
When it comes to heart and brain health, these are numbers you should know
Feb. 5—American Heart Association News
Heart disease is once again the leading cause of death in the U.S., according to a new statistical report from the American Heart Association.
Cardiovascular diseases, which include heart disease and stroke, claimed more lives in the U.S. than all forms of cancer and accidental deaths — the No. 2 and No. 3 causes of death — combined. But that key stat from the annual update, published Monday in the AHA journal Circulation, is not the only one worthy of your attention.
Here are other details about the state of heart disease and stroke in the U.S. — and how you can use that info to increase your own odds of staying healthy.
1. A post-COVID decline, but still a problem
According to the report, in 2022 (the most recent year for which final data is available) the overall number of cardiovascular disease-related deaths in the U.S. was 941,652, an increase of more than 10,000 from 2021.
But the rate of deaths from cardiovascular disease that adjusted for age fell slightly, from 233.3 per 100,000 in 2021 to 224.3 in 2022.
Cardiovascular-related deaths appear to be leveling off after an increase during the COVID-19 pandemic. Age-adjusted death rates dropped for all but one of the 10 leading causes of death: kidney disease.
But nearly 2,500 people in the U.S. are still dying from cardiovascular disease every day, Dr. Keith Churchwell, the AHA's president, said in a news release.
"Those are alarming statistics to me — and they should be alarming for all of us, because it's likely many among those whom we lose will be our friends and loved ones," said Churchwell, an associate clinical professor of medicine at Yale School of Medicine in New Haven, Connecticut, and an adjunct associate professor of medicine at the Vanderbilt School of Medicine in Nashville, Tennessee.
2. The numbers behind those numbers
According to the update, nearly 47% of adults in the U.S. have high blood pressure, and 57% of adults have been diagnosed with Type 2 diabetes or prediabetes.
High blood pressure and diabetes are major cardiovascular risk factors. Cardiovascular disease is the leading cause of death and disability among people with Type 2 diabetes, which occurs when the body is unable to efficiently use the insulin it makes or when the pancreas loses its capacity to produce insulin.
Blood pressure levels may be affected by many factors, such as being overweight, smoking, not getting enough physical activity, eating a poor diet or too much sodium or not getting good sleep.
Diet and exercise also are among the targets for reducing the risk of heart disease among people with Type 2 diabetes, along with managing blood sugar and cholesterol levels, not smoking and not drinking alcohol.
3. Obesity remains a problem
Obesity is growing among young people and globally.
Around 40% of children in the U.S. have an unhealthy weight, which is defined as a body mass index in the 85th percentile or higher. About 20% have obesity, which is defined as a BMI in the 95th percentile or higher.
Globally, nearly 60% of adults have an unhealthy weight. In the U.S., about 71% of adults have unhealthy weight, and about 42% have obesity. (In adults, an unhealthy weight is defined as a BMI of 25 or higher, and obesity is defined as a BMI of 30 or more.)
"In the update, we noted calculations that found excess weight contributes to as many as 1,300 additional deaths per day in the U.S., nearly 500,000 per year," Dr. Latha P. Palaniappan, vice chair of the report's writing committee, said in the news release.
Excess weight lowers life expectancy by as much as 2.4 years compared to a healthy weight, said Palaniappan, a professor of cardiovascular medicine at Stanford University in California. "Being overweight is the new smoking when it comes to health threats."
4. Concerns about kidneys
While age-adjusted death rates dropped in nine other categories in 2022, kidney disease death rates increased 1.5%.
"Kidney disease has actually been on the rise over the past decade," writing committee chair Dr. Seth S. Martin said in the news release.
"The reason this is important is that, first, cardiovascular disease is a major contributor to kidney disease," said Martin, a professor of medicine and cardiologist at Johns Hopkins School of Medicine in Baltimore. "Second, the risk factors of these diseases are closely interrelated. These include high blood pressure, obesity and diabetes — all health conditions that are rising substantially across the U.S. and the world."
Among Medicare beneficiaries, kidney disease increased from 9.2% in 2011 to 14.2% in 2021, the report said. The global prevalence of kidney disease has increased more than 27% in relative terms since 2010, Martin said.
5. Cardiovascular disease not the same for every group
In an editorial that accompanied the statistics report, Dr. Dhruv S. Kazi, head of health economics and associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center in Boston, wrote it was important to acknowledge that "although (cardiovascular disease) affects us all, it doesn't affect us all equally."
Some examples: — Overall obesity prevalence ranged from a low of 14.5% among Asian women to a high of 57.9% among Black women. — Overall diabetes prevalence ranged from a high of 14.5% among Hispanic men to a low of 7.7% among white women. — Black women had the highest rate of high blood pressure at 58.4%; the lowest rate, 35.3%, was among Hispanic women.
"These disparities in risk and outcomes call for tailored interventions among high-risk populations," wrote Kazi, who also is an associate professor at Harvard Medical School. "A good place to start is to ensure that every member of the population can access affordable, high-quality care for the prevention and treatment of (cardiovascular disease)."
6. Good news on tobacco and cholesterol
Smoking greatly raises the risk for heart disease and stroke. So it's good news that smoking rates have been on a steady decline. The AHA update says: — Since the U.S. surgeon general's first report on the health dangers of smoking, age-adjusted prevalence of smoking among adults has declined, from 51% of men smoking in 1965 to 15.6% in 2018. Among women, it has fallen from 34% in 1965 to 12% in 2018. — In 2023, 12.6% of high school students reported current use of any tobacco product, compared to 16.5% in 2022. — About 28% of high school students reported ever using any tobacco product in 2023, compared to about 34% in 2022. — Among high school students, 10% reported using e-cigarettes in 2023, compared to 14.1% in 2022.
"Another positive trend over the years has been a reduction in the rates of high cholesterol," Churchwell said. "That's likely thanks, in part, to increased awareness about the dietary and lifestyle factors that impact cholesterol levels, along with the availability of medications and better clinical control."
Recent clinical research has identified new medications to address obesity as well, he said, "and we look forward to learning more about those advances as the body of science builds."
More importantly, Churchwell said, "we need to stop these risk factors in their tracks, keep people healthy throughout their lifespan. That will only be possible with a strong emphasis on early prevention and equitable health access for all."
American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.
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