According to new research from the American Heart Association released on Tuesday, June 4th, 2024, more than 61% U.S. adults will have some type of cardiovascular disease (CVD) by 2050.

Cardiovascular disease refers to conditions such as coronary heart disease, including heart attacks; heart failure, which is when the heart doesn't pump as well as it should; heart arrhythmias, including a type of irregular heart rhythm called atrial fibrillation; vascular disease, which affects the veins and arteries; congenital heart defects; stroke; and high blood pressure.

CVD is the leading cause of death and disability in the United States, which might prove to be a bigger risk in the next three decades. According to the study released on Tuesday, the organization increased its prediction of adult stroke and cardiovascular disease deaths from 28 million in 2020 to 45 million in 2050, excluding high blood pressure.

The majority of those who now have or will acquire high blood pressure, which increases their risk of serious conditions like a heart attack or stroke, will be the main driver of this trend. Clinically, cardiovascular disease is identified as some specific conditions, including coronary heart disease (including heart attack), arrhythmias (including atrial fibrillation), valvular disease, congenital heart disease, heart failure, stroke, and hypertension," the association defined in its report. "However, high blood pressure is also known as a major risk factor contributing to both heart disease and stroke."

cardiovascular disease
Image Source: University Diagnostic Medical Imaging

Heart attacks, arrhythmias such as atrial fibrillation or a-fib, heart failure, and congenital heart disease are further cardiovascular issues. This is mostly due to the estimated 184 million individuals who have high blood pressure, or hypertension, which is predicted to rise from 51.2% in 2020 to 61% in 2025. Heart disease has been the top cause of mortality in America for decades, accounting for over 800,000 deaths annually, despite advancements in treatment.

According to two American Heart Association presidential advisories released on Tuesday, the expected growth in heart disease and stroke, together with many other risk factors like high blood pressure and obesity, is predicted to quadruple related expenditures to $1.8 trillion by 2050, as in the AHA journal Circulation. One report looks at the projected increase in cardiovascular disease rates in the decades ahead, while the other projects their total related costs.

"The landscape of cardiovascular disease in the U.S. is seeing the arrival of a near-perfect storm," Dr. Dhruv S. Kazi, vice chair of the advisory writing group, said in a news release. Kazi is head of health economics and associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology and director of the cardiac critical care unit at Beth Israel Deaconess Medical Center in Boston.

"The last decade has seen a surge of cardiovascular risk factors such as uncontrolled high blood pressure, diabetes, and obesity, each of which raises the risks of developing heart disease and stroke," he said. "It is not surprising that an enormous increase in cardiovascular risk factors and diseases will produce a substantial economic burden."

Another factor driving these changes will be an aging population since cardiac issues are more common as people age. Studies show that whereas seniors made up only 13% of the population ten years ago, they will make up 22% of the US population by 2050. According to projections, the US median age will rise from 37 in 2010 to 41 in 2050, other research shows.

Alarming Rise in Cardiovascular Disease

Additionally, communities of color often have a disproportionately high rate of cardiac issues, and the American population is growing increasingly diverse. People who identify as Black will make up 14.4% of the US population by 2050, up from 13.6% currently, while Hispanics will make up around 25% of the population, compared to 20% currently. According to US Census projections, the proportion of persons who identify as Asian will rise as well, from 6.2% to 8.6% of the total population.

These disparities can be attributed to "individual, structural and systemic racism, as well as socioeconomic factors and access to care," the report notes. "By 2060, more than two-thirds of children will belong to underserved, disenfranchised populations, which traditionally have higher rates of cardiovascular disease and risk factors," Kazi said.

According to the new research, the population increase for cardiovascular disease and stroke is expected to be highest among those who identify as Hispanic. Because virtually all forms of heart disease and stroke are associated with hypertension or high blood pressure, researchers made distinct forecasts for this condition. According to their projections, from 2020 to 2050, high blood pressure is expected to rise from 51.2% to 61% of the U.S. population.

"We found larger increases in the prevalence of cardiovascular disease and risk factors, and in the number of people with these conditions, among people from racially and ethnically diverse backgrounds," Dr. Karen E. Joynt Maddox, chair of the writing committee, said in the release. She is an associate professor of medicine at Washington University School of Medicine in St. Louis. While some of the increase is due to U.S. demographic shifts, much of the inequity in cardiovascular disease and risk factors "remains attributed to systemic racism, as well as socioeconomic factors and access to care," she said.

Researchers predict that by 2050, 15% of the population—excluding those with high blood pressure—will have cardiovascular disease, up from 11.3% in 2020. Stroke rates will double as a result of this. Due to bad diets, obesity rates are predicted to rise from 43.1% to 60.6% of the population, with individuals ages 20 to 64 likely to see the greatest growth. It is predicted that the percentage of people with diabetes would increase from 16.3% to 26.8%. Risk factors are increasing, especially in young people and children.

Obesity is predicted to impact one-third of children by 2050, up from 20% in 2020. It is anticipated that children aged 12 to 19 and 2 to 5 would experience the greatest increases. Contributing elements include a lack of physical activity and a poor diet, which are expected to remain as high as 60% of all children over the next three decades. They recommend several important changes, including the development of clinical and policy initiatives designed expressly to assist people of color, who are disproportionately impacted by heart issues and typically have less access to basic, inexpensive healthcare.

According to the experts, prevention initiatives to enhance population health would be crucial and save the US a substantial sum of money. By 2050, it's predicted that the expenses associated with cardiovascular issues—including direct medical expenses and lost productivity—will have nearly tripled to over $1.8 trillion.

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