Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). Methods: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. Results: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. Conclusions: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions. 

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

Association of Cumulative Blood Pressure With Cognitive Decline, Dementia, and Mortality.

Background the course of depression is variable, but it is unknown how this variability over time affects long-term cognitive decline. Objective to examine the relationship of different trajectories of depressive symptoms on rates of subsequent cognitive decline in older adults. Design population-based cohort study. Setting communities in the USA and England. Subjects 17,556 older adults from the Health and Retirement Study and the English Longitudinal Study of Ageing. Methods depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and trajectories were calculated using group-based trajectory modelling. Global cognitive function and three cognitive domains of memory, executive function and temporal orientation were assessed for up to 18 years. Results five trajectories of depressive symptoms were identified. Compared with the 'non-depressed' trajectory, the 'worsening depressive symptoms' trajectory (pooled β = -0.016 standard deviation (SD)/year, 95% confidence interval (CI): -0.021 to -0.010), 'persistent depressive symptoms' trajectory (pooled β = -0.016 SD/year, 95% CI: -0.024 to -0.008), and 'mild depressive symptoms' trajectory (pooled β = -0.008 SD/year, 95% CI: -0.014 to -0.003) were associated with faster rates of cognitive decline, while no such association was found for the 'improving depressive symptoms' trajectory (pooled β = 0.001 SD/year, 95% CI: -0.010 to 0.012). Conclusions subthreshold depressive symptoms are associated with an increased rate of cognitive decline, while individuals who show improving depressive symptoms do not exhibit accelerated cognitive decline. These findings raise the possibility that maintaining depressive symptoms as low as possible and ignoring the clinical threshold, might mitigate cognitive decline in older adults.

Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts.

Persistent moderate to severe pain and long-term cognitive decline.

The relationship between low levels of serum low-density lipoprotein cholesterol (LDL-C) and subsequent cognitive decline remains unclear The present study aimed to evaluate the longitudinal association between low LDL-C levels and cognition decline in the context of the current aggressive guideline-recommended targets (LDL-C levels less than 55 mg/dL for individuals at very high risk of cardiovascular events, and less than 70 mg/dL for high risk individuals) Data from wave 13 (2016) to wave 14 (2018) of the Health and Retirement Study (HRS) were utilized LDL-C concentrations measured at wave 13 were categorized into 5 levels, reflecting currently recommended values for lipid lowering treatment Of 7129 included participants (mean age: 690 ± 99 years, 603% female), we found that compared to participants with LDL-C levels of 700–999 mg/dL, those with LDL-C levels of

Low levels of low-density lipoprotein cholesterol and cognitive decline

Background and purpose We aimed to test whether higher long-term blood pressure variability was associated with accelerated rate of cognitive decline and evaluate potential dose-response relationship. Methods Original survey data from the Health and Retirement Study and the English Longitudinal Study of Ageing were used. Standardized Z score of cognitive function was the main outcome measure. Visit-to-visit blood pressure SD, coefficient of variation, and variation independent of mean were used. Linear mixed model and restricted spline were applied to assess association and explore dose-response pattern. Segmented regression was used to analyze dose-response relationship and estimate turning point. Meta-analysis using random-effects model was conducted to pool results, with I2 used to test heterogeneity. Results A total of 12 298 dementia-free participants were included (mean age: 64.6±8.6 years). Significant association was observed between blood pressure variability and cognitive decline. Each 10% increment in coefficient of variation of systolic and diastolic blood pressure was associated with accelerated global cognitive decline of 0.026 SD/y (95% CI, 0.016-0.036, P Conclusions Higher long-term blood pressure variability was associated with accelerated cognitive decline among general adults aged ≥50 years, with nonlinear dose-response relationship. Further randomized controlled trials are warranted to evaluate potential benefits of blood pressure variability-lowering strategies from a cognitive health perspective.

Dose-Response Relationship Between Long-Term Blood Pressure Variability and Cognitive Decline

In recent years, an increasing amount of short-chain perfluoroalkyl substance (PFAS) alternatives has been used in industrial and commercial products. However, short-chain PFASs remain persistent, potentially toxic, and extremely mobile, posing potential threats to human health because of their widespread pollution and accumulation in the water cycle. This study systematically summarized the removal effect, operation conditions, treating time, and removal mechanism of various low carbon treatment techniques for short-chain PFASs, involving adsorption, advanced oxidation, and other practices. By the comparison of applicability, pros, and cons, as well as bottlenecks and development trends, the most widely used and effective method was adsorption, which could eliminate short-chain PFASs with a broad range of concentrations and meet the low-carbon policy, although the adsorbent regeneration was undesirable. In addition, advanced oxidation techniques could degrade short-chain PFASs with low energy consumption but unsatisfied mineralization rates. Therefore, combined with the actual situation, it is urgent to enhance and upgrade the water treatment techniques to improve the treatment efficiency of short-chain PFASs, for providing a scientific basis for the effective treatment of PFASs pollution in water bodies globally.

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Chenglong Li

Papers

Association of Cumulative Blood Pressure With Cognitive Decline, Dementia, and Mortality.

Low levels of low-density lipoprotein cholesterol and cognitive decline

Dose-Response Relationship Between Long-Term Blood Pressure Variability and Cognitive Decline

A Review of Treatment Techniques for Short-Chain Perfluoroalkyl Substances

Deep learning algorithm using fundus photographs for 10-year risk assessment of ischemic cardiovascular diseases in China