The American Heart Association has revealed that nearly half of the adults in the United States have some type of cardiovascular disease.

The organization defines the condition as coronary heart disease, heart failure, stroke or high blood pressure.

After decades of declines, deaths from cardiovascular disease are on the rise again, with 840,678 deaths recorded in 2016, up from 836,546 in 2015, according to the association’s annual report, Heart and Stroke Statistics published on Jan. 31, 2019, in the medical journal Circulation.

“Cardiovascular disease produces immense health and economic burdens in the United States and globally,” the authors wrote.

The 48% prevalence of cardiovascular disease ­— nearly 121.5 million adults – is a significant uptick over the rate cited last year, although this was mainly driven by the way high blood pressure is defined.  Hypertension guidelines were updated so that people whose blood pressure is 130/80 or above, are now consider “hypertensive.” Previously, the definition was 140/90.

Dr. David Zhao, chief of cardiology medicine and executive director of the Heart and Vascular Center at Wake Forest Baptist Health in Winston-Salem, North Carolina, described the new report as a “painful reminder” that heart disease is still the number one cause of death and disease in  the nation.

“Overall, we have made a lot of progress,” Zhao, who was not involved in the report, said. Still, “we have not yet made substantial advancement in obesity, diabetes and unhealthy behavior,” which includes smoking, not exercising, poor diet and being overweight.

About eight of every 10 cases of cardiovascular disease can be prevented by controlling high blood pressure, diabetes and high cholesterol and maintaining a healthy lifestyle, according to the Heart Association.

The scorecard also shows some terrific gains. Self-reported inactivity among adults has been declining since 1998, with the trend escalating in recent years. Passivity plummeted from 40.1% to 26.9% between 2007 and 2016, the report shows.

Over the past five decades, smoking rates have also declined: about 51% of males and 34% of females smoked in 1965, compared with just 16.7% of males and 13.6% of females in 2015.

The report includes a new recommendation that adults get at least seven hours of sleep per night to promote optimal health. One recent study found that too much or too little — more than eight hours or less than seven hours per night — was linked with a greater risk of death from all causes.

“We really have to work harder to reduce all the risk factors in order to reduce rates of cardiovascular disease,” Zhao said, highlighting obesity. Nearly four out of 10 U.S. adults and nearly one out of five youths is obese, while 7.7% of adults and 5.6% of youth are severely so, the report finds.

Overall, Zhao believes that “lots of work still needs to be done.”

We may be seeing downward trajectory in some risk factors and cardiovascular disease itself, “but we’re not there yet,” he said.

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