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. 2022 Aug 9;80(6):565-578.
doi: 10.1016/j.jacc.2022.05.033.

Cardiovascular Disease Projections in the United States Based on the 2020 Census Estimates

Reza Mohebi  1 , Chen Chen  1 , Nasrien E Ibrahim  2 , Cian P McCarthy  1 , Hanna K Gaggin  1 , Daniel E Singer  3 , Emily P Hyle  1 , Jason H Wasfy  1 , James L Januzzi Jr  4
Affiliations

Cardiovascular Disease Projections in the United States Based on the 2020 Census Estimates

Reza Mohebi et al. J Am Coll Cardiol. .

Abstract

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.

Keywords: ethnicity; heart disease; population health; projection; race; sex.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Mohebi is supported by the Barry Fellowship. Dr McCarthy is supported by a National. Heart, Lung, and Blood Institute T32 postdoctoral training grant (5T32HL094301-12). Dr Hyle is supported by the National Institute on Aging (R01 AG069575). Dr Januzzi is supported by the Hutter Family Professorship. Dr Ibrahim has received honoraria from Cytokinetics, Medtronic, Novartis, and Roche. Dr Gaggin has received research grant support from Roche Diagnostics, Jana Care, Ortho Clinical, Novartis, Pfizer, Alnylam, and Akcea; has received consulting income from Amgen, Eko, Merck, Roche Diagnostics, and Pfizer; has stock ownership for Eko; has received research payments for clinical endpoint committees from Radiometer; and has received research payment for clinical endpoint committees from the Baim Institute for Clinical Research for Abbott, Siemens, and Beckman Coulter. Dr Singer receives research support from Bristol Myers Squibb; and has received consulting income from Bristol Myers Squibb, Fitbit, Medtronic, and Pfizer. Dr Wasfy is supported by a grant from the American Heart Association (18 CDA 34110215); and has received consulting income from Pfizer and Biotronik. Dr Januzzi is supported by the Hutter Family Professorship; is a Trustee of the American College of Cardiology; is a board member of Imbria Pharmaceuticals; has received grant support from Abbott Diagnostics, Applied Therapeutics, Innolife, and Novartis; has received consulting income from Abbott Diagnostics, Boehringer Ingelheim, Janssen, Novartis, and Roche Diagnostics; and participates in clinical endpoint committees/data safety monitoring boards for AbbVie, Siemens, Takeda, and Vifor. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

FIGURE 1
FIGURE 1. Projected Number (95% CI) of Adults With CV Risk Factors, 2025–2060
Diabetes mellitus (A), hypertension (B), dyslipidemia (C), and obesity (D). Under each figure is provided the total number in millions (M) and stratified according to sex. CV = cardiovascular.
FIGURE 1
FIGURE 1. Projected Number (95% CI) of Adults With CV Risk Factors, 2025–2060
Diabetes mellitus (A), hypertension (B), dyslipidemia (C), and obesity (D). Under each figure is provided the total number in millions (M) and stratified according to sex. CV = cardiovascular.
FIGURE 2
FIGURE 2. Percent Change in Prevalence of CV Risk Factors Every 5 Years
Percentage change was calculated as: [prevalence (at the end of 5 years) – prevalence (in the beginning of 5 years)]/prevalence (in the beginning of 5 years) × 100. The greatest percent changes in prevalence of cardiovascular (CV) risk factors are expected to occur between 2025 and 2030.
FIGURE 3
FIGURE 3. Projected Number (95% CI) of Adults With CV Disease, 2025–2060
Ischemic heart disease (A), heart failure (B), myocardial infarction (C), and stroke (D). Under each figure is provided the total number in millions and stratified according to sex. CV = cardiovascular.
FIGURE 3
FIGURE 3. Projected Number (95% CI) of Adults With CV Disease, 2025–2060
Ischemic heart disease (A), heart failure (B), myocardial infarction (C), and stroke (D). Under each figure is provided the total number in millions and stratified according to sex. CV = cardiovascular.
FIGURE 4
FIGURE 4. Percent Change in Prevalence of CV Diseases Every 5 Years
Percentage change was calculated as: [prevalence (at the end of 5 years) – prevalence (in the beginning of 5 years)]/prevalence (in the beginning of 5 years) × 100. The greatest percent changes in prevalence of cardiovascular (CV) diseases are expected to occur between 2025 and 2030.
CENTRAL ILLUSTRATION
CENTRAL ILLUSTRATION. Projected Future of Cardiovascular Risk Factors and Cardiovascular Diseases by 2060
Dramatic increases in risk factors such as diabetes, hypertension, and dyslipidemia are projected to disproportionately affect ethnic and racial minority groups, resulting in a parallel rise of ischemic heart disease and heart failure in these populations.
See this image and copyright information in PMC

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