Until 2011, advancements in the diagnosis and treatment of cardiometabolic disease helped reduce total deaths from these conditions, says Sadiya S. Khan, MD, senior author of the study and an assistant professor at Northwestern University Feinberg School of Medicine in Chicago. But since then, declines in deaths from heart disease have slowed, fatalities from diabetes and stroke have leveled off, and deaths from high blood pressure have kept climbing. Americans’ burgeoning waistlines are a big part of the problem, Dr. Khan says. “Our suspicion is that with the growing number of people with obesity and severe obesity, deaths attributable to all of these conditions may be growing,” Khan says. More than 70 percent of American adults are overweight or obese today, up from about 56 percent in the late 1980s and early 1990s, according to the U.S. Centers for Disease Control and Prevention (CDC). Obesity is a leading cause of heart disease, diabetes, and certain cancers as well as disability and premature death, per to the CDC. For the current study, Khan and colleagues examined CDC mortality data from 1999 to 2017 to calculate age-adjusted mortality rates from cardiometabolic disease for every 100,000 people in the U.S. population. For heart disease, stroke, and diabetes, death rates hit an inflection point in 2010. Before 2010, the number of deaths from heart disease dropped by 8.3 people for every 100,000 each year. After that, however, the number of deaths for every 100,000 declined by just 1.8 each year. For stroke, the number of deaths for every 100,000 people dropped by 2.3 a year until 2010 and then held steady. With diabetes, deaths dropped by 0.4 per 100,000 people each year until 2010 and then stopped changing. High blood pressure death rates climbed by 0.3 per 100,000 each year until 2003 and then rose less, by 0.1 per 100,000 in subsequent years. In 1999, 266.5 people in every 100,000 died from heart disease; 61.6 died from stroke; 25 died from diabetes; and 6.2 died from high blood pressure. By 2017, total deaths from heart disease for every 100,000 people dropped to 165; while 37.6 died from stroke; 21.5 died from diabetes; and 9 died from high blood pressure. During the study period, 12.3 percent of cardiometabolic deaths occurred in black individuals, 85.1 percent occurred in white people, and 51.3 percent occurred in women. Black people consistently had higher death rates than white people, the study found. The study wasn’t a controlled experiment designed to prove whether or how any one factor might have directly contributed to these deaths, or to show racial disparities in mortality rates. “There are likely many reasons that are contributing to the disparities that we are seeing, including disparities in access to healthcare, poverty, and education,” Khan says. RELATED: Obesity and Heart Disease: What’s the Connection?
How to Reverse This Troubling Trend
Khan also says that nearly all of these deaths can be prevented. Eating right, exercising, maintaining a healthy weight, avoiding cigarettes, and drinking in moderation can help minimize the risk of heart disease, diabetes, stroke and high blood pressure. A diet rich in whole grains, fruits, vegetables, and healthy fats is associated with a lower risk of cardiometabolic disease, according to the National Institutes of Health. Too much salt, sugar, or red and processed meats can increase the risk. Men can also lower their risk of disease by drinking no more than two beers or cocktails a day, while women should stick to just one daily drink, according to the CDC. And adults need at least 150 minutes of moderate-to-vigorous aerobic activity each week, with muscle strengthening activities on two days during the week to stay healthy, according to recommendations in a November 2018 press release from U.S. Department of Health and Human Services.
