Executive Summary: Heart Disease and Stroke Statistics—2011 Update
2011; Lippincott Williams & Wilkins; Volume: 123; Issue: 4 Linguagem: Inglês
10.1161/cir.0b013e31820c7a50
ISSN1524-4539
AutoresVéronique L. Roger, Alan S. Go, Donald M. Lloyd‐Jones, Robert J. Adams, Jarett D. Berry, Todd M. Brown, Mercedes R. Carnethon, Shifan Dai, Giovanni de Simone, Earl S. Ford, Caroline S. Fox, Heather J. Fullerton, Cathleen Gillespie, Kurt J. Greenlund, Susan M. Hailpern, John A. Heit, P. Michael Ho, Virginia J. Howard, Brett Kissela, Steven J. Kittner, Daniel T. Lackland, Judith H. Lichtman, Lynda D. Lisabeth, Diane M. Makuc, Gregory M. Marcus, Ariane Marelli, David B. Matchar, Mary Mcdermott, James B. Meigs, Claudia S. Moy, Dariush Mozaffarian, Michael E. Mussolino, Graham Nichol, Nina P. Paynter, Wayne D. Rosamond, Paul D. Sorlie, Randall S. Stafford, Tanya N. Turan, Melanie B. Turner, Nathan D. Wong, Judith Wylie‐Rosett,
Tópico(s)Cardiovascular Function and Risk Factors
ResumoHomeCirculationVol. 123, No. 4Executive Summary: Heart Disease and Stroke Statistics—2011 Update Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessResearch ArticlePDF/EPUBExecutive Summary: Heart Disease and Stroke Statistics—2011 UpdateA Report From the American Heart Association Writing Group Members Véronique L. Roger, MD, MPH, FAHA, Alan S. Go, MD, Donald M. Lloyd-Jones, MD, ScM, FAHA, Robert J. Adams, MD, MS, FAHA, Jarett D. Berry, MD, Todd M. Brown, MD, MSPH, Mercedes R. Carnethon, PhD, FAHA, Shifan Dai, MD, PhD, Giovanni de Simone, MD, FAHA, Earl S. Ford, MD, MPH, FAHA, Caroline S. Fox, MD, MPH, Heather J. Fullerton, MD, Cathleen Gillespie, MS, Kurt J. Greenlund, PhD, Susan M. Hailpern, DPH, MS, John A. Heit, MD, FAHA, P. Michael Ho, MD, PhD, Virginia J. Howard, PhD, FAHA, Brett M. Kissela, MD, Steven J. Kittner, MD, FAHA, Daniel T. Lackland, DrPH, MSPH, FAHA, Judith H. Lichtman, PhD, MPH, Lynda D. Lisabeth, PhD, FAHA, Diane M. Makuc, DrPH, Gregory M. Marcus, MD, MAS, FAHA, Ariane Marelli, MD, David B. Matchar, MD, FAHA, Mary M. McDermott, MD, James B. Meigs, MD, MPH, Claudia S. Moy, PhD, MPH, Dariush Mozaffarian, MD, DrPH, FAHA, Michael E. Mussolino, PhD, Graham Nichol, MD, MPH, FAHA, Nina P. Paynter, PhD, MHSc, Wayne D. Rosamond, PhD, FAHA, Paul D. Sorlie, PhD, Randall S. Stafford, MD, PhD, MHS, FAHA, Tanya N. Turan, MD, FAHA, Melanie B. Turner, MPH, Nathan D. Wong, PhD, MPH, FAHA and Judith Wylie-Rosett, EdD, RD Writing Group Members , Véronique L. RogerVéronique L. Roger , Alan S. GoAlan S. Go , Donald M. Lloyd-JonesDonald M. Lloyd-Jones , Robert J. AdamsRobert J. Adams , Jarett D. BerryJarett D. Berry , Todd M. BrownTodd M. Brown , Mercedes R. CarnethonMercedes R. Carnethon , Shifan DaiShifan Dai , Giovanni de SimoneGiovanni de Simone , Earl S. FordEarl S. Ford , Caroline S. FoxCaroline S. Fox , Heather J. FullertonHeather J. Fullerton , Cathleen GillespieCathleen Gillespie , Kurt J. GreenlundKurt J. Greenlund , Susan M. HailpernSusan M. Hailpern , John A. HeitJohn A. Heit , P. Michael HoP. Michael Ho , Virginia J. HowardVirginia J. Howard , Brett M. KisselaBrett M. Kissela , Steven J. KittnerSteven J. Kittner , Daniel T. LacklandDaniel T. Lackland , Judith H. LichtmanJudith H. Lichtman , Lynda D. LisabethLynda D. Lisabeth , Diane M. MakucDiane M. Makuc , Gregory M. MarcusGregory M. Marcus , Ariane MarelliAriane Marelli , David B. MatcharDavid B. Matchar , Mary M. McDermottMary M. McDermott , James B. MeigsJames B. Meigs , Claudia S. MoyClaudia S. Moy , Dariush MozaffarianDariush Mozaffarian , Michael E. MussolinoMichael E. Mussolino , Graham NicholGraham Nichol , Nina P. PaynterNina P. Paynter , Wayne D. RosamondWayne D. Rosamond , Paul D. SorliePaul D. Sorlie , Randall S. StaffordRandall S. Stafford , Tanya N. TuranTanya N. Turan , Melanie B. TurnerMelanie B. Turner , Nathan D. WongNathan D. Wong and Judith Wylie-RosettJudith Wylie-Rosett and on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Originally published1 Feb 2011https://doi.org/10.1161/CIR.0b013e31820c7a50Circulation. 2011;123:459–463Roger Véronique L., MD, MPH, FAHATurner Melanie B., MPHand On behalf of the American Heart Association Heart Disease and Stroke Statistics Writing GroupSummaryEach 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 disease 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 more than 8700 times in the literature (including citations of all annual versions). In 2009 alone, the various Statistical Updates were cited ≈1600 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. 