{"id":7435,"date":"2023-10-05T12:41:05","date_gmt":"2023-10-05T16:41:05","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7435"},"modified":"2023-10-05T12:42:06","modified_gmt":"2023-10-05T16:42:06","slug":"more-older-americans-likely-to-die-of-heart-disease-in-the-future","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2023\/10\/more-older-americans-likely-to-die-of-heart-disease-in-the-future\/","title":{"rendered":"More Older Americans Likely to Die of Heart Disease in the Future"},"content":{"rendered":"

Deaths from heart disease were dropping nicely for a while, but after 2010, the number of fatalities began to rise again. In this piece written for <\/span><\/i>KFF Health News<\/span><\/a>, Judith Graham delves into the reasons for this change, what it portends for the future and what COVID revealed about the groups and parts of the country most at risk. <\/span><\/i>KFF Health News <\/span>posted her piece on its website on May 30, 2023. It also ran on the <\/span><\/i>Washington Post<\/a>.<\/span><\/p>\n

Cardiovascular disease\u2014the No. 1 cause of death among people 65 and older\u2014is poised to become more prevalent in the years ahead, disproportionately affecting Black and Hispanic communities and exacting an enormous toll on the health and quality of life of older Americans.<\/span><\/p>\n

The estimates are sobering: by 2060, the prevalence of ischemic heart disease (a condition caused by blocked arteries and also known as coronary artery disease) is projected to rise 31 percent compared with 2025; heart failure will increase 33 percent; heart attacks will grow by 30 percent; and strokes will increase by 34 percent, according to a <\/span>team of researchers<\/span><\/a> from Harvard and other institutions. The greatest increase will come between 2025 and 2030, they predicted.<\/span><\/p>\n

The dramatic expansion of the US aging population (cardiovascular disease is far more common in older adults than in younger people) and rising numbers of people with conditions that put them at risk of heart disease and stroke\u2014high blood pressure, diabetes, and obesity foremost among them\u2014are expected to contribute to this alarming scenario.<\/span><\/p>\n

Because the risk factors are more common among Black and Hispanic populations, cardiovascular illness and death will become even more common for these groups, the researchers predicted. (Hispanic people can be of any race or combination of races.)<\/span><\/p>\n

\u201cDisparities in the burden of cardiovascular disease are only going to be exacerbated\u201d unless targeted efforts are made to strengthen health education, expand prevention and improve access to effective therapies, wrote the authors of an <\/span>accompanying editorial<\/a>,<\/span> from Stony Brook University in New York and Baylor University Medical Center in Texas.<\/span><\/p>\n

Between 2011 and 2019, deaths from cardiovascular disease increased by 13 percent.<\/b><\/p><\/blockquote>\n

\u201cWhatever focus we\u2019ve had before on managing [cardiovascular] disease risk in Black and Hispanic Americans, we need to redouble our efforts,\u201d said Clyde Yancy, MD, chief of cardiology and vice dean for diversity and inclusion at Northwestern University\u2019s Feinberg School of Medicine in Chicago, who was not involved with the research.<\/span><\/p>\n

Of course, medical advances, public health policies and other developments could alter the outlook for cardiovascular disease over the next several decades.<\/span><\/p>\n

More than 80 percent<\/span><\/a> of cardiovascular deaths occur among adults 65 or older. For about a dozen years, the total number of cardiovascular deaths in this age group has steadily ticked upward, as the ranks of older adults have expanded and previous progress in curbing fatalities from heart disease and strokes has been undermined by Americans\u2019 <\/span>expanding waistlines, poor diets and physical inactivity<\/a>.<\/span><\/p>\n

Among people 65 and older, cardiovascular deaths plunged 22 percent between 1999 and 2010, according to data from the National Heart, Lung, and Blood Institute\u2014a testament to new medical and surgical therapies and treatments and a sharp decline in smoking, among other public health initiatives. Then between 2011 and 2019, deaths climbed 13 percent.<\/span><\/p>\n

The COVID-19 pandemic has also added to the death toll, with coronavirus infections causing serious complications such as blood clots and millions of seniors avoiding seeking medical care out of fear of becoming infected. Most affected have been low-income individuals and older, non-Hispanic Black and Hispanic people, who have died from the virus at disproportionately higher rates than non-Hispanic white people.<\/span><\/p>\n

African Americans, facing the stress of racial discrimination, are more likely to have high blood pressure and other conditions that increase the risk of cardiovascular disease. <\/b><\/p><\/blockquote>\n

\u201cThe pandemic laid bare ongoing health inequities,\u201d and that has fueled a new wave of research into disparities across various medical conditions and their causes, said Nakela Cook, MD, a cardiologist and executive director of the Patient-Centered Outcomes Research Institute, an independent organization authorized by Congress.<\/span><\/p>\n

