In a study published online by JAMA Cardiology, Stephen Sidney, M.D., M.P.H., of Kaiser Permanente Northern California, Oakland, and colleagues examined recent national trends in death rates due to all cardiovascular disease (CVD), heart disease (HD), stroke, and cancer, and also evaluated the gap between mortality rates from HD and cancer.
With the exception of the flu pandemic years of 1918-1920, