Millions more Americans are expected to develop cardiovascular disease (CVD) in the coming decades, according to projections.
Major increases in people with CVD are expected from 2025 to 2060 in line with changing demographics:
- Ischemic heart disease: 21.9 million to 28.7 million
- Heart failure: 9.7 million to 12.9 million
- Myocardial infarction: 12.3 million to 16.0 million
- Stroke: 10.8 million to 14.5 million
In addition, by 2060, there will be 54.6 million Americans with diabetes, 162.5 million with hypertension, 125.7 million with dyslipidemia and 125.7 million with obesity, reported James Januzzi, MD, of Massachusetts General Hospital and Harvard Medical. School in Boston, and colleagues.
While gender differences will remain largely stable over time, CVD will disproportionately affect black and Hispanic people, the authors noted in the report. Journal of the American College of Cardiology.
The prevalence of cardiovascular (CV) risk factors and disease is expected to decline in white individuals by 2060 and increase in all other races and ethnicities. For example, in black adults, the estimated prevalence of diabetes, hypertension, dyslipidemia, and obesity will be 19.8%, 59.9%, 35.9%, and 45.6%, respectively.
“With an increasing aggregate number of risk factors and cardiovascular disease disproportionately affecting an aging population from populations with limited access to quality preventive care, the potential burden on the U.S. health care system is great,” Januzzi’s group wrote.
“Emphasis on CV risk factor education, improving access to quality healthcare, and facilitating cheaper access to effective therapies for treating CV risk factors can halt the rising tide of CV disease in at-risk individuals; such advances should be applied in a more equitable way across the United States,” they added.
In an accompanying editorial, Andreas Kalogeropoulos, MD, MPH, PhD, of Stony Brook University in New York, and Javed Butler, MD, MPH, MBA, of Baylor University Medical Center in Dallas and the University of Mississippi Medical Center in Jackson suggested , that the tide of deterioration in heart health can be managed with appropriately targeted policies.
It will be important for policymakers to emphasize CVD prevention, optimize cardiovascular care teams and tailor the training of future cardiologists, they noted, while also pointing out the worsening workforce challenges among health professionals during the COVID-19 pandemic.
“In this vein, educating physician staff of diverse racial, ethnic, and socioeconomic backgrounds could be a solid step toward better primary care and prevention efforts. However, recent data suggests that we still need to do a lot of work in this direction,” he wrote. the duo.
The study’s projections were based on data from the 2013-2018 National Health and Nutrition Examination Survey, merged with the 2020 US Census projection counts for the years 2025-2060.
Januzzi and colleagues recognized that their modeling assumes unchanging patterns of cardiovascular health and that self-reported data on heart disease are reliable. In addition, the authors did not take into account COVID-19 in their analyses.
“Despite the fact that several assumptions underlie these projections, the importance of this work cannot be overstated,” Kalogeropoulos said in a press release. “Unless targeted action is taken, the disparities in the burden of cardiovascular disease will only widen over time.”
Januzzi reported support from the Hutter Family Professorship; received grants from Abbott Diagnostics, Applied Therapeutics, Innolife and Novartis; receiving consultancy fees from Abbott Diagnostics, Boehringer Ingelheim, Janssen, Novartis and Roche Diagnostics; participation in clinical endpoint committees/data safety monitoring boards for AbbVie, Siemens, Takeda and Vifor; and is a Trustee of the American College of Cardiology and a board member of Imbria Pharmaceuticals.
Kalogeropoulos announced research funding from the National Heart, Lung and Blood Institute, the American Heart Association and the CDC.
Butler reported consulting for Abbott, Amgen, American Regent, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CVRx, G3 Pharmaceutical, Impulse Dynamics, Innolife, Janssen, LivaNova, Medtronic, Merck, Novartis, Novo Nordisk, Pfizer, Roche and Vifor .