Skip to main content
SpringerLink
Log in

National and Global Trends of Cardiovascular Disease Mortality, Morbidity, and Risk

  • Chapter
  • First Online:
ASPC Manual of Preventive Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Cardiovascular disease (CVD) continues to be the most common cause of death in the USA. The burden of cardiovascular mortality is now increasing once again after decades of persistent declines and has contributed to a reduction in overall life expectancy in the USA. The prevalence of CVD (including hypertension) in the USA is estimated to be 48%, which represents 121.5 million American adults. However, significant heterogeneity in rates of CVD across race-sex groups exists, and these disparities are strongly influenced by social and structural determinants of health and disease (e.g., education, income, racism). As part of the American Heart Association Strategic Impact Goal for 2020, the construct of cardiovascular health (CVH) was developed to monitor, target, and improve the health of our nation. While progress has been made in the last two decades in lowering population-level cholesterol levels and reducing rates of cigarette smoking, growing rates of obesity and diabetes have offset these gains, and disparities have persisted in poor CVH and CVD morbidity and mortality. Worldwide, the burden of CVD is growing in many low- and middle-income countries undergoing rapid economic development, such as India, China, and South Africa. A large proportion of preventable CVD deaths are estimated to be attributable to poor dietary quality, hypertension, obesity, hyperlipidemia, diabetes, smoking, and physical inactivity by the Global Burden of Disease program. Therefore, reversing these unfavorable trends nationally and internationally will require coordination and aggressive action focusing on CVD risk factor prevention across the life course, which informs the new American Heart Association Strategic Impact Goal for 2030 to strive to equitably increase healthy life expectancy by 2 years in the USA and 3 years worldwide together by 2030.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Shah NS, Lloyd-Jones DM, O’Flaherty M, et al. Trends in cardiometabolic mortality in the United States, 1999-2017. JAMA. 2019;322(8):780–2.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sidney S, Go AS, Jaffe MG, Solomon MD, Ambrosy AP, Rana JS. Association between aging of the US population and heart disease mortality from 2011 to 2017. JAMA Cardiol. 2019;4(12):1280.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141(9):e139–596.

    Article  PubMed  Google Scholar 

  4. National Heart, Lung, and Blood Institute. U.S. Department of Health and Human Services National Institutes of Health. Fact book. 2012.

    Google Scholar 

  5. Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med. 2007;356(23):2388–98.

    Article  CAS  PubMed  Google Scholar 

  6. National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov).

  7. Ritchey MD, Loustalot F, Bowman BA, Hong Y. Trends in mortality rates by subtypes of heart disease in the United States, 2000-2010. JAMA. 2014;312(19):2037–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ma J, Ward EM, Siegel RL, Jemal A. Temporal trends in mortality in the United States, 1969-2013. JAMA. 2015;314(16):1731–9.

    Article  CAS  PubMed  Google Scholar 

  9. Sidney S, Quesenberry CP Jr, Jaffe MG, et al. Recent trends in cardiovascular mortality in the United States and public health goals. JAMA Cardiol. 2016;1(5):594–9.

    Article  PubMed  Google Scholar 

  10. Curtin SC. Trends in cancer and heart disease death rates among adults aged 45-64: United States, 1999-2017. Natl Vital Stat Rep. 2019;68(5):1–9.

    PubMed  Google Scholar 

  11. Woolf SH, Schoomaker H. Life expectancy and mortality rates in the United States, 1959-2017. JAMA. 2019;322(20):1996–2016.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mehta NK, Abrams LR, Myrskyla M. US life expectancy stalls due to cardiovascular disease, not drug deaths. Proc Natl Acad Sci U S A. 2020;117(13):6998–7000.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistics-2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67–e492.

    Article  PubMed  Google Scholar 

  14. Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.

    Article  PubMed  Google Scholar 

  15. Khavjou OA. Projections of cardiovascular disease prevalence and costs 2015–2035. 2016. http://www.heart.org/idc/groups/ahaeccpublic/@wcm/@global/documents/downloadable/ucm_491130.pdf

  16. Lloyd-Jones DM. Slowing progress in cardiovascular mortality rates: you reap what you sow. JAMA Cardiol. 2016;1(5):599–600.

    Article  PubMed  Google Scholar 

  17. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation. 2010;121(4):586–613.

    Article  PubMed  Google Scholar 

  18. Angell SY, McConnell MV, Anderson CAM, et al. The American Heart Association 2030 impact goal: a presidential advisory from the American Heart Association. Circulation. 2020;141(9):e120–38.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Frieden TR, Berwick DM. The “Million Hearts” initiative--preventing heart attacks and strokes. N Engl J Med. 2011;365(13):e27.

    Article  PubMed  Google Scholar 

  20. Sacco RL, Roth GA, Reddy KS, et al. The heart of 25 by 25: achieving the goal of reducing global and regional premature deaths from cardiovascular diseases and stroke: a modeling study from the American Heart Association and World Heart Federation. Circulation. 2016;133(23):e674–90.

    Article  PubMed  Google Scholar 

  21. National Center for Health Statistics. Multiple cause of death 1999–2018 on CDC WONDER online database, released in 2020. Data are from the Multiple Cause of Death Files, 1999–2018, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Mar 24, 2020 6:01:43 AM.

  22. Institute NC. Joinpoint regression program, version 4.7.0.0 - February 2019; Statistical methodology and applications branch, surveillance research program. In Software Citation: Joinpoint Regression Program, Version 4.8.0.1 - April 2020; Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute. https://surveillance.cancer.gov/help/joinpoint/tech-help/citation.

  23. Global Burden of Cardiovascular Diseases Collaboration, Roth GA, Johnson CO, et al. The burden of cardiovascular diseases among US states, 1990-2016. JAMA Cardiol. 2018;3(5):375–89.

    Article  PubMed Central  Google Scholar 

  24. Roth GA, Dwyer-Lindgren L, Bertozzi-Villa A, et al. Trends and patterns of geographic variation in cardiovascular mortality among US counties, 1980-2014. JAMA. 2017;317(19):1976–92.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mensah GA, Mokdad AH, Ford ES, Greenlund KJ, Croft JB. State of disparities in cardiovascular health in the United States. Circulation. 2005;111(10):1233–41.

    Article  PubMed  Google Scholar 

  26. Mensah GA, Roth GA, Sampson UK, et al. Mortality from cardiovascular diseases in sub-Saharan Africa, 1990-2013: a systematic analysis of data from the Global Burden of Disease Study 2013. Cardiovasc J Afr. 2015;26(2 Suppl 1):S6–10.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Mensah GA, Cooper RS, Siega-Riz AM, et al. Reducing cardiovascular disparities through community-engaged implementation research: a National Heart, Lung, and Blood Institute workshop report. Circ Res. 2018;122(2):213–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Sidney S, Quesenberry CP Jr, Jaffe MG, Sorel M, Go AS, Rana JS. Heterogeneity in national U.S. mortality trends within heart disease subgroups, 2000-2015. BMC Cardiovasc Disord. 2017;17(1):192.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Arora S, Stouffer GA, Kucharska-Newton AM, et al. Twenty year trends and sex differences in young adults hospitalized with acute myocardial infarction. Circulation. 2019;139(8):1047–56.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ovbiagele B, Goldstein LB, Higashida RT, et al. Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association. Stroke. 2013;44(8):2361–75.

    Article  PubMed  Google Scholar 

  31. George MG, Tong X, Bowman BA. Prevalence of cardiovascular risk factors and strokes in younger adults. JAMA Neurol. 2017;74(6):695–703.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Koton S, Schneider AL, Rosamond WD, et al. Stroke incidence and mortality trends in US communities, 1987 to 2011. JAMA. 2014;312(3):259–68.

    Article  CAS  PubMed  Google Scholar 

  33. Howard VJ, Kleindorfer DO, Judd SE, et al. Disparities in stroke incidence contributing to disparities in stroke mortality. Ann Neurol. 2011;69(4):619–27.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kleindorfer D, Broderick J, Khoury J, et al. The unchanging incidence and case-fatality of stroke in the 1990s: a population-based study. Stroke. 2006;37(10):2473–8.

    Article  PubMed  Google Scholar 

  35. Foreman KJ, Naghavi M, Ezzati M. Improving the usefulness of US mortality data: new methods for reclassification of underlying cause of death. Popul Health Metrics. 2016;14:14.

    Article  Google Scholar 

  36. Glynn P, Lloyd-Jones DM, Feinstein MJ, Carnethon M, Khan SS. Disparities in cardiovascular mortality related to heart failure in the United States. J Am Coll Cardiol. 2019;73(18):2354–5.

    Article  PubMed  Google Scholar 

  37. McCarthy CP, Vaduganathan M, Patel KV, et al. Association of the New Peer Group-Stratified Method with the reclassification of penalty status in the hospital readmission reduction program. JAMA Netw Open. 2019;2(4):e192987.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Wadhera RK, Joynt Maddox KE, Wasfy JH, Haneuse S, Shen C, Yeh RW. Association of the Hospital Readmissions Reduction Program with mortality among medicare beneficiaries hospitalized for heart failure, acute myocardial infarction, and pneumonia. JAMA. 2018;320(24):2542–52.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Wadhera RK, Vaduganathan M, Jiang GY, et al. Performance in federal value-based programs of hospitals recognized by the American Heart Association and American College of Cardiology for high-quality heart failure and acute myocardial infarction care. JAMA Cardiol. 2020;5(5):1–8. https://doi.org/10.1001/jamacardio.2020.0001. Online ahead of print. PMID:32074242

