Heart disease remains the leading cause of death in the United States, even though many of its major risk factors can be treated or reduced.
More than 82 million American adults are living with heart disease, and when high blood pressure, stroke and other cardiovascular conditions are included, about half of U.S. adults have some form of cardiovascular disease.
The latest picture of U.S. heart health has been reported in the Journal of the American College of Cardiology, while related research has also shown that health is shaped by much more than medical care alone. Income, education, access to healthy food and the conditions in which people live can all influence the chances of developing heart disease.
One of the biggest dangers is high blood pressure, also called hypertension. Blood pressure measures the force of blood pushing against artery walls as the heart pumps it around the body. When that pressure remains too high for years, it can slowly damage blood vessels and organs.
Hypertension is often called a silent killer because people can feel completely well while damage is taking place. In 2023, high blood pressure was listed as a primary or contributing cause in about 664,000 U.S. deaths. It can raise the risk of heart attack, stroke, heart failure, kidney disease and narrowing of the arteries.
Alfonso Waller, professor of medicine and radiology and chief of the Division of Cardiology at Rutgers New Jersey Medical School, says prevention starts with understanding personal risk. Some risk factors cannot be changed, including age and family history, but many others can be improved.
Common changeable risks include smoking, high cholesterol, diabetes, obesity, physical inactivity and high blood pressure. These problems often occur together and can reinforce one another. For example, inactivity may contribute to weight gain, while excess weight can make high blood pressure and diabetes more likely.
Age also matters because the risk of cardiovascular disease rises over time. Men tend to develop heart disease at younger ages, while women’s risk rises notably after menopause. Heart disease is the leading cause of death among both men and women in the United States.
Awareness is particularly important for women because heart problems are not always experienced in the way people expect. Chest pressure or discomfort can occur in anyone, but women may also report symptoms such as unusual tiredness, nausea or shortness of breath. If these warning signs are not recognized, diagnosis and treatment may be delayed.
Heart disease also does not affect every community equally. People living in areas with limited access to medical care or affordable healthy food may have fewer opportunities to prevent disease early. Neighborhoods that are difficult or unsafe to walk in can also make regular physical activity harder.
Environmental exposures matter as well. Secondhand tobacco smoke and air pollution have been linked with poorer cardiovascular health. These factors help explain why telling people simply to “make healthier choices” does not capture the full problem.
Stress can add another layer of risk. Long-term stress may raise heart rate and blood pressure, and it can make healthy routines harder to maintain. Some people respond to stress by eating poorly, smoking, drinking more alcohol or exercising less.
Diet and exercise remain important because they influence several risks at once. Regular movement can help lower blood pressure, improve fitness and support a healthy body weight. A balanced diet that limits excess salt and foods high in unhealthy fats can also support healthier blood pressure and cholesterol levels.
One of the simplest steps is also one of the easiest to overlook: have blood pressure and cholesterol checked. Because hypertension and high cholesterol may cause no symptoms, testing can uncover risk before a heart attack or stroke occurs. People who have not had a routine health check for some time can discuss these measurements and their overall risk with a primary care doctor.
The evidence reviewed by Rutgers cardiovascular experts has an important strength: it places heart disease in a broad context rather than treating it as the result of one behavior or one medical problem. It recognizes the combined roles of biology, lifestyle, access to care and the environment, which gives a more realistic picture of why cardiovascular disease remains so common.
However, population statistics cannot predict exactly what will happen to an individual. Risk varies according to medical history, age, medications, family history and many other factors, and associations involving social conditions do not prove that one factor alone causes heart disease.
The practical message is therefore not that every case can be prevented, but that earlier screening and better control of known risks can reduce many avoidable complications.
Overall, the findings and expert analysis show why prevention needs to begin before symptoms appear. High blood pressure and high cholesterol can quietly cause damage for years, making routine checks especially valuable.
Combining medical care with healthier living conditions and practical lifestyle changes offers the strongest path toward reducing the enormous burden of heart disease.
If you care about health, please read studies that apple juice could benefit your heart health, and Yogurt may help lower the death risks in heart disease.
For more health information, please see recent studies that Vitamin D deficiency can increase heart disease risk, and results showing Zinc and vitamin B6 linked to lower death risk in heart disease.
Source: Rutgers University.
