Rising obesity rates, coupled with an associated jump in diabetes and high blood pressure cases, appears to be undoing decades of gains made against heart disease, a new study finds.
After 2010, the rate of deaths from heart disease continued to drop, but more slowly. Deaths from stroke leveled off, and deaths from high blood pressure ("hypertension") increased, researchers report.
"These findings are surprising and alarming, because despite medical and surgical advances and public policy initiatives around cholesterol and blood pressure awareness, we are losing ground in the battle against cardiovascular disease," said lead researcher Dr. Sadiya Khan. She is an assistant professor of cardiology at Northwestern University Feinberg School of Medicine, in Chicago.
"The culprit may be the rise in obesity," she added, though the study could not prove that definitively.
"One of the greatest success stories of the past century has been the marked reduction in cardiovascular disease death rates," Khan said.
Despite this progress, heart disease continues to be the number one killer of American men and women. Moreover, the positive progress that was being made has slowed or stopped, Khan noted.
"The reversal of these trends is concerning," she said. "Even more alarming is the fact that cardiovascular death rates for black Americans remain higher than those for white Americans."
For the study, Khan and her colleagues used data from the U.S. Centers for Disease Control and Prevention on deaths from heart disease, stroke, diabetes and hypertension from 1999 through 2017.
The findings highlight the urgency to address the obesity epidemic and the increasing deaths from heart disease, Khan said. "We need to come up with better ways to fight cardiovascular disease, and quickly," she explained.
Heart disease is largely preventable. "We know that prevention of risk factors and aggressive management beginning early in life is critical," Khan added. People should talk with their doctor about their risk factors and how to live a heart-healthy lifestyle, she suggested.
Targeting people early in life and focusing on prevention even in childhood and young adulthood can go a long way to prevent heart disease later, she said.
"To support individual lifestyle changes, policymakers need prevention strategies to support Americans in eating a healthy diet, having safe places to exercise in the neighborhood, and access to health care and medications," she said.
The report was published Aug. 27 in the Journal of the American Medical Association.
The findings really emphasize the need to focus on prevention, said Dr. Richard Becker, an American Heart Association expert and chair of medicine at the University of Cincinnati College of Medicine.
The increase in deaths from heart disease is a public health challenge that involves health care providers, national organizations and the health care industry, Becker said.
Prevention needs to start early, he stressed. "Without early identification and early intervention, we will not be able to reverse these alarming trends," he added.
Curbing the obesity epidemic, with its probable effect of reducing the prevalence of diabetes and high blood pressure, is needed, Becker suggested.
"But in all likelihood, if we started today with some initiatives, it may take five to 10 years before you're going to see the fruits of these labors," Becker said. "So, we could start seeing an increase in cardiovascular deaths before they start to go down again."