Cardiovascular disease is on the rise

According to Graham, cardiovascular disease is the leading cause of death for people ages 65 and older, and as the U.S. population ages, more people will be at-risk of developing heart conditions. And more and more people are developing conditions that put them at risk of cardiovascular disease and stroke, including high blood pressure, diabetes, and obesity.

Between 1999 and 2010, data from the National Heart, Lung, and Blood Institute shows that deaths from cardiovascular disease among people ages 65 and older dropped 22%, largely due to new medical treatments and a decline in smoking. However, between 2011 and 2019, cardiovascular deaths increased by 13% — a number that likely grew during the pandemic.

Over the next few decades, rates of cardiovascular disease are expected to increase significantly. In a 2022 study published in the Journal of American College of Cardiology (JACC), researchers estimated that several cardiovascular conditions, including coronary heart disease, heart failure, heart attacks, and strokes, will rise between 30% and 34% by 2060, with the greatest increase occurring between 2025 and 2030.

This increase is also likely to disproportionately impact people of color, especially the Black and Hispanic populations, who are more likely to have health conditions that increase their risk. According to the study, rates of diabetes, hypertension, dyslipidemia, and obesity are all expected to rise in these groups by 2060, with Hispanic individuals seeing the largest increase.

"Whatever focus we've had before on managing [cardiovascular] disease risk in Black and Hispanic Americans, we need to redouble our efforts," said Clyde Yancy, chief of cardiology and vice dean for diversity and inclusion at Northwestern University's Feinberg School of Medicine, who was not involved in the study.

Commentary

In an accompanying editorial to the JACC study, Andreas Kalogeropoulos from Stony Brook University and Javed Butler from Baylor University Medical Center, noted that "[d]isparities in the burden of cardiovascular disease are only going to be exacerbated" unless targeted efforts are made to improve education, prevention, and access to effective treatments.

In particular, Gregory Roth, an associate professor of cardiology at the University of Washington School of Medicine, called for an increased effort to educate individuals living in at-risk communities about "modifiable risk factors." These risk factors include high blood pressure, high cholesterol, obesity, diabetes, smoking, and more.

Separately, Michelle Albert, a cardiologist and current president of the American Heart Association, said that medical education needs to have an increased focus on social determinants of health, such as income, education, housing, and community characteristics, so healthcare providers are more prepared to address unmet health needs in vulnerable areas.

"We really need to be going into vulnerable communities and reaching people where they're at to increase their knowledge of risk factors and how to reduce them," said Natalie Bello, a cardiologist and director of hypertension research at the Smidt Heart Institute at Cedars-Sinai Medical Center.

According to Bello, some suggestions to improve care in these areas include deploying more community health workers or expanding innovative programs, like bringing pharmacists into Black-owned barbershops to provide education to Black men.

"Now, more than ever, we have the medical therapies and technologies in place to treat cardiovascular conditions," said Rishi Wadhera, a cardiologist and section head of health policy and equity research at the Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center. But more efforts are needed to ensure that all older patients, particularly those in disadvantaged communities, can connect with primary care physicians and receive the care they need to prevent and treat cardiovascular disease in a timely manner. (Graham, KFF Health News, 5/30)

Leaders across the health care industry increasingly recognize the need to reduce disparities in care access, cost, and quality. Download our take to learn six strategies to fully leverage their patient and community data to reduce these disparities.