Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on 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 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. The 2020 Statistical Update is the product of a full year’s worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year’s edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals. Results: Each of the 26 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, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Background Evaluation of candidates for living kidney donation relies on screening for individual risk factors for end-stage renal disease (ESRD). To support an empirical approach to donor selection, we developed a tool that simultaneously incorporates multiple health characteristics to estimate a person’s likely long-term risk of ESRD in the absence of donation. Methods We used meta-analyzed risk associations from 7 general population cohorts, calibrated to US population-level incidence of ESRD and mortality, to project the estimated long-term incidence of ESRD in the absence of donation according to 10 demographic and health characteristics. We then compared 15-year projections to observed risk among recent US living kidney donors (N=52,998). Results There were 4,933,314 participants followed a median of 4 to 16 years. For a 40-year-old person with health characteristics similar to age-matched kidney donors, the 15-year ESRD risk projections in the absence of donation varied by race and sex: 0.24%, 0.15%, 0.06%, and 0.04% in black men, black women, white men, and white women. Risk projections were higher in the presence of lower estimated glomerular filtration rate, higher albuminuria, hypertension, smoking, diabetes, and obesity. In the model-based lifetime projections, ESRD risk was highest at younger age, particularly among African Americans. Risk projections in the absence of donation were 3.5–5.3-fold lower than 15-year observed risk post-donation in US kidney donors. Conclusions We suggest multiple health characteristics be considered together to estimate long-term ESRD risk for living kidney donor candidates.