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Cardiovascular Disease Projections in the United States Based on the 2020 Census Estimates
Reza Mohebi1, Chen Chen1, Nasrien E Ibrahim2
1Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
Insights
Cardiovascular disease and risk factors will significantly increase by 2060, disproportionately impacting minority populations. Public health strategies must address these disparities for equitable care.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Medicine
Background:
- Understanding cardiovascular (CV) risk factors and disease trends by demographics is crucial for public health policy.
- Key CV risk factors include diabetes mellitus, hypertension, dyslipidemia, and obesity.
- CV diseases encompass ischemic heart disease, heart failure, myocardial infarction, and stroke.
Purpose of the Study:
- To project future numbers of individuals with CV risk factors and diseases.
- To analyze sex, race, and ethnic disparities in CV risk and disease prevalence.
- To inform policy planning and public health interventions.
Main Methods:
- Utilized logistic regression models with National Health and Nutrition Examination Survey data (2013-2018).
- Integrated U.S. Census projection counts (2020) for projections spanning 2025-2060.
- Estimated prevalence of specific CV risk factors and diseases across demographic groups.
Main Results:
- By 2060, significant increases are projected for diabetes mellitus (39.3%), hypertension (27.2%), dyslipidemia (27.5%), and obesity (18.3%).
- CV diseases are also projected to rise: ischemic heart disease (31.1%), heart failure (33.0%), myocardial infarction (30.1%), and stroke (34.3%).
- Prevalence is expected to decrease among White individuals but increase significantly among racial and ethnic minorities.
Conclusions:
- Future increases in CV risk factors and diseases are projected, with a disproportionate burden on minority populations.
- Health policies and public health efforts must consider these disparities.
- Ensuring quality, affordable, and accessible healthcare is paramount.
Background:
Understanding trends in cardiovascular (CV) risk factors and CV disease according to age, sex, race, and ethnicity is important for policy planning and public health interventions.
Objectives:
The goal of this study was to project the number of people with CV risk factors and disease and further explore sex, race, and ethnical disparities.
Methods:
The prevalence of CV risk factors (diabetes mellitus, hypertension, dyslipidemia, and obesity) and CV disease (ischemic heart disease, heart failure, myocardial infarction, and stroke) according to age, sex, race, and ethnicity was estimated by using logistic regression models based on 2013-2018 National Health and Nutrition Examination Survey data and further combining them with 2020 U.S. Census projection counts for years 2025-2060.
Results:
By the year 2060, compared with the year 2025, the number of people with diabetes mellitus will increase by 39.3% (39.2 million [M] to 54.6M), hypertension by 27.2% (127.8M to 162.5M), dyslipidemia by 27.5% (98.6M to 125.7M), and obesity by 18.3% (106.3M to 125.7M). Concurrently, projected prevalence will similarly increase compared with 2025 for ischemic heart disease by 31.1% (21.9M to 28.7M), heart failure by 33.0% (9.7M to 12.9M), myocardial infarction by 30.1% (12.3M to 16.0M), and stroke by 34.3% (10.8M to 14.5M). Among White individuals, the prevalence of CV risk factors and disease is projected to decrease, whereas significant increases are projected in racial and ethnic minorities.
Conclusions:
Large future increases in CV risk factors and CV disease prevalence are projected, disproportionately affecting racial and ethnic minorities. Future health policies and public health efforts should take these results into account to provide quality, affordable, and accessible health care.
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