Cardiovascular Diseases in United States

United States

Cardiovascular diseases (CVDs) refer to several conditions resulting from plaque building up in arteries, including coronary artery disease, heart attack and stroke. Risk factors for CVDs include high blood pressure, high cholesterol, obesity, physical inactivity, unhealthy diet, diabetes, smoking, excessive alcohol consumption and family history of heart disease or stroke.

Heart disease and stroke were the first- and fourth-leading causes of death in the United States in 2023, respectively. Heart failure is often accompanied by fatigue, shortness of breath, lack of appetite and impaired thinking, and can damage the liver and kidneys and lead to additional heart conditions. Strokes can cause long-term disabilities such as paralysis, speech difficulties and emotional problems.

In the 2019-2020 fiscal year, CVDs cost the U.S. approximately $422.3 billion in combined direct and indirect expenses. The American Heart Association projects CVD costs to triple by 2050, reaching $1344 billion, with strokes accounting for the largest increase.

According to America’s Health Rankings analysis, the prevalence of CVDs is higher among:

• Men compared with women.
• Adults age 65 and older, who have a prevalence nearly 10 times that of adults ages 18-44.
• American Indian/Alaska Native, white, multiracial and Black adults compared with Asian and Hispanic adults.
• Adults with less than a high school education compared with college graduates.
• Adults with an annual household income less than $25,000, who have a prevalence more than three times that of adults with incomes of $150,000 or more. The prevalence is significantly higher with each decrease in income level. 
• Adults living in nonmetropolitan areas compared with adults in metropolitan areas.
• Adults who have difficulty with self-care, who have a prevalence more than five times that of adults without a disability. 
• Straight adults compared with lesbian, gay, bisexual and queer (LGBQ+) adults.
• Adults who have served in the U.S. armed forces compared with those who have not served.

Most deaths resulting from heart disease and stroke are preventable. Lifestyle changes, medication or medical procedures may reduce risk factors. Lifestyle changes that can help prevent heart disease include:

• Eating a healthy diet with more fresh fruit and vegetables and fewer foods high in saturated and trans fats. 
• Getting regular physical activity.
• Not smoking, or quitting smoking.

Between 1980 and 2000, the death rate from coronary heart disease fell 50%; 47% of that decrease was because of medical interventions like coronary artery bypass and statin therapy. Another 44% of the decline was attributable to improvements in risk factors, including increases in physical activity, reductions in smoking prevalence and reductions in cholesterol and blood pressure. 

The Life’s Essential 8 tool, developed by the American Heart Association, can help individuals measure and manage their heart health.

Healthy People 2030 provides several objectives related to improving cardiac health, including:

• Improving cardiovascular health among adults.
• Reducing coronary heart disease deaths.
• Reducing stroke deaths.
• Increasing control of blood pressure in adults.
• Increasing cholesterol treatment in adults. 

Additionally, the Million Hearts 2027 initiative is a national effort to prevent 1 million heart attacks and strokes in five years by promoting community and clinical prevention programs.

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Kazi, Dhruv S., Mitchell S. V. Elkind, Anne Deutsch, William N. Dowd, Paul Heidenreich, Olga Khavjou, Daniel Mark, et al. “Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association.” Circulation 150, no. 4 (July 23, 2024). https://doi.org/10.1161/CIR.0000000000001258.

Martin, Seth S., Aaron W. Aday, Zaid I. Almarzooq, Cheryl A. M. Anderson, Pankaj Arora, Christy L. Avery, Carissa M. Baker-Smith, et al. “2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.” Circulation 149, no. 8 (February 20, 2024). https://doi.org/10.1161/CIR.0000000000001209.

Murphy, Sherry L., Kenneth D. Kochanek, Jiaquan Xu, and Elizabeth Arias. Mortality in the United States, 2023. NCHS Data Brief No. 521. Hyattsville, MD: National Center for Health Statistics, December 19, 2024.https://doi.org/10.15620/cdc/170564.