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 and added a new chapter detailing how family history and genetics play a role in cardiovascular disease (CVD) risk. Also, the 2011 Statistical Update is a major source for monitoring both cardiovascular health and disease in the population, with a focus on progress toward achievement of the AHA's 2020 Impact Goals. Below are a few highlights from this year's Update.Death Rates From CVD Have Declined, Yet the Burden of Disease Remains HighThe 2007 overall death rate from CVD (International Classification of Diseases 10, I00–I99) was 251.2 per 100 000. The rates were 294.0 per 100 000 for white males, 405.9 per 100 000 for black males, 205.7 per 100 000 for white females, and 286.1 per 100 000 for black females. From 1997 to 2007, the death rate from CVD declined 27.8%. Mortality data for 2007 show that CVD (I00–I99; Q20–Q28) accounted for 33.6% (813 804) of all 2 243 712 deaths in 2007, or 1 of every 2.9 deaths in the United States.On the basis of 2007 mortality rate data, more than 2200 Americans die of CVD each day, an average of 1 death every 39 seconds. More than 150 000 Americans killed by CVD (I00–I99) in 2007 were <65 years of age. In 2007, nearly 33% of deaths due to CVD occurred before the age of 75 years, which is well before the average life expectancy of 77.9 years.Coronary heart disease caused ≈1 of every 6 deaths in the United States in 2007. Coronary heart disease mortality in 2007 was 406 351. Each year, an estimated 785 000 Americans will have a new coronary attack, and ≈470 000 will have a recurrent attack. It is estimated that an additional 195 000 silent first myocardial infarctions occur each year. Approximately every 25 seconds, an American will have a coronary event, and approximately every minute, someone will die of one.Each year, ≈795 000 people experience a new or recurrent stroke. Approximately 610 000 of these are first attacks, and 185 000 are recurrent attacks. Mortality data from 2007 indicate that stroke accounted for ≈1 of every 18 deaths in the United States. On average, every 40 seconds, someone in the United States has a stroke. From 1997 to 2007, the stroke death rate fell 44.8%, and the actual number of stroke deaths declined 14.7%.In 2007, 1 in 9 death certificates (277 193 deaths) in the United States mentioned heart failure.Prevalence and Control of Traditional Risk Factors Remains an Issue for Many AmericansData from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 indicate that 33.5% of US adults ≥20 years of age have hypertension (Table 7-1). This amounts to an estimated 76 400 000 US adults with hypertension. The prevalence of hypertension is nearly equal between men and women. African American adults have among the highest rates of hypertension in the world, at 44%. Among hypertensive adults, ≈80% are aware of their condition, 71% are using antihypertensive medication, and only 48% of those aware that they have hypertension have their condition controlled.Despite 4 decades of progress, in 2008, among Americans ≥18 years of age, 23.1% of men and 18.3% of women continued to be cigarette smokers. In 2009, 19.5% of students in grades 9 through 12 reported current tobacco use. The percentage of the nonsmoking population with detectable serum cotinine (indicating exposure to secondhand smoke) was 46.4% in 1999 to 2004, with declines occurring, and was highest for those 4 to 11 years of age (60.5%) and those 12 to 19 years of age (55.4%).An estimated 33 600 000 adults ≥20 years of age have total serum cholesterol levels ≥240 mg/dL, with a prevalence of 15.0% (Table 13-1).In 2008, an estimated 18 300 000 Americans had diagnosed diabetes mellitus, representing 8.0% of the adult population. An additional 7 100 000 had undiagnosed diabetes mellitus, and 36.8% had prediabetes, with abnormal fasting glucose levels. African Americans, Mexican Americans, Hispanic/Latino individuals, and other ethnic minorities bear a strikingly disproportionate burden of diabetes mellitus in the United States (Table 16-1).The 2011 Update Expands Data Coverage of the Obesity Epidemic and Its Antecedents and ConsequencesThe