  40. Heidenreich PA, Albert NM, Allen LA, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6(3):606–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Gerber Y, Weston SA, Redfield MM, et al. A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA Intern Med. 2015;175(6):996–1004.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Huffman MD, Berry JD, Ning H, et al. Lifetime risk for heart failure among white and black Americans: cardiovascular lifetime risk pooling project. J Am Coll Cardiol. 2013;61(14):1510–7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Oktay AA, Rich JD, Shah SJ. The emerging epidemic of heart failure with preserved ejection fraction. Curr Heart Fail Rep. 2013;10(4):401–10.

    Article  PubMed  Google Scholar 

  44. Pandey A, Golwala H, Sheng S, et al. Factors associated with and prognostic implications of cardiac troponin elevation in decompensated heart failure with preserved ejection fraction: findings from the American Heart Association get with the guidelines-heart failure program. JAMA Cardiol. 2017;2(2):136–45.

    Article  PubMed  Google Scholar 

  45. Cheng RK, Cox M, Neely ML, et al. Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population. Am Heart J. 2014;168(5):721–30.

    Article  PubMed  Google Scholar 

  46. Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol. 2017;70(20):2476–86.

    Article  PubMed  Google Scholar 

  47. Muntner P, Carey RM, Gidding S, et al. Potential US population impact of the 2017 ACC/AHA high blood pressure guideline. Circulation. 2018;137(2):109–18.

    Article  PubMed  Google Scholar 

  48. Patel KV, Li X, Kondamudi N, et al. Prevalence of apparent treatment-resistant hypertension in the United States according to the 2017 high blood pressure guideline. Mayo Clin Proc. 2019;94(5):776–82.

    Article  PubMed  Google Scholar 

  49. Patel SA, Winkel M, Ali MK, Narayan KM, Mehta NK. Cardiovascular mortality associated with 5 leading risk factors: national and state preventable fractions estimated from survey data. Ann Intern Med. 2015;163(4):245–53.

    Article  PubMed  Google Scholar 

  50. d'Arcy JL, Coffey S, Loudon MA, et al. Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study. Eur Heart J. 2016;37(47):3515–22.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Gooding HC, Shay CM, Ning H, et al. Optimal lifestyle components in young adulthood are associated with maintaining the ideal cardiovascular health profile into middle age. J Am Heart Assoc. 2015;4(11)

    Google Scholar 

  52. Ning H, Labarthe DR, Shay CM, et al. Status of cardiovascular health in US children up to 11 years of age: the National Health and Nutrition Examination Surveys 2003-2010. Circ Cardiovasc Qual Outcomes. 2015;8(2):164–71.

    Article  PubMed  Google Scholar 

  53. Shay CM, Ning H, Allen NB, et al. Status of cardiovascular health in US adults: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2003-2008. Circulation. 2012;125(1):45–56.

    Article  PubMed  Google Scholar 

  54. Shay CM, Ning H, Daniels SR, Rooks CR, Gidding SS, Lloyd-Jones DM. Status of cardiovascular health in US adolescents: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2005-2010. Circulation. 2013;127(13):1369–76.

    Article  PubMed  Google Scholar 

  55. Allen NB, Krefman AE, Labarthe D, et al. Cardiovascular health trajectories from childhood through middle age and their association with subclinical atherosclerosis. JAMA Cardiol. 2020;5(5):1–10. https://doi.org/10.1001/jamacardio.2020.0140. Online ahead of print. PMID:32159727

  56. Khan SS, Ning H, Wilkins JT, et al. Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity. JAMA Cardiol. 2018;3(4):280–7.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Folsom AR, Yatsuya H, Nettleton JA, et al. Community prevalence of ideal cardiovascular health, by the American Heart Association definition, and relationship with cardiovascular disease incidence. J Am Coll Cardiol. 2011;57(16):1690–6.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Allen NB, Zhao L, Liu L, et al. Favorable cardiovascular health, compression of morbidity, and healthcare costs: forty-year follow-up of the CHA study (Chicago Heart Association Detection Project in Industry). Circulation. 2017;135(18):1693–701.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Sengelov M, Cheng S, Biering-Sorensen T, et al. Ideal cardiovascular health and the prevalence and severity of aortic stenosis in elderly patients. J Am Heart Assoc. 2018;7(3)

    Google Scholar 

  60. Shah AM, Claggett B, Folsom AR, et al. Ideal cardiovascular health during adult life and cardiovascular structure and function among the elderly. Circulation. 2015;132(21):1979–89.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Rasmussen-Torvik LJ, Shay CM, Abramson JG, et al. Ideal cardiovascular health is inversely associated with incident cancer: the Atherosclerosis Risk in Communities study. Circulation. 2013;127(12):1270–5.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Rana JS, Liu JY, Moffet HH, et al. Risk of atherosclerotic cardiovascular disease by cardiovascular health metric categories in approximately 1 million patients. Eur J Prev Cardiol. 2020:2047487320905025.

