaths in females and lung cancer caused 70,389 deaths in females.

    “There were 40 678 deaths attributable to breast cancer in females in 2009; lung cancer claimed 70 389 females.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Before age 75, a higher proportion of CVD events attributable to coronary heart disease occur in men than women, while a higher proportion attributable to stroke occur in women than men.

    “Before 75 years of age, a higher proportion of CVD events attributable to CHD occur in men than in women, and a higher proportion of events attributable to stroke occur in women than in men.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4]

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  • May combine two claims.

    Findingcitation

    In NOMAS, among Hispanics (primarily Cuban and Puerto Rican) compared with whites, relative rates were 5.00 for intracranial atherosclerotic stroke, 1.71 for extracranial atherosclerotic stroke, 2.32 for lacunar stroke, and 1.42 for cardioembolic stroke.

    “Among Hispanics (primarily Cuban and Puerto Rican), compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00; of extracranial atherosclerotic stroke, 1.71; of lacunar stroke, 2.32; and of cardioembolic stroke, 1.42.23”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23]

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  • May combine two claims.

    Findingcitation

    In GCNKSS, there were no changes in incidence of ischemic stroke for blacks or of hemorrhagic strokes in blacks or whites.

    “There were no changes in incidence of ischemic stroke for blacks or of hemorrhagic strokes in blacks or whites.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

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  • May combine two claims.

    Findingcitation

    In NOMAS, among blacks compared with whites, relative rates were 5.85 for intracranial atherosclerotic stroke, 3.18 for extracranial atherosclerotic stroke, 3.09 for lacunar stroke, and 1.58 for cardioembolic stroke.

    “Among blacks, compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85; of extracranial atherosclerotic stroke, 3.18; of lacunar stroke, 3.09; and of cardioembolic stroke, 1.58.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23]

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  • May combine two claims.

    Findingcitation

    GCNKSS data show that stroke incidence in 2005 was lower for whites than in the 1990s, when incidence rates were stable.

    “In a similar fashion, data from the most recent GCNKSS show that compared with the 1990s, when incidence rates of stroke were stable, stroke incidence in 2005 was decreased for whites.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

      Not checked in the free run.

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

    Findingcitation

    In 2005, tobacco smoking and high blood pressure were estimated to be responsible for 467,000 deaths, about 1 in 5 or 6 deaths among US adults.

    “In 2005, tobacco smoking and HBP were estimated to be responsible for 467 000 deaths, accounting for ≈1 in 5 or 6 deaths among US adults.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In BASIC, crude 3-year cumulative incidence for 2000-2002 was 16.8 per 1000 in Mexican Americans and 13.6 per 1000 in non-Hispanic whites.

    “The crude 3-year cumulative incidence (2000–2002) was 16.8 per 1000 in Mexican Americans and 13.6 per 1000 in non-Hispanic whites.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In that survey, people with household income of at least $50,000 had the lowest prevalence (28.8%) and those with household income below $10,000 had the highest prevalence (52.5%).

    “People reporting household income of ≥$50 000 had the lowest prevalence (28.8%), and those reporting household income of <$10 000 had the highest prevalence (52.5%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

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  • May combine two claims.

    Findingcitation

    In that survey, prevalence of at least 2 risk factors was highest among blacks (48.7%) and American Indian/Alaska Natives (46.7%) and lowest among Asians (25.9%).

    “The prevalence of having ≥2 risk factors was highest among blacks (48.7%) and American Indian/Alaska Natives (46.7%) and lowest among Asians (25.9%);”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

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  • May combine two claims.

    Findingcitation

    Awareness of heart disease as the leading cause of death among women approximately doubled among white and Hispanic women and tripled among black women between 1997 and 2009.

    “Awareness of HD as the leading cause of death among women has approximately doubled among white and Hispanic women and tripled among black women between the first survey in 1997 and the current 2009 survey.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In that survey, adults unable to work had the highest prevalence (69.3%) of at least 2 risk factors, followed by retired people (45.1%), unemployed adults (43.4%), homemakers (34.3%), and employed people (34.0%).

    “Adults who reported being unable to work had the highest prevalence (69.3%) of ≥2 risk factors, followed by retired people (45.1%), unemployed adults (43.4%), homemakers (34.3%), and employed people (34.0%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

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

    Findingcitation

    Among an estimated 45 million people with functional disabilities in the United States, heart disease, stroke, and hypertension are among the 15 leading conditions causing those disabilities.

    “Among an estimated 45 million people with functional disabilities in the United States, HD, stroke, and hypertension are among the 15 leading conditions that caused those disabilities.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In the Framingham Heart Study, age-adjusted incidence of first stroke per 1000 person-years was 7.6 in men and 6.2 in women for 1950-1977, 6.2 and 5.8 for 1978-1989, and 5.3 and 5.1 for 1990-2004.

    “Data from 1950 to 1977, 1978 to 1989, and 1990 to 2004 showed that the age-adjusted incidence of first stroke per 1000 person-years in each of the 3 periods was 7.6, 6.2, and 5.3 in men and 6.2, 5.8, and 5.1 in women, respectively.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21]

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  • May combine two claims.

    Findingcitation

    In that survey, 42% correctly recognized CVD as the greatest cause of death for men, and 14% correctly recognized it for women.

    “When asked to identify the greatest cause of death for each sex, 42% correctly recognized CVD for men, and 14% correctly recognized CVD for women;”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

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  • May combine two claims.

    Findingcitation

    In 2009, awareness of heart disease as the leading cause of death among women was 54%, significantly higher than in 1997.

    “in 2009, awareness of HD as the leading cause of death among women was 54%, significantly higher than in 1997.12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

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  • May combine two claims.

    Findingcitation

    In BASIC, Mexican Americans had higher cumulative incidence of ischemic stroke at ages 45-59 (RR 2.04; 95% CI 1.55-2.69) and 60-74 (RR 1.58; 95% CI 1.31-1.91) but not at ages 75 or older (RR 1.12; 95% CI 0.94-1.32).

    “Specifically, Mexican Americans had a higher cumulative incidence for ischemic stroke at younger ages (45–59 years of age: RR, 2.04; 95% CI, 1.55–2.69; 60–74 years of age: RR, 1.58; 95% CI, 1.31–1.91) but not at older ages (≥75 years of age: RR, 1.12; 95% CI, 0.94– 1.32).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22]

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

    Findingcitation

    Overweight/obesity and physical inactivity were each estimated to be responsible for nearly 1 in 10 US adult deaths.

    “Overweight/obesity and physical inactivity were each estimated to be responsible for nearly 1 in 10 deaths.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In that survey, nearly 17% selected CVD as the greatest lifetime risk, making it the third most popular choice after accidents and cancer.

    “Nearly 17% selected CVD as the greatest lifetime risk, which made it the third most popular choice after accidents and cancer.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

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

    Findingcitation

    In GCNKS using 1993 and 1994 data, age-, sex-, and race-adjusted incidence rates for TIA were 0.83 per 10,000.

    “In the GCNKS, using data from 1993 and 1994, the age-, sex-, and race-adjusted incidence rates for TIA were 0.83 per 10 000.27”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27]

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

    Findingcitation

    When considered separately from other cardiovascular diseases, stroke ranks fourth among all causes of death, behind heart diseases, cancer, and chronic lower respiratory disease.

    “When considered separately from other CVDs, stroke ranks No. 4 among all causes of death, behind diseases of the heart, cancer, and CLRD (NCHS mortality data).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

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  • May combine two claims.

    Findingcitation

    Those individuals have a combined 10-year risk of stroke, myocardial infarction, or vascular death of 43%, or 4% per year.

    “Individuals who have a TIA and survive the initial high-risk period have a 10-year stroke risk of roughly 19% and a combined 10-year stroke, MI, or vascular death risk of 43% (4% per year).34”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34]

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

    Findingcitation

    Approximately 56% of stroke deaths in 2009 occurred outside the hospital.

    “Approximately 56% of stroke deaths in 2009 occurred out of the hospital (unpublished tabulation of NCHS 2009 Mortality Data Set).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    For changes in stroke death rates from 1980 to 2005, the decline was greater in men than in women, with the age-adjusted male-to-female ratio decreasing from 1.11 to 1.03.

    “There was a greater decline in stroke death rates in men than in women, with a male-to-female ratio decreasing from 1.11 to 1.03 (age adjusted).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37]

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

    Findingcitation

    The stroke death rate in 2009 was 38.9 per 100,000.

    “Stroke mortality as an underlying cause of death in 2009 was 128 824; any-mention mortality in 2009 was 215 864, and the death rate was 38.9 per 100 000.36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

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

    Findingcitation

    Stroke mortality as an underlying cause of death in 2009 was 128,824.

    “Stroke mortality as an underlying cause of death in 2009 was 128 824; any-mention mortality in 2009 was 215 864, and the death rate was 38.9 per 100 000.36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Stroke death rates declined more in men than in women and more among people aged 65 years or older than among younger people.

    “There were greater declines in stroke death rates in men than in women and among people ≥65 years of age than among younger ages.37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37]

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  • May combine two claims.

    Findingcitation

    Meta-analyses of TIA cohorts show short-term stroke risk after TIA of about 3% to 10% at 2 days and 9% to 17% at 90 days.

    “Meta-analyses of cohorts of patients with TIA have shown the short-term risk of stroke after TIA to be ≈3% to 10% at 2 days and 9% to 17% at 90 days.32,33”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [32]

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    • cites [33]

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

    Findingcitation

    Women accounted for almost 60% of US stroke deaths in 2009.

    “Women accounted for almost 60% of US stroke deaths in 2009 (AHA tabulation).36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

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  • May combine two claims.

    Findingcitation

    Predictors of stroke after TIA included age over 60 years, diabetes mellitus, focal symptoms of weakness or speech impairment, and TIA lasting more than 10 minutes.

    “Predictors of stroke included age >60 years, DM, focal symptoms of weakness or speech impairment, and TIA that lasted >10 minutes.31”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31]

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

    Findingcitation

    In 2002, death certificate data showed that the mean age at stroke death was 79.6 years.

    “In 2002, death certificate data showed that the mean age at stroke death was 79.6 years; however, males had a younger mean age at stroke death than females.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40]

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

    Findingcitation

    Stroke accounted for about 1 of every 19 deaths in the United States in 2009.

    “Stroke accounted for ≈1 of every 19 deaths in the United States in 2009.36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

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

    Findingcitation

    On average, someone in the United States dies of stroke every 4 minutes.

    “On average, every 4 minutes, someone dies of a stroke (NCHS, NHLBI).36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    TIA incidence increases with age and varies by sex and race/ethnicity.

    “Incidence of TIA increases with age and varies by sex and race/ethnicity.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [22]

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    • cites [27]

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    • cites [29]

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

    Findingcitation

    In an Italian community-based registry conducted in 2007-2009, the crude TIA incidence rate was 0.52 per 1000.

    “In a more recent Italian community-based registry conducted in 2007 to 2009, the crude TIA incidence rate was 0.52 per 1000.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29]

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

    Findingcitation

    In a nationwide survey of US adults, estimated prevalence of self-reported physician-diagnosed TIA was 2.3%, corresponding to about 5 million people.

    “In a nationwide survey of US adults, the estimated prevalence of self-reported physician-diagnosed TIA was 2.3%, which translates into ≈5 million people.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Blacks, American Indian/Alaska Natives, and Asian/Pacific Islanders had younger mean ages at stroke death than whites.

    “Blacks, American Indian/Alaska Natives, and Asian/Pacific Islanders had younger mean ages than whites, and the mean age at stroke death was also younger among Hispanics than non-Hispanics.40”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40]

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

    Findingcitation

    In Rochester, Minnesota, age- and sex-adjusted TIA incidence rates were estimated at 0.68 per 1000 for 1985 through 1989.

    “Age- and sex-adjusted incidence rates for TIA in Rochester, MN, were estimated at 0.68 per 1000 for the years 1985 through 1989.28”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28]

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

    Findingcitation

    Any-mention stroke mortality in 2009 was 215,864.

    “Stroke mortality as an underlying cause of death in 2009 was 128 824; any-mention mortality in 2009 was 215 864, and the death rate was 38.9 per 100 000.36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Anticipated declines in smoking, high cholesterol, and high blood pressure in men would be offset by substantial increases in obesity and diabetes and small changes in ideal dietary patterns or physical activity.

    “anticipated declines in prevalence of smoking, high cholesterol, and high BP (in men) would be offset by substantial increases in the prevalence of obesity and DM and small expected changes in ideal dietary patterns or PA.2”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2]

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  • May combine two claims.

    Interpretationown data

    Overall, the data demonstrate the relevance of the cardiovascular health concept to future risk factors, disease, and mortality, with a strong inverse stepwise association with all-cause, cardiovascular, and ischemic heart disease mortality.

    “Overall, these data demonstrate the relevance of the concept of cardiovascular health to risk of future risk factors, disease, and mortality, with strong inverse, stepwise association with all-cause, CVD, and ischemic HD mortality.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Small reductions in population blood pressure could result from small health behavior changes at the population level, such as increased physical activity, increased fruit and vegetable consumption, decreased sodium intake, decreased adiposity, or a combination, with resulting substantial projected decreases in cardiovascular disease rates in US adults.

    “Such small reductions in population BP could result from small health behavior changes at a population level, such as increased PA, increased fruit and vegetable consumption, decreased sodium intake, decreased adiposity, or some combination of these and other lifestyle changes, with resulting substantial projected decreases in CVD rates in US adults.9”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9]

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  • May combine two claims.

    Interpretationown data

    A reduction in population mean blood pressure of just 2 mm Hg would result in 56.1% of US adults having ideal blood pressure levels, a 26.8% relative improvement.

    “On the basis of NHANES data, a reduction in population mean BP of just 2 mm Hg would result in 56.1% of US adults having ideal levels of BP, which represents a 26.8% relative improvement in this metric (Table 2-7).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationown data

    Taken together, these data demonstrate the tremendous relevance of the AHA 2020 Impact Goals for cardiovascular health and the substantial progress needed to achieve these goals over the next decade.

    “Taken together, these data continue to demonstrate both the tremendous relevance of the AHA 2020 Impact Goals for cardiovascular health and the substantial progress that will be needed to achieve these goals over the next decade.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    In a summary of WHO data sources, the economic costs of physical inactivity were estimated to account for 1.5% to 3.0% of total direct healthcare expenditures in developed countries such as the United States.

    “In a summary of WHO data sources, the economic costs of physical inactivity were estimated to account for 1.5% to 3.0% of total direct healthcare expenditures in developed countries such as the United States.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35]

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  • May combine two claims.

    Premisecitation

    A DASH dietary pattern with low sodium reduced systolic blood pressure by 7.1 mm Hg in adults without hypertension and by 11.5 mm Hg in adults with hypertension.

    “A DASH dietary pattern with low sodium reduced SBP by 7.1 mm Hg in adults without hypertension and by 11.5 mm Hg in adults with hypertension.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] source

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  • May combine two claims.

    Premisecitation

    Compared with a baseline usual diet, DASH-type diets reduced systolic blood pressure by 8 to 10 mm Hg, diastolic blood pressure by 4 to 5 mm Hg, and LDL cholesterol by 12 to 14 mg/dL.

    “Compared with a baseline usual diet, each of the DASH-type diets, which included various percentages (27%–37%) of total fat and focused on whole foods such as fruits, vegetables, whole grains, and fish, as well as potassium and other minerals and low sodium, reduced SBP by 8 to 10 mm Hg, DBP by 4 to 5 mm Hg, and LDL cholesterol by 12 to 14 mg/dL.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [64]

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  • May combine two claims.

    Premisecitation

    The CARDIoGRAM consortium is the largest genetic study of myocardial infarction to date, comprising 22,233 MI cases and 64,762 controls, with independent validation in an additional 56,682 individuals.

    “Table 7-2 presents results from the CARDIoGRAM (Coronary ARteryDIsease Genome-wide Replication And Meta-analysis) consortium, which represents the largest genetic study of MI to date, with 22 233 MI case subjects and 64 762 control subjects and with independent validation in an additional 56 682 individuals.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

      Not checked in the free run.

    • Rests on an assumption: Genome-wide association is a robust technique for identifying associations between genotypes and phenotypes.

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

    Interpretationreasoning

    The data suggest that the mean age at which people are diagnosed with diabetes is decreasing, or that higher CVD mortality among older diabetic individuals is removing them from the ability to self-report CVD.

    “If the total number of people with DM and self-reported CVD increased over this period but proportions with self-reported CVD declined, the data suggest that the mean age at which people have been diagnosed is decreasing, or the higher CVD mortality rate among older diabetic individuals is removing them from ability to self-report CVD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33]

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

    Premisecitation

    In 2007, the total cost attributable to diabetes mellitus in the United States was $174 billion, consisting of $116 billion in direct costs and $58 billion in indirect costs.

    “In 2007, the direct ($116 billion) and indirect ($58 billion) cost attributable to DM was $174 billion.3”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3]

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    • cites [61]

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

    Premisecitation

    For youths with type 1 versus type 2 diabetes, mean annual costs were $9333 versus $5683.

    “For type 1 compared with type 2 DM, costs were $9333 versus $5683, respectively.64”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64]

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

    Premisecitation

    Hypoglycemia accounted for 0.3% of outpatient costs among individuals with type 2 diabetes.

    “and 0.3% of outpatient costs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59]

      Not checked in the free run.

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

    Premisecitation

    The estimated economic cost of undiagnosed diabetes in 2007 was $18 billion, including $11 billion in medical costs and $7 billion in indirect costs.

    “A study of data from NHANES 2003–2006, Ingenix Research Data Mart, 2003–2005 NAMCS, the 2003–2005 NHAMCS, the 2004–2005 Nationwide Inpatient Sample, and the 2003–2005 MEPS found that the estimated economic cost of undiagnosed DM in 2007 was $18 billion, including medical costs of $11 billion and indirect costs of $7 billion.62”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62]

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  • May combine two claims.

    Premisecitation

    Females with type 1 diabetes had a 13.2-fold incremental mortality risk compared with a 5.0-fold increased risk in males.

    “Females had a 13.2-fold incremental mortality risk compared with a 5.0-fold increased risk in males.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] source

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

    Premisecitation

    Among youths with type 1 diabetes, the prevalence of overweight is 22.1%.

    “Among youths with type 1 DM, the prevalence of overweight is 22.1%”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

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

    Premisecitation

    Hypoglycemia accounted for 2.7% of emergency department costs among individuals with type 2 diabetes.

    “2.7% of ED costs,”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59]

      Not checked in the free run.

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

    Premisecitation

    Type 1 diabetes constitutes 5% to 10% of diabetes in the United States.

    “Type 1 DM constitutes 5% to 10% of DM in the United States.66”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66]

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

    Premisecitation

    Among youths with type 1 diabetes, the prevalence of obesity is 12.6%.

    “and the prevalence of obesity is 12.6%.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6]

      Not checked in the free run.

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

    Premisecitation

    Among youths with diabetes, 43% of their annual cost was for prescription drugs.

    “43% of this cost was for prescription drugs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the same study, women with 1-2 components had a CVD HR of 3.39 (95% CI 1.31-8.81) and those with ≥3 had 5.95 (95% CI 2.20-16.11).

    “Among women, the HRs were 3.39 (95% CI, 1.31–8.81) for 1 or 2 components and 5.95 (95% CI, 2.20–16.11) for ≥3 components.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the Framingham Offspring Study, among all 3-component combinations, central obesity plus elevated BP plus hyperglycemia gave the highest CVD risk (HR 2.36, 95% CI 1.54-3.61) and mortality risk (HR 3.09, 95% CI 1.93-4.94).

    “Of all possible ways to have 3 metabolic syndrome components, the combination of central obesity, elevated BP, and hyperglycemia conferred the greatest risk for CVD (HR, 2.36; 95% CI, 1.54–3.61) and mortality (HR, 3.09; 95% CI, 1.93–4.94) in the Framingham Offspring Study.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25]

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  • May combine two claims.

    Premisecitation

    For 20-year CHD events in that study, AUC values were 0.68 for FRS and 0.59 for the metabolic syndrome component count.

    “For CHD events during 20 years of follow-up, the areas under the receiver-operating characteristic curves were 0.68 for the FRS and 0.59 for the number of metabolic syndrome components.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23]

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

    Premisecitation

    Despite its prevalence, the public's recognition of metabolic syndrome is limited.

    “Despite its prevalence, the public’s recognition of metabolic syndrome is limited.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that meta-analysis, CVD risk associated with metabolic syndrome was higher in women (RR 2.63) than men (RR 1.98), with P=0.09.

    “The risk of CVD tended to be higher in women (summary RR, 2.63) than in men (summary RR, 1.98; P=0.09).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the Framingham Offspring Study, men with 1-2 components had a CVD HR of 1.48 (95% CI 0.69-3.16) and those with ≥3 had 3.99 (95% CI 1.89-8.41), relative to men with no abnormal component.

    “Compared with men without an abnormal component in the Framingham Offspring Study, the HRs for CVD were 1.48 (95% CI, 0.69–3.16) for men with 1 or 2 components and 3.99 (95% CI, 1.89–8.41) for men with ≥3 components.24”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 1999 to 2004, 4.5% of white adolescents, 3.0% of black adolescents, and 7.1% of Mexican American adolescents had metabolic syndrome.

    “Furthermore, 4.5% of white adolescents, 3.0% of black adolescents, and 7.1% of Mexican American adolescents had metabolic syndrome.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In NHANES 1999-2002, the prevalence of metabolic syndrome in adolescents 12 to 19 years of age was 13.2% in boys, 5.3% in girls, 10.7% in whites, 5.2% in blacks, and 11.1% in Mexican Americans.

    “It was 13.2% in boys, 5.3% in girls, 10.7% in whites, 5.2% in blacks, and 11.1% in Mexican Americans.11”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

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

    Premisereasoning

    In 2006, this prevalence would have represented approximately 1.1 million adolescents 12 to 17 years of age with metabolic syndrome.

    “In 2006, this prevalence would have represented ≈1.1 million adolescents 12 to 17 years of age with metabolic syndrome.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The prevalence of metabolic syndrome increased from 1.2% among adolescents 12 to 13 years of age to 7.1% among those 14 to 15 years of age and was higher among boys (6.7%) than girls (2.1%).

    “It increased from 1.2% among those 12 to 13 years of age to 7.1% among those 14 to 15 years of age and was higher among boys (6.7%) than girls (2.1%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that meta-analysis, metabolic syndrome was associated with significantly increased risks (RR 1.6-2.9) for all-cause mortality, CVD mortality, MI, and stroke, and for those with metabolic syndrome without DM.

    “with significant increased risks (RRs ranging from 1.6 to 2.9) for all-cause mortality, CVD mortality, MI, and stroke, as well as for those with metabolic syndrome without DM.19”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In San Antonio Heart Study, AUC for FRS was 0.816 and for FRS plus metabolic syndrome 0.811.

    “In the San Antonio Heart Study, the area under the receiver-operating characteristic curve was 0.816 for the FRS and 0.811 for the FRS plus the metabolic syndrome. 21”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21]

      Not checked in the free run.

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

    Premisecitation

    On the basis of NHANES 1999-2002 data, the prevalence of metabolic syndrome in adolescents 12 to 19 years of age was 9.4%, representing approximately 2.9 million people.

    “On the basis of NHANES 1999–2002 data, the prevalence of metabolic syndrome in adolescents 12 to 19 years of age was 9.4%, which represents ≈2.9 million people.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

      Not checked in the free run.

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

    Premisecitation

    In 2010, 16,843 kidney transplants were performed.

    “16843 kidney transplants were performed.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In INTERHEART, the MI population attributable risk for metabolic syndrome was 14.5% (95% CI 12.7-16.3) by WHO and 16.8% (95% CI 14.8-18.8) by IDF.

    “with a PAR of 14.5% (95% CI, 12.7%–16.3%) and 16.8% (95% CI, 14.8%–18.8%), respectively”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In INTERHEART, metabolic syndrome was linked to higher MI risk under the WHO definition (OR 2.69, 95% CI 2.45-2.95) and the IDF definition (OR 2.20, 95% CI 2.03-2.38).

    “In the INTERHEART case-control study of 26 903 subjects from 52 countries, metabolic syndrome was associated with an increased risk of MI, both according to the WHO (OR, 2.69; 95% CI, 2.45–2.95) and International Diabetes Federation (OR, 2.20; 95% CI, 2.03–2.38) definitions”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29]

      Not checked in the free run.

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

    Premisecitation

    In 2010, ESRD prevalence was 593,086, and 65% of prevalent cases received hemodialysis.

    “The prevalence of ESRD was 593 086, with 65% of these prevalent cases being treated with hemodialysis.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that population, BP-related ESRD risks were higher in men than women and in black than white patients.

    “and in this same patient population, BP-associated risks were greater in men than in women and in blacks than in whites.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In ARIC, relative to the lowest leisure-time physical activity quartile, the odds of developing metabolic syndrome were 0.80 (95% CI 0.71-0.91) for the highest quartile and 0.92 (95% CI 0.81-1.04) for the middle quartile.

    “Compared with the lowest quartile of leisure-time PA, the ORs of developing metabolic syndrome were 0.80 (95% CI, 0.71–0.91) and 0.92 (95% CI, 0.81–1.04) for people in the highest and middle quartiles, respectively.85”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [85] source

      Not checked in the free run.

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

    Premisecitation

    In 2010, 114,083 new ESRD cases were reported.

    “114 083 new cases of ESRD were reported.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A broad set of factors-including age, low education, low socioeconomic status, smoking, low physical activity, low fitness, soft drinks, diet soda, magnesium, energy, carbohydrate, total fat, Western diet, meat, fried foods, heavy alcohol, alcohol abstention, parental DM, work stress, pediatric metabolic syndrome, obesity/BMI, childhood obesity, waist circumference, intraabdominal fat, weight gain

    “In prospective or retrospective cohort studies, the following factors have been reported as being directly associated with incident metabolic syndrome, defined by one of the major definitions:”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The kidneys excrete cystatin C; it is filtered at the glomerulus and almost fully reabsorbed by proximal tubular cells.

    “Cystatin C is excreted by the kidneys, filtered through the glomerulus, and nearly completely reabsorbed by proximal tubular cells.36”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

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

    Interpretationnone given

    The exact reasons CKD and ESRD increase CVD risk are not fully delineated, but they are clearly multifactorial and likely involve pathological alterations across multiple organ systems and pathways.

    “The exact reasons why CKD and ESRD increase the risk of CVD have not been completely delineated but are clearly multifactorial and likely involve pathological alterations in multiple organ systems and pathways.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Cystatin C is a small protein made steadily by all nucleated cells; age, sex, and muscle mass appear not to affect it much.

    “It is a low-molecular-weight protein produced at a constant rate by all nucleated cells and appears not to be affected significantly across age, sex, and levels of muscle mass.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

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

    Interpretationcitation

    By 2030, 40.8% of the US population is projected to have some form of cardiovascular disease.

    “By 2030, 40.8% of the US population is projected to have some form of CVD (unpublished AHA computation, based on methodology described in Heidenreich et al3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Heidenreich et al3

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    TIAs confer a substantial short-term risk of stroke, hospitalization for cardiovascular events, and death.

    “TIAs confer a substantial short-term risk of stroke, hospitalization for CVD events, and death.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31]

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    More women than men die of stroke each year because there are more elderly women.

    “More women than men die of stroke each year because of the larger number of elderly women.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

418 of 418

  • The paper relies on this without support.

    Biologically related first-degree relatives share roughly 50% of their genetic variation with one another.

    “Biologically related first-degree relatives (siblings, offspring and parents) share roughly 50% of their genetic variation with one another.”

  • The paper relies on this without support.

    Racial/ethnic minorities are more likely to share their genetic variation within their demographic than with other demographics.

    “Similarly, racial/ethnic minorities are more likely to share their genetic variation within their demographic than with other demographics.”

  • The paper relies on this without support.

    Genome-wide association is a robust technique for identifying associations between genotypes and phenotypes.

    “Genome-wide association is a robust technique to identify associations between genotypes and phenotypes.”

  • The paper relies on this without support.

    CKD incidence and prevalence are rising in the US.

    “The incidence and prevalence of CKD are increasing in the United States”

  • The paper relies on this without support.

    CKD is linked to poor outcomes and high costs for the US healthcare system.

    “are associated with poor outcomes and a high cost to the US healthcare system.”

  • The paper relies on this without support.

    People with CKD are more likely to die from CVD than to progress to ESRD.

    “In fact, individuals with CKD are more likely to die of CVD than to transition to ESRD.”

  • The paper relies on this without support.

    Many traditional CVD risk factors also raise CKD risk, including older age, male sex, hypertension, diabetes, smoking, and family history of CVD.

    “Many traditional CVD risk factors are also risk factors for CKD, including older age, male sex, hypertension, DM, smoking, and family history of CVD.”
7 of 7

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?

Self-check

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

Each contradiction between two passages listed here was confirmed by an independent check.

  • Unaware diabetes count does not match the stated total

    Minor

    The stated 5.7 million unaware adults are 31.1% of the stated 18.3 million adults with diabetes, rather than 26.7%.

    Reported 26.7 · recomputed 31.147541

  • Treated hypertension control rate does not match its component rates

    Minor

    If 50.1% of people with hypertension had controlled blood pressure and 73.5% received treatment, the controlled share of those treated cannot be 72.3%; dividing the reported rates gives 68.2%.

    Reported 72.3 · recomputed 68.163265

  • Exposure prevalences are reported as percentage declines

    Minor

    The summary labels 53.6%, 46.5%, and 36.7% as declines in secondhand-smoke exposure. The smoking chapter identifies those same figures as the percentages with detectable cotinine in 2007-2008, not changes over time.

3 of 3

Cites

Flagged first, then by citations

19 of the 1311 references couldn’t be matched to a known paper.

Research works printed but not linked: 64

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  3. National Association for Sport and Physical Education. Moving Into the Future: National Standards for Physical Education. 2nd ed. Reston, VA: National Association for Sport and Physical Education; 2004.
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  11. Barnes PM, Adams PF, Powell-Griner E. Health Characteristics of the Asian Adult Population: United States, 2004–2006. Advance Data From Vital and Health Statistics; No. 394. Hyattsville, MD: National Center for Health Statistics; 2008.
  12. American Medical Association Expert Task Force on Childhood Obesity. Expert Committee recommendations on the assessment prevention and treatment of child and adolescent overweight and obesity. http://www.ama-assn.org/ama1/pub/upload/mm/433/ped_obesity_recs.pdf. Accessed September 20 2012.
  13. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2010: Key Indicators of Well-Being. Washington, DC: US Government Printing Office; 2010.
  14. Barnes PM, Adams PF, Powell-Griner E. Health Characteristics of the Asian Adult Population: United States, 2004–2006. Advance Data From Vital and Health Statistics; No. 394. Hyattsville, MD: National Center for Health Statistics; 2008.
  15. Centers for Disease Control and Prevention. National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.
  16. Barnes PM, Adams PF, Powell-Griner E. Health Characteristics of the Asian Adult Population: United States, 2004–2006. Advance Data From Vital and Health Statistics; No. 394. Hyattsville, MD: National Center for Health Statistics; 2008.
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  23. US Renal Data System.USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease.Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2012. http://www.usrds.org/atlas.aspx. Accessed November 12, 2012.
  24. Schiller J Lucas J Peregoy J. Summary health statistics for U.S. adults: National Health Interview Survey 2011. Vital Health Stat 10. In press.
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  26. Incidence and Prevalence: 2006 Chart Book on Cardiovascular and Lung Diseases. Bethesda, MD: National Heart, Lung, and Blood Institute; 2006.
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  34. Casper ML, Nwaise IA, Croft JB, Nilasena DS. Atlas of Stroke Hospitalizations among Medicare Beneficiaries. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2008.
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  42. Schiller J Lucas J Peregoy J. Summary health statistics for U.S. adults: National Health Interview Survey 2011. Vital Health Stat 10. In press.
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  59. Incidence and Prevalence: 2006 Chart Book on Cardiovascular and Lung Diseases. Bethesda, MD: National Heart, Lung, and Blood Institute; 2006.
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  62. Fowler V, Scheld W, Bayer A. Endocarditis and intravascular infections. In: , Mandell GL, Bennett JE, Dolin R, eds. Principles and Practices of Infectious Diseases. 6th ed. New York, NY: Elsevier; 2005:975–1021.
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Cited by

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Related

Authors
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., Fox, C. S., Franco, S., Fullerton, H. J., Gillespie, C., Hailpern, S. M., Heit, J. A., Howard, V. J., Huffman, M. D., Kissela, B. M., Kittner, S. J., Lackland, D. T., Lichtman, J. H., Lisabeth, L. D., Magid, D., Marcus, G. M., Marelli, A., Matchar, D. B., McGuire, D. K., Mohler, E. R., Moy, C. S., Mussolino, M. E., Nichol, G., Paynter, N. P., Schreiner, P. J., Sorlie, P. D., Stein, J., Turan, T. N., Virani, S. S., Wong, N. D., Woo, D., & Turner, M. B.
Affiliations
  • Duke Medical Center (US)
  • University of California, San Francisco (US)
  • Medical University of South Carolina (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-01
Volume
127
Issue
1
Pages
e6-e245
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/cir.0b013e31828124ad
PMC
PMC5408511
OpenAlex
W2050856345
Semantic Scholar
dc4aed5ae29ad3a1bdd76f303c0af56ee537e44a
Cited by
5,292
References
1,311
Citations by year
2026: 16 · 2025: 45 · 2024: 67 · 2023: 79 · 2022: 136 · 2021: 174 · 2020: 177 · 2019: 212 · 2018: 295 · 2017: 413 · 2016: 620 · 2015: 951 · 2014: 1367 · 2013: 688 · 2012: 24
FWCI
623.70
Type
journal article
Language
en
Update notices
correction (2013-06-11)
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
Funders
  • American Heart Association
  • National Institutes of Health (CC999999, UL1TR000077)
  • Centers for Disease Control and Prevention
  • National Heart, Lung, and Blood Institute
  • National Institute of Neurological Disorders and Stroke
  • National Center for Advancing Translational Sciences
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, cardiovascular risk factors, cardiovascular health behaviors, cardiovascular morbidity and mortality, cardiovascular disease costs, cardiovascular monitoring, vascular disease
MeSH terms
American Heart Association, Heart Diseases, Humans, Risk Factors, United States, 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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

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.

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