WASHINGTON — Roughly one to two Americans die from cardiovascular disease every minute, according to the CDC. While those numbers are troubling today, research published by the American College of Cardiology is sounding the alarm bell about America’s cardiovascular future. Scientists project rates of both cardiovascular risk factors and disease will increase significantly across the United States by the year 2060.
This predicted increase in cardiovascular disease rates may place further pressure on an already burdened U.S. health care system, study authors theorize. They believe these findings make a strong argument for equitable access to prevention education and treatments today to prevent disease tomorrow.
Researchers used data provided by the 2020 U.S. Census Bureau report to estimate what will happen between 2025 and 2060, before combining those census estimates with the prevalence of cardiovascular risk factors or disease according to the U.S. National Health and Nutrition Examination Survey.
Using those estimates, study authors analyzed projected cardiovascular risk factors and diseases in groups based on sex (male, female), age (18-44 years; 45-64; 67-79; >80), and race/ethnicity (Asian, Black, Hispanic, White, other). Meanwhile, researchers also analyzed projected rates for both cardiovascular risk factors (diabetes, hypertension, dyslipidemia, obesity) and cardiovascular diseases (ischemic heart disease, heart failure, heart attack, stroke).
Who will be at risk of heart disease in the future?
The study found that among the general U.S. population, all four relevant cardiovascular risk factors are projected to increase between 2025 and 2060. The biggest percentage increase was found among those with diabetes (39.3% increase to 55 million people), followed by dyslipidemia (27.6% to 126 million), hypertension (25.1% to 162 million), and obesity (18.3% to 126 million).
What about actual cardiovascular disease events? Stroke (33.8% to 15 million) and heart failure (33.4% to 13 million) showed the highest projected increases in terms of rates, with ischemic heart disease (30.7% to 29 million) and heart attack (16.9% to 16 million) following behind.
Regarding sex, risk factors between this time period are actually expected to stabilize for males versus females (unless the person is obese). Researchers reported the same for age. However, while projections for race and ethnicity minority groups exponentially rose, projections for Caucasians gradually declined. Notably, African-Americans are predicted to experience the highest cardiovascular risk factor burden. Moreover, cardiovascular disease rate increases are projected to impact Black and Hispanic populations the most.
“Our analysis projects that that the prevalence of cardiovascular risk factors and diseases will continue to rise with worrisome trends,” says James L. Januzzi Jr., MD, a cardiologist at Massachusetts General Hospital, in a media release. “These striking projections will disproportionately affect racial and ethnic minority populations in the U.S. Understanding these results will hopefully inform future public health policy efforts and allow us to implement prevention and treatment measures in an equitable manner.”
How can we stop this prediction from becoming reality?
Study authors suggest placing particular emphasis on better education when it comes to cardiovascular risk factors, as well as improvements in access to quality health care and improved access to effective treatment therapies. According to the study, new health policies should also be developed aimed at upgrading health care access to historically neglected populations, implementing customized preventive strategies and dismantling broader systems that result in racial and ethnic minorities receiving inferior care.
“Ultimately, as prevention is imperative to tackle the future burden of cardiovascular disease, the results from this study pose an important challenge,” explains lead study author Reza Mohebi, MD, the Dennis and Marilyn Barry Fellow in Cardiology at Massachusetts General Hospital. “In order to reduce the burden of cardiovascular disease in the U.S. population, health care policymakers will need to allocate preventive measures and health care resources to the more vulnerable populations we projected to have higher percentage rise in disease.”
“Despite that several assumptions underlie these projections, the importance of this work cannot be overestimated,” adds Andreas Kalogeropoulos, MD, MPH, PhD, clinical and outcomes researcher at Stony Brook University Medical Center. “The absolute numbers are staggering and suggest that by year 2060, compared to 2025, the numbers of people, particularly minorities, with CV risk factors are expected to increase dramatically. Unless targeted action is taken, disparities in the burden of cardiovascular disease are only going to be exacerbated over time.”
It’s worth noting that the team says their project was limited in a number of ways, such as the conventional method of generating predictions for future cardiovascular disease by assuming future patterns of cardiovascular risk factors. The research team did not account for the COVID-19 pandemic. Also, cardiovascular disease cases were defined based on self-reports of patients.
The study is published in the Journal of the American College of Cardiology.