    Google Scholar 

  63. Huffman MD, Capewell S, Ning H, Shay CM, Ford ES, Lloyd-Jones DM. Cardiovascular health behavior and health factor changes (1988-2008) and projections to 2020: results from the National Health and Nutrition Examination Surveys. Circulation. 2012;125(21):2595–602.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Pool LR, Ning H, Lloyd-Jones DM, Allen NB. Trends in racial/ethnic disparities in cardiovascular health among US adults from 1999-2012. J Am Heart Assoc. 2017;6:9.

    Article  Google Scholar 

  65. Allen NB, Lloyd-Jones D, Hwang SJ, et al. Genetic loci associated with ideal cardiovascular health: a meta-analysis of genome-wide association studies. Am Heart J. 2016;175:112–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Allen NB, Hwang S-J, Cupples LA, et al. Abstract 17245: the heritability of ideal cardiovascular health: the Framingham Heart Study. Circulation. 2010;122(Suppl 21):A17245.

    Google Scholar 

  67. Liu K, Daviglus ML, Loria CM, et al. Healthy lifestyle through young adulthood and the presence of low cardiovascular disease risk profile in middle age: the Coronary Artery Risk Development in (Young) Adults (CARDIA) study. Circulation. 2012;125(8):996–1004.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Labarthe D, Lloyd-Jones DM. 50x50x50: cardiovascular health and the cardiovascular disease endgame. Circulation. 2018;138(10):968–70.

    Article  PubMed  Google Scholar 

  69. Global burden of disease study 2017 (GBD 2017). Seattle: Institute for Health Metrics and Evaluation (IHME), University of Washington; 2018. http://ghdx.healthdata.org/gbd-results-tool. Accessed 1 Apr 2019.

  70. Global status report on noncommunicable diseases 2014. Geneva, Switzerland: World Health Organization; 2014. http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf. Accessed 19 Aug 2019.

  71. Bloom DECE, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, Feigl AB, Gaziano T, Mowafi M, Pandya A, et al. The global economic burden of non-communicable diseases. Geneva: World Economic Forum; 2011.

    Google Scholar 

  72. Timmis A, Townsend N, Gale CP, et al. European Society of Cardiology: cardiovascular disease statistics 2019. Eur Heart J. 2020;41(1):12–85.

    Article  PubMed  Google Scholar 

  73. Celermajer DS, Chow CK, Marijon E, Anstey NM, Woo KS. Cardiovascular disease in the developing world: prevalences, patterns, and the potential of early disease detection. J Am Coll Cardiol. 2012;60(14):1207–16.

    Article  PubMed  Google Scholar 

  74. Roth GA, Huffman MD, Moran AE, et al. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation. 2015;132(17):1667–78.

    Article  PubMed  Google Scholar 

  75. Zou Z, Cini K, Dong B, et al. Time trends in cardiovascular disease mortality across the BRICS: an age-period-cohort analysis of key nations with emerging economies using the global burden of disease study 2017. Circulation. 2020;141(10):790–9.

    Article  PubMed  Google Scholar 

  76. US Burden of Disease Collaborators, Mokdad AH, Ballestros K, et al. The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018;319(14):1444–72.

    Article  Google Scholar 

  77. Ritchey MD, Loustalot F, Wall HK, et al. Million hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016. J Am Heart Assoc. 2017;6:5.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology/Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Sadiya S. Khan

  2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Stephen Sidney

  3. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Donald M. Lloyd-Jones

  4. Division of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA

    Jamal S. Rana

Authors
  1. Sadiya S. Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen Sidney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Donald M. Lloyd-Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jamal S. Rana
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jamal S. Rana .

Editor information

Editors and Affiliations

  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA

    Nathan D. Wong

  2. Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, USA

    Ezra A. Amsterdam

  3. Cicarrone Center for the Prevention of Cardiovascular Disease, John Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Khan, S.S., Sidney, S., Lloyd-Jones, D.M., Rana, J.S. (2021). National and Global Trends of Cardiovascular Disease Mortality, Morbidity, and Risk. In: Wong, N.D., Amsterdam, E.A., Toth, P.P. (eds) ASPC Manual of Preventive Cardiology. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-56279-3_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-56279-3_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-56278-6

  • Online ISBN: 978-3-030-56279-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation