CVD Remains Leading Cause of Death in US: AHA 2025 Statistical Update

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The American Heart Association (AHA) has published its 2025 update on cardiovascular disease (CVD) and stroke statistics, offering the latest insights into CVD prevalence, risk factors, and mortality trends.1

The statistical update, published in Circulation on behalf of the AHA Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Committee, provides an overview on CVD, stroke, and risk factors aligned with the AHA’s Life’s Essential 8 framework.1

“Too many people are dying from heart disease and from stroke, which remains the fifth-leading cause of death. Together, they kill more people than all cancers and accidental deaths — the No. 2 and No. 3 causes of death — combined," Keith Churchwell, MD, associate clinical professor of medicine at Yale School of Medicine, adjunct associate professor of medicine at the Vanderbilt School of Medicine, and volunteer president of the AHA, said in a press release.2

CVD prevalence and mortality

According to the report, nearly 40% of CVD-related deaths in the US in 2022 were due to coronary heart disease (CHD). The age-adjusted mortality rate for CVD was 224.3 per 100 000 population, with the highest rate among non-Hispanic Black men (379.7 per 100 000) and the lowest among Asian women (104.9 per 100 000). The economic burden of CVD continues to rise, with direct costs increasing from $189.7 billion in 2012-2013 to $233.3 billion in 2020-2021.1

Encouragingly, survival rates after in-hospital cardiac arrest have shown modest improvement, according to the report. Using data from Get with The Guidelines–Resuscitation, investigators observed modest year-over-year improvement in both return of spontaneous circulation (adjusted OR [aOR] per year = 1.04) and survival to hospital discharge (aOR per year = 1.03).1

Changes in CVD risk factors

For every 1 standard deviation increase in the AHA Life’s Essential 8 score—which encompasses smoking cessation, physical activity, a healthy diet, proper sleep, and control of weight, cholesterol, blood pressure, and glucose—there was a 36% reduction in CVD risk, according to the document.1

Although adult and youth cigarette smoking has declined in the US in the past 2 decades, the prevalence of e-cigarette use in the past 30 days among middle and high school students was 4.6% and 10%, respectively, with 89.4% young e-cigarette users reporting use of flavored products and 25.2% daily use, researchers reported.1

Exercise levels among adults have remained stagnant, with 48% meeting recommended aerobic activity levels from 2020 to 2022. Prevalence of a healthy dietary pattern, as measured by the Healthy Eating Index, slightly improved in the past 10 years, with the current average index score of 59 out of 100, according to the report.1

Obesity continues to be a pressing issue, with all US states reporting a prevalence exceeding 20% as of 2022. The overall rates of cholesterol evaluation in adults with dyslipidemia did not change.1

In 2022, the prevalence of hypertension was reported as follows1:

• 28.5% among individuals aged 20-44 years
• 58.6% among those aged 45-64 years
• 76.5% among adults aged 65 years and older

Also, CVD remains the leading cause of death among individuals with diabetes, with fewer than 20% achieving recommended levels for HbA1c, blood pressure, and lipid control, according to the report.1

“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,” Churchwell said in the release.2

References:

1. Martin SS, Aday AW, Allen NB, et al. 2025 heart disease and stroke statistics: A report of US and global data from the American Heart Association. Circulation. Published online January 27, 2025. doi: 10.1161/CIR.0000000000001303

2. Heart disease remains leading cause of death as key health risk factors continue to rise. News release. American Heart Association. January 27, 2025. Accessed January 27, 2025. https://newsroom.heart.org/news/heart-disease-remains-leading-cause-of-death-as-key-health-risk-factors-continue-to-rise