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CLINICAL STATEMENTS AND GUIDELINES

August 29, 2023 Circulation. 2023;148:e9–e119. DOI: 10.1161/CIR.0000000000001168

Virani et al 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Chronic Coronary Disease Guideline

glucose cotransporter 2 [SGLT2] inhibitors, glucagon-like peptide-1 [GLP-1] receptor agonists, proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors, bempe- doic acid, and inclisiran) emerging in these areas, and the range of diagnostic and interventional procedures available for use in patients with CCD has expanded. Thus,

Table 4.  US Heart Disease Prevalence, by Age, Race, Ethnicity, and Sex, 2015 to 2018

Population Group Prevalence, CHD, 2015–2018, Age ≥20 y Prevalence, MI, 2015–2018, Age ≥20 y Prevalence, AP,* 2015–2018, Age ≥20 y Both sexes 20.1 million (7.2% [95% CI, 6.5–7.9]) 8.8 million (3.1% [95% CI, 2.7–3.6]) 11 million (4.1%) Men 11 million (8.3%) 5.8 million (4.3%) 5.3 million (4.2%) Women 9.1 million (6.2%) 3 million (2.1%) 5.7 million (4.0%) NH White men 8.7% 4.4% 4.5% NH White women 6.0% 2.0% 4.0% NH Black men 6.7% 3.9% 3.3% NH Black women 7.2% 2.3% 4.7% Hispanic men 6.8% 3.7% 3.5% Hispanic women 6.4% 2.1% 4.3% NH Asian men 5.0% 2.7% 2.1% NH Asian women 3.2% 0.7% 2.2% NH Native American/Alaska Native --- --- --- CHD includes people who responded “yes” to at least 1 of the questions in “Has a doctor or other health professional ever told you that you had CHD, angina or angina pectoris, heart attack, or MI?” Those who answered “no” but were diagnosed with Rose angina are also included (the Rose questionnaire is administered only to survey participants >40 y of age). CIs have been added for overall prevalence estimates in key chapters. CIs have not been included in this table for all subcategories of prevalence for ease of reading. Source: Prevalence of CHD: unpublished National Heart, Lung, and Blood Institute (NHLBI) tabulation using National Health and Nutrition Examination Survey and Behavioral Risk Factor Surveillance System data.3,4 Percentages for racial and ethnic groups are age adjusted for Americans ≥20 y of age. Age-specific percentages are extrapolated to the 2018 US population estimates. These data, based on self-reports, include people who either answered “yes” to the question of ever having angina or angina pectoris or were diagnosed with Rose angina (the Rose questionnaire is administered only to survey participants >40 y of age). Percentages for racial and ethnic groups are age adjusted for US adults ≥20 y of age. Estimates from NHANES 2015 to 2018 were applied to 2018 population estimates (≥20 y of age). *AP is chest pain or discomfort that results from insufficient blood flow to the heart muscle. Stable AP is predictable chest pain on exertion or under mental or emotional stress. The incidence estimate is for AP without MI.

AP indicates angina pectoris; CHD, coronary heart disease; CI, confidence interval; MI, myocardial infarction; and NH, non-Hispanic. Adapted with permission from Tsao CW et al.1 Copyright 2022 American Heart Association, Inc.

Figure 1. US Prevalence of CHD per 100 000, by Age and Sex (NHANES 2015 to 2018). CHD indicates coronary heart disease. Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey (NHANES) public use data files. Accessed April 15, 2021. https://www.cdc.gov/nchs/nhanes/. Reprinted with permission from Tsao CW et al.1 Copyright 2022 American Heart Association, Inc.

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