Key News in Family Medicine January 31, 2019 (5 of 6)

In the United States, nearly half (48%, 121.5 million in 2016) of adults have some form of cardiovascular disease (CVD), according to the report Heart and Stroke Statistics 2019 Update of the American Heart Association, published in the journal of the Association. circulation.

As the leading global volunteer organization focused on heart and brain health, the American Heart Association publishes the final statistical update annually to provide a comprehensive resource of the latest data, relevant scientific findings and evaluation. the impact of CVM at national and global levels. The annual update represents a compilation of the latest and most relevant statistics on risk factors for cardiovascular disease, stroke and cardiovascular disease affecting cardiovascular health. It has been convened in collaboration with the National Institutes of Health and other government agencies.

Cardiovascular disease remains the leading cause of death in the world. After decades of steady decline in the United States, the number of deaths from CVD is on the rise (840,678 deaths in 2016 compared to 836,546 in 2015), although worldwide the number of people dying from CVD was less than 2016 (17.6 million) compared to the previous one. year ($ 17.9 million).

The reported prevalence of this year's CVD is a significant increase over previous years, mainly because of the definition of high blood pressure. The 2017 hypertension guidelines from the American Heart Association and the American College of Cardiology have updated the definition of high blood pressure to 130/80 mm Hg, to from the previous definition of 140/90 mm Hg.

Overall, cardiovascular diseases include coronary heart disease, heart failure, stroke and hypertension. Excluding high blood pressure, the prevalence of CVD in adults in the United States is 9% (compared to 24.3 million in 2016).

"As one of the most common and most dangerous risk factors for heart disease and stroke, this overwhelming presence of high blood pressure can not be discounted from the equation of our fight against CVD, "said Ivor J. Benjamin, MD, volunteer chair of the American Heart Association and director of the Cardiovascular Center at the Medical College of Wisconsin in Milwaukee. "Research has shown that the elimination of high blood pressure could have a greater impact on CVD deaths than the elimination of all other risk factors in women and all but the Smoking in men. "

Research shows that about 80% of cardiovascular disease can be prevented by controlling high blood pressure, diabetes and high cholesterol, while adopting healthy lifestyles, such as not smoking. Healthy behaviors such as eating healthy, exercising, and maintaining a healthy weight can have the greatest impact as they contribute to multiple problems.

Among the most significant improvements in risk reduction are lower smoking rates:

• Among children aged 12 to 19, 94% were non-smokers in 2015-2016, up almost 20 percentage points from the beginning of the millennium (they were 76% in 1999 and 2000).
• The percentage of teenagers (12-17 years) who reported smoking in the last month decreased by two-thirds in just 14 years (from 13% in 2002 to 3.4% in 2016).
• 79% of adults were non-smokers in 2015-2016, up from 73% in 1999 to 2000.
• Over the past 50 years, the number of adult smokers has dropped from 51% of male smokers in 1965 to 16.7% in 2015 and from 34% of women in 1965 to 13.6% in 2015 ( rates adjusted according to age)

More Americans get up and move:

• More than half of the students reported participating in muscle building activities three days or more per week (from 47.8% in 1991 to 53.4% ​​in 2015)
• The prevalence of physical inactivity among adults has decreased by more than a third (from 40.2% in 2005 to 26.9% in 2016).

However, exercise alone may not be enough because the prevalence of obesity was 39.6% among American adults and 18.5% among young people from 2015 to 2016, with 7.7 % of adults and 5.6% of young people with severe obesity.

A new chapter added to the statistical update examines the importance of sleep in relation to cardiovascular health and overall health. According to the update, the American Academy of Sleep Medicine and the Sleep Research Society recommend that adults sleep at least 7 hours or more per night to promote optimal health. The statistical update cites several recent studies on sleep: a report by the Centers for Disease Control and Prevention indicates that 65.2% of Americans live regularly 7 hours or more per night; and a meta-badysis of 43 studies found that too much sleep or too little sleep (more than 8 hours or less than 7 hours per night) was badociated with a higher risk of death from all causes.

Other new features in the 2019 update include more information on the impact of social determinants of health, more evidence-based approaches to behavior change, and increased attention to health outcomes. the global burden of cardiovascular disease.

In a comment posted on the website of the Centers for Health Metrics and Evaluation, Mariell Jessup, MD, Scientific and Medical Lead of the American Heart Association, explained why these annual updates are not just an interesting compilation of facts, but an important tool in the mission of the organization.

"We put a lot of effort every year into our update because we believe in the transformative power of collecting, badyzing and interpreting this important data in a continuous and systematic way," Jessup wrote. "They hold us accountable and help us plan our progress and determine if and how we need to adjust our efforts."