Heart disease remains the leading cause of death worldwide

Heart disease remains the number one killer worldwide, outstripping all other causes of death as key risk factors continue to surge, according to the 2025 Heart Disease and Stroke Statistics: A Report of U.S. and Global Data From the American Heart Association. 

Released in the journal Circulation, the flagship peer-reviewed publication of the American Heart Association (AHA), the comprehensive annual update underscores the urgent need to accelerate efforts to prevent and treat heart disease.

“Did you know that in the U.S., someone dies of cardiovascular disease every 34 seconds? Nearly 2,500 people in the U.S. die from cardiovascular disease every day. Those are alarming statistics to me – and they should be alarming for all of us, because it’s likely many among those whom we lose will be our friends and loved ones,” said Keith Churchwell, the volunteer president of the AHA.

“Too many people are dying from heart disease and from stroke which remains the 5th leading cause of death. Together, they kill more people than all cancers and accidental deaths – the #2 and #3 causes of death – combined.”

Disturbing rise in cardiovascular deaths

The new report highlights the persistent risk of cardiovascular disease (CVD) in the United States. The experts found that more than 941,652 CVD-related deaths were recorded in 2022 – over 10,000 above the 931,578 reported in 2021.

The age-adjusted CVD death rate was 224.3 per 100,000 people in 2022, a marginal drop from 233.3 per 100,000 in 2021, yet the overall number of fatalities remains on an upward trajectory.

While the data suggest that some aspects of the mortality rate may be stabilizing after a spike during the COVID-19 pandemic, many risk factors continue to worsen. 

The report further notes that nearly all major causes of death saw reductions in their age-adjusted rates, except for kidney disease, which climbed by 1.5%.

Kidney disease on the rise

Seth S. Martin, chair of the AHA’s statistical update writing committee and a cardiologist at Johns Hopkins School of Medicine, emphasized that kidney disease and cardiovascular disease share interrelated risk factors.

“Kidney disease has actually been on the rise over the past decade. In our report, we noted a significant increase in the prevalence of chronic kidney disease among Medicare beneficiaries from 9.2% in 2011 to 14.2% in 2021. Additionally, the global prevalence of kidney disease has increased more than 27% in relative terms since 2010,” explained Martin.

He added that high blood pressure, obesity, and diabetes are closely linked to both heart and kidney ailments, creating a compounded health threat that underscores the importance of addressing these conditions holistically.

Risk factors for heart disease

The report sheds light on several alarming statistics about cardiovascular risk factors in the United States. Nearly 47% of U.S. adults are affected by high blood pressure, while more than 50% live with type 2 diabetes or prediabetes.

In addition, over 72% of U.S. adults exceed healthy weight thresholds, with nearly 42% classified as obese.

In younger populations, obesity is also on the rise, with an estimated 40% of U.S. children having an unhealthy weight, including 20% meeting obesity criteria. Globally, about 60% of adults are considered overweight or obese, illustrating the widespread nature of these trends.

“In the update, we noted calculations that found excess weight contributes to as many as 1,300 additional deaths per day in the U.S., nearly 500,000 per year. It lowers life expectancy by as much as 2.4 years compared to a healthy weight,” said Latha P. Palaniappan, vice-chair of the statistical update writing committee and a professor of cardiovascular medicine at Stanford University.

“The impact on lives lost is twice as high for women, and higher for Black adults than for white adults. It’s alarming to note that excess weight now costs us even more lives than smoking.”

Disparities in risk factors

The study highlights major disparities in risk factors based on race, ethnicity, and sex. For obesity, Black women exhibit the highest rates at 57.9%, while Asian women register the lowest rate at 14.5%. 

Hispanic men show the highest diabetes prevalence at 14.5%, contrasted with a 7.7% rate among white women. In the case of high blood pressure, 58.4% of Black women experience hypertension, compared with 35.3% of Hispanic women.

“And it is important to acknowledge that, although cardiovascular disease affects us all, it doesn’t affect us all equally. For instance, there is wide variation in the prevalence of obesity, diabetes and high blood pressure by sex and race/ethnicity,” observed Dhruv S. Kazi, the associate director at Beth Israel Deaconess Medical Center.

Encouraging trends in tobacco use

Amid these alarming findings, there is a silver lining in the falling rates of tobacco consumption. Since 1965, adult smoking rates have dropped significantly. 

Furthermore, current cigarette use among high schoolers fell from 16.5% in 2022 to 12.6% in 2023, while e-cigarette use also declined from 14.1% to 10% in the same period.

“Another positive trend over the years has been a reduction in the rates of high cholesterol,” said Keith Churchwell, pointing out that a combination of heightened awareness, lifestyle changes, and medical treatments has contributed to these gains.

The need for holistic prevention

Despite improved treatments and lower tobacco usage, the anticipated surge in obesity, diabetes, and hypertension poses an enormous challenge for public health. Researchers warn that if current trends continue, the U.S. could face a 300% jump in heart disease-related healthcare costs by 2050.

“If recent trends continue, hypertension and obesity will each affect more than 180 million U.S. adults by 2050, whereas the prevalence of diabetes will climb to more than 80 million. And over the same time period, we expect to see a 300% increase in health care costs related to cardiovascular disease,” Kazi said.

He and Churchwell emphasize that solutions must go beyond clinical discoveries, extending to community interventions that ensure equal access to care and tackle socioeconomic barriers.

Reversing the trend of heart disease

The report urges policymakers, healthcare professionals, and communities to collaborate in order to halt the escalation of key risk factors for heart disease. This means prioritizing obesity prevention, controlling high blood pressure, improving dietary habits, and expanding the availability of new therapies for those who need them most.

“Heart disease was once considered a death sentence, but thanks to the many advances in clinical diagnosis and treatment, people are able to live longer, healthier lives even after a cardiovascular event,” Churchwell explained.

“Certainly, any medical or clinical therapy that can treat the risk factors that contribute to CVD are essential. More importantly, I would say that we need to stop these risk factors in their tracks, keep people healthy throughout their lifespan. That will only be possible with a strong emphasis on early prevention and equitable health access for all.”

With a continued and concerted focus on prevention, early detection, and equitable health policies, experts believe it is still possible to reverse the upward curve of heart disease and save countless lives.

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