One of the most detailed examinations yet, published in <\/span>JAMA Cardiology<\/span><\/i> in March, examined <\/span>mortality rates<\/span><\/a> in Hispanic, non-Hispanic Black, and non-Hispanic white populations from 1990 to 2019 in all 50 states and the District of Columbia. It showed that Black men remain at the highest risk of dying from cardiovascular disease, especially in Southern states along the Mississippi River and in the northern Midwest. (The age-adjusted mortality rate from cardiovascular disease for Black men in 2019 was 245 per 100,000, compared with 191 per 100,000 for white men and 135 per 100,000 for Hispanic men. Results for women within each demographic were lower.)<\/span><\/p>\n

Progress stemming deaths from cardiovascular disease in Black men slowed considerably between 2010 and 2019. Across the country, cardiovascular deaths for that group dropped 13 percent, far less than the 28 percent decline from 2000 to 2010 and 19 percent decline from 1990 to 2000. In the regions where Black men were most at risk, the picture was even worse: in Mississippi, for instance, deaths of Black men fell only 1 percent  from 2010 to 2019, while in Michigan they dropped 4 percent. In the District of Columbia, they actually rose by nearly 5 percent.<\/span><\/p>\n

While individual lifestyles are partly responsible for the unequal burden of cardiovascular disease, the American Heart Association\u2019s 2017 <\/span>scientific statement<\/span><\/a> on the cardiovascular health of African Americans notes that \u201cperceived racial discrimination\u201d and related stress are associated with hypertension, obesity, persistent inflammation and other clinical processes that raise the risk of cardiovascular disease.<\/span><\/p>\n

Though Black people are deeply affected, so are other racial and ethnic minorities who experience adversity in their day-to-day lives, several experts noted. However, recent studies of cardiovascular deaths don\u2019t feature some of these groups, including Asian Americans and Native Americans.<\/span><\/p>\n

We really need to be going into vulnerable communities and reaching people where they\u2019re at to increase their knowledge of risk factors and how to reduce them.<\/b><\/p>\n

\u2014Natalie Bello, MD<\/b><\/p><\/blockquote>\n

What are the implications for the future? Noting significant variations in cardiovascular health outcomes by geographic location, Alain Bertoni, MD, an internist and professor of epidemiology and prevention at Wake Forest University School of Medicine, said, \u201cWe may need different solutions in different parts of the country.\u201d<\/span><\/p>\n

Gregory Roth, a coauthor of the <\/span>JAMA Cardiology<\/span><\/i> paper and an associate professor of cardiology at the University of Washington School of Medicine, called for a renewed effort to educate people in at-risk communities about \u201cmodifiable risk factors\u201d\u2014high blood pressure, high cholesterol, obesity, diabetes, smoking, inadequate physical activity, unhealthy diet and insufficient sleep. The American Heart Association has <\/span>suggestions<\/span><\/a> on its website for promoting cardiovascular health in each of these areas.<\/span><\/p>\n

Michelle Albert, MD, a cardiologist and the current president of the American Heart Association, said more attention needs to be paid in medical education to \u201csocial determinants of health\u201d\u2014including income, education, housing, neighborhood environments and community characteristics\u2014so the health care workforce is better prepared to address unmet health needs in vulnerable populations.<\/span><\/p>\n

Natalie Bello, MD, a cardiologist and the director of hypertension research at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles, said, \u201cWe really need to be going into vulnerable communities and reaching people where they\u2019re at to increase their knowledge of risk factors and how to reduce them.\u201d This could mean deploying community health workers more broadly or expanding innovative programs like ones that <\/span>bring pharmacists into Black-owned barberships<\/span><\/a> to educate Black men about high blood pressure, she suggested.<\/span><\/p>\n

\u201cNow, more than ever, we have the medical therapies and technologies in place to treat cardiovascular conditions,\u201d said Rishi Wadhera, MD, a cardiologist and section head of health policy and equity research at the Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center in Boston. What\u2019s needed, he said, are more vigorous efforts to ensure all older patients, including those from disadvantaged communities, are connected with primary care physicians and receive appropriate screening and treatment for cardiovascular risk factors, and high-quality, evidence-based care in the event of heart failure, a heart attack or a stroke.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Cardiovascular disease\u2014the No. 1 cause of death among people 65 and older\u2014is poised to become more prevalent in the years ahead<\/span><\/p>\n

Read more More Older Americans Likely to Die of Heart Disease in the Future<\/span> ›<\/span><\/a><\/div>\n

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