estimated prevalence of overweight and obesity in US adults (≥20 years of age) is 149 300 000, which represents 67.3% of this group in 2008. Fully 33.7% of US adults are obese (body mass index ≥30 kg/m2). Men and women of all race/ethnic groups in the population are affected by the epidemic of overweight and obesity (Table 15-1).Among children 2 to 19 years of age, 31.9% are overweight and obese (which represents 23 500 000 children), and 16.3% are obese (12 000 000 children). Mexican American boys and girls and African American girls are disproportionately affected. Over the past 3 decades, the prevalence of obesity in children 6 to 11 years of age has increased from ≈4% to more than 20%.Obesity (body mass index ≥30 kg/m2) is associated with marked excess mortality in the US population. 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, degenerative joint disease, and many others.The prevalence of diabetes mellitus is increasing dramatically over time, in parallel with the increases in prevalence of overweight and obesity.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).The proportion of youth (≤18 years of age) who report engaging in no regular physical activity is high, and the proportion increases with age. In 2007, among adolescents in grades 9 through 12, 29.9% of girls and 17.0% of boys reported that they had not engaged in 60 minutes of moderate-to-vigorous physical activity, defined as any activity that increased heart rate or breathing rate, even once in the previous 7 days, despite recommendations that children engage in such activity ≥5 days per week.Thirty-six percent of adults reported engaging in no vigorous activity (activity that causes heavy sweating and a large increase in breathing or heart rate).Data from NHANES indicate that between 1971 and 2004, average total energy consumption among US adults increased by 22% in women (from 1542 to 1886 kcal/d) and by 10% in men (from 2450 to 2693 kcal/d; see Chart 19-1).The increases in calories consumed during this time period are attributable primarily to greater average carbohydrate intake, in particular, of starches, refined grains, and sugars. 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.The 2011 Update Provides Critical Data Regarding Cardiovascular Quality of Care, Procedure Utilization, and CostsIn light of the current national focus on healthcare utilization, costs, and quality, it is critical to monitor and understand the magnitude of healthcare delivery and costs, as well as the quality of healthcare delivery, related to CVDs. The Update provides these critical data in several sections.Quality-of-Care Metrics for CVDsChapter 20 reviews many metrics related to the quality of care delivered to patients with CVDs, as well as healthcare disparities. In particular, quality data are available from the AHA's "Get With The Guidelines" programs for coronary artery disease and heart failure and the American Stroke Association/ AHA's "Get With the Guidelines" program for acute stroke. Similar data from the Veterans Healthcare Administration, national Medicare and Medicaid data and National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network - "Get With The Guidelines" Registry data are also reviewed. These data show impressive adherence with guideline recommendations for many, but not all, metrics of quality of care for these hospitalized patients. Data are also reviewed on screening for cardiovascular risk factor levels and control.Cardiovascular Procedure Utilization and CostsChapter 21 provides data on trends and current usage of cardiovascular surgical and invasive procedures. For example, the total number of inpatient cardiovascular operations and procedures increased 27%, from 5 382 000 in 1997 to 6 846 000 in 2007 (National Heart, Lung, and Blood Institute computation based on National Center for Health Statistics annual data).Chapter 22 reviews current estimates of direct and indirect healthcare costs related to CVDs, stroke, and related conditions using Medical Expenditure Panel Survey data. The total direct and indirect cost of CVD and stroke in the United States for 2007 is estimated to be $286 billion. This figure includes health expenditures (direct costs, which include the cost of physicians and other professionals, hospital services, prescribed medications, home health care, and other medical durables) and lost productivity resulting from mortality (indirect costs). By comparison, in 2008, the estimated cost of all cancer and benign neoplasms was $228 billion ($93 billion in direct costs, $19 billion in morbidity indirect costs, and $116 billion in mortality indirect costs). CVD costs more than any other diagnostic group.The AHA, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current data available in the Statistics Update. The 2007 mortality data have been released. More information can be found at the National Center for Health Statistics Web site, http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_01.pdf.Finally, it must be noted that this annual Statistical Update is the product of an entire year's worth of effort by dedicated professionals, volunteer physicians and scientists, and outstanding AHA staff members, without whom publication of this valuable resource would be impossible. Their contributions are gratefully acknowledged.AcknowledgmentsWe wish to thank Thomas Thom, Jonathan Pool, Michael Wolz, and Sean Coady for their valuable comments and contributions. We would like to acknowledge Karen Modesitt for her administrative assistance.DisclosuresWriting Group DisclosuresWriting Group MemberEmploymentResearch GrantOther Research SupportSpeakers' Bureau/HonorariaExpert WitnessOwnership InterestConsultant/Advisory BoardOtherVéronique L. RogerMayo ClinicNoneNoneNoneNoneNoneNoneNoneRobert J. AdamsMedical University of South CarolinaNHLBI†NoneBoehringerIngelheim†;Genentech*NoneNoneBoehringerIngelheim†;Novartis*NoneJarett D. BerryUT Southwestern Medical SchoolAHA†; NHLBI†NoneMerck†NoneNoneNoneNoneTodd M. BrownUniversity of Alabama at BirminghamNIH†NoneNoneNoneNoneNoneNoneMercedes R. CarnethonNorthwestern UniversityNoneNoneNoneNoneNoneNoneNoneShifan DaiCenters for Disease Control and PreventionNoneNoneNoneNoneNoneNoneNoneGiovanni de SimoneFederico II University of NaplesNoneNoneNoneNoneNoneNoneNoneEarl S. FordCenters for Disease Control and PreventionNoneNoneNoneNoneNoneNoneNoneCaroline S. FoxNHLBINoneNoneNoneNoneNoneNoneNoneHeather J. FullertonUniversity of California, San FranciscoNoneNoneNoneNoneNoneNoneNoneCathleen GillespieCenters for Disease Control and PreventionNoneNoneNoneNoneNoneNoneNoneAlan S. GoThe Permanente Medical GroupJohnson & Johnson†;GlaxoSmithKline†NoneNoneNoneNoneNoneNoneKurt J. GreenlundCenters for Disease Control and PreventionNoneNoneNoneNoneNoneNoneNoneSusan M. HailpernNorthern Westchester HospitalNoneNoneNoneNoneNoneNoneNoneJohn A. HeitMayo ClinicNoneNoneNoneNoneNoneNoneNoneP. Michael HoDenver VA Medical CenterNoneNoneNoneNoneNoneWellpoint Inc.*NoneVirginia J. HowardUniversity of Alabama at BirminghamNIH/NINDS†NoneNoneNoneNoneNoneNoneBrett M. KisselaUniversity of CincinnatiNIH/NCRR†; NIH/NINDS†NoneNoneExpert witness for defense in 1 stroke-related case in 2010†NoneAllergan†NoneSteven J. KittnerUniversity of Maryland School of MedicineNoneNoneNoneNoneNoneNoneNoneDaniel T. LacklandMedical University of South CarolinaNoneNoneNoneNoneNoneNoneNoneJudith H. LichtmanYale School of MedicineNoneNoneNoneNoneNoneNoneNoneLynda D. LisabethUniversity of MichiganNoneNoneNoneNoneNoneNoneNoneDonald M. Lloyd-JonesNorthwesternNoneNoneNoneNoneNoneNoneNoneDiane M. MakucNational Center for Health Statistics, CDCNoneNoneNoneNoneNoneNoneNoneGregory M. MarcusUCSFNoneNoneNoneNoneNoneNoneNoneAriane MarelliMcGill University Health CenterNoneNoneNoneNoneNoneNoneNoneDavid B. MatcharDuke-NUS Graduate Medical SchoolNoneNoneNoneNoneNoneBoehringerIngelheim*NoneMary M. McDermottNorthwestern University's Feinberg School of MedicineNoneNoneNoneNoneNoneNoneContributing Editor for JAMAJames B. MeigsMassachusetts General HospitalNoneNoneNoneNoneNoneNoneNoneClaudia S. MoyNational Institutes of HealthNoneNoneNoneNoneNoneNoneNoneDariush MozaffarianHarvard School of Public HealthNIH†;Harvard†;Gates Foundation/ World Health Organization†;Searle Funds at the Chicago Community Trust†NoneAramark*;International Life Sciences Institute*;SPRIM*;Unilvever*;US Food and Drug Administration*;World Health Organization*NoneRoyalties from UpToDate for an online chapter*Nutrition Impact*NoneMichael E. MussolinoNational Heart, Lung, and Blood InstituteNoneNoneNoneNoneNoneNoneNoneGraham NicholUniversity of WashingtonAsmund S Laerdal Foundation for Acute Medicine†;Medtronic Inc.†;NHLBI†;NIH†NoneNoneNoneNoneGambro Renal Inc*;Lifebridge Medizintechnik AG*;Sotera Wireless*NoneNina P. PaynterBrigham and Women's HospitalF. HoffmanLaRoche Ltd.†NoneNoneNoneNoneNoneNoneWayne D. RosamondUniversity of North CarolinaNoneNoneNoneNoneNoneNoneNonePaul D. SorlieNational Heat, Lung and Blood Institute, NIHNoneNoneNoneNoneNoneNoneNoneRandall S. StaffordStanford UniversityNoneNoneNoneNoneNoneNoneNoneTanya N. TuranMedical University of South CarolinaApplied Clinical Intelligence*;NIH/NINDS†NoneNoneNoneNoneNoneAAN Clinical Research Fellowship†Melanie B. TurnerAmerican Heart AssociationNoneNoneNoneNoneNoneNoneNoneNathan D. WongUniversity of California, IrvineBristol-Myers Squibb†;Forest†;Novartis Pharmaceuticals†NoneNoneNoneNoneNoneNoneJudith Wylie-RosettAlbert Einstein College of MedicineKraft via subcontract from Provident*NoneNoneNoneNoneNoneNoneThis table represents the relationships of writing group members that may be perceived as actual or reasonably perceived conflicts of interest as reported on the Disclosure Questionnaire, which all members of the writing group are required to complete and submit. A relationship is considered to be "significant" if (a) the person receives $10 000 or more during any 12-month period, or 5% or more of the person's gross income; or (b) the person owns 5% or more of the voting stock or share of the entity, or owns $10 000 or more of the fair market value of the entity. A relationship is considered to be "modest" if it is less than "significant" under the preceding definition.*Modest.†Significant.Footnotes*The findings and conclusions of this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.The 2011 Statistical Update full text is available online at http://circ.ahajournals.org/cgi/content/full/123/4/e18.The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.The American Heart Association requests that this document be cited as follows: Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Greenlund KJ, Hailpern SM, Heit JA, Ho PM, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, McDermott MM, Meigs JB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Rosamond WD, Sorlie PD, Stafford RS, Turan TN, Turner MB, Wong ND, Wylie-Rosett J; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation. 2011;123:459–463.A copy of the statement is available at http://www.americanheart.org/presenter.jhtml?identifier=3003999 by selecting either the "topic list" link or the "chronological list" link (No. KB-0192). To purchase additional reprints, call 843-216-2533 or e-mail kelle.[email protected]com.Expert peer review of AHA Scientific Statements is conducted at the AHA National Center. For more on AHA statements and guidelines development, visit http://www.americanheart.org/presenter.jhtml?identifier=3023366.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml?identifier=4431. A link to the "Permission Request Form" appears on the right side of the page.Note: Population data used in the compilation of NHANES prevalence estimates is for the latest year of the NHANES survey being used. Extrapolations for NHANES prevalence estimates are based on the census resident population for 2008 because this is the most recent year of NHANES data used in the Statistical Update. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Brown A, Dababneh E, Chaus A, Chyzhyk V, Marinescu V and Pyslar N (2021) Genetic Disorders of Lipoprotein Metabolism Therapeutic Lipidology, 10.1007/978-3-030-56514-5_3, (35-80), . Khani Jeihooni A, Jormand H, Saadat N, Hatami M, Abdul Manaf R and Afzali Harsini P (2021) The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women, BMC Cardiovascular Disorders, 10.1186/s12872-021-02399-3, 21:1, Online publication date: 1-Dec-2021. 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Report of Two Cases, Asploro Journal of Biomedical and Clinical Case Reports, 10.36502/2020/ASJBCCR.6209, 3:3, (178-185) February 1, 2011Vol 123, Issue 4 Advertisement Article InformationMetrics © 2011 American Heart Association, Inc.https://doi.org/10.1161/CIR.0b013e31820c7a50 Originally publishedFebruary 1, 2011 Keywordsrisk factorscardiovascular diseasesstatisticsepidemiologyAHA Statistical UpdatestrokePDF download Advertisement SubjectsStatements and Guidelines
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