Heart disease is the leading cause of death in the United States, according to the Journal of the American College of Cardiology. More than 82 million U.S. adults are living with heart disease, and roughly half of all U.S. adults have some form of cardiovascular disease when broader conditions like stroke and high blood pressure are included.
Hypertension remains a major and often unrecognized risk factor for cardiovascular disease, often called the "silent killer" because it typically presents without symptoms. In 2023, hypertension was the primary or contributing cause of about 664,000 deaths in the United States. As it progresses, hypertension can contribute to more serious conditions including angina, heart attacks and atherosclerosis, a buildup of plaque in the arteries.
Well-established modifiable risk factors include high blood pressure, high cholesterol, obesity, diabetes, smoking and physical inactivity. Nonmodifiable risks include family history, gender and age. Men develop heart disease earlier, while women typically develop it after menopause, and risk increases with age. Heart disease affects populations unequally across socioeconomic status, race and ethnicity, with communities of color experiencing higher rates, earlier onset and worse outcomes.
Social determinants such as food insecurity, limited access to preventive care, neighborhood walkability and exposure to secondhand smoke or air pollution also influence outcomes. Women may present with different symptoms than men, including nausea, fatigue and shortness of breath compared with the isolated chest discomfort described in men, which can contribute to delays in diagnosis. Many women are not aware that heart disease is the leading cause of death among women.
Lifestyle changes including a healthy diet and regular exercise can promote heart health by lowering blood pressure and cholesterol levels and maintaining a healthy weight. Experts recommend that those who have not seen their primary care doctor recently make an appointment to check blood pressure and cholesterol levels and discuss lifestyle modifications or medications if needed. For those with heart disease, a low-salt, low-cholesterol diet and regular follow-up are important.
