3 in 5 US adults projected to have CVD by 2050, with a price tag of $1.8T—can cardiologists ‘turn the tide’?

At least 61% of adults in the United States are expected to have cardiovascular disease (CVD) by 2050, according to new data published by the American Heart Association (AHA). CVD-related costs during that time, meanwhile, could reach up to $1.8 trillion.

Two new AHA presidential advisories, both published in Circulation, explore these findings at length. One advisory is focused on the risk factors associated with CVD and stroke, including what cardiologists and other healthcare professionals can do to help reach patients as early as possible.[1] The other examines the economic burden of CVD and stroke, which is expected to “increase substantially in the coming decades.”[2]

“Supported by efforts led by the AHA, death rates from heart disease have been cut in half in the past 100 years,” Karen E. Joynt Maddox, MD, MPH, a cardiologist and health policy researcher at Washington University School of Medicine in St. Louis and volunteer chair of the advisories’ writing groups, said in a prepared statement. “Deaths from stroke have been cut by a third since the creation of the American Stroke Association in 1998. Yet, these are still leading causes of death and disability in the U.S. So, in analyzing the data for these advisories, we set out to learn just what we may expect over the next 30 years, and to identify specific issues that need to be addressed to ensure that we continue our forward progress. Armed with these findings, we can take steps to turn the tide on this dire forecast.”

“It is crucial to quantify the full burden of cardiovascular disease so we can better inform the policies and community-level and health system interventions needed to change this current path,” added Nancy Brown, AHA CEO. “We recognize that the landscape of cardiovascular health will change over the next three decades because of the coming tsunami of rising health care costs, an older population living longer and increasing numbers of people from under-resourced populations. The findings of these important advisories predict a dire human and economic toll from heart disease and stroke if changes are not made. However, this does not have to be the reality of our future.”

Diving deeper into the data, rates of high blood pressure, stroke, obesity and diabetes are all projected to increase significantly in the United States in the coming years. Obesity, for instance, could impact more than 180 million people by 2050.

Obesity among children is one area where the projections are especially troubling. While the obesity was seen in 20.6% of children between the ages of 2 and 19 in 2020, that is expected to hit 33% by 2050.

The AHA projections also show that racial and ethnic disparities continue to be a major issue throughout the country.

Black adults have higher projected rates of hypertension, diabetes and obesity than any other group, for example, in addition to the highest projected prevalence of inadequate sleep and poor diet. Asian adults, meanwhile, have the highest projected prevalence of inadequate physical activity.

“We found larger increases in the prevalence of CVD and risk factors, and in the number of people with these conditions, among people from racially and ethnically diverse backgrounds,” Joynt Maddox said. “Some of this is due to demographic shifts in the U.S., with projections suggesting that Asian and Hispanic populations will nearly double by 2060. However, much of the inequity we see in CVD and risk factors remains attributed to systemic racism, as well as socioeconomic factors and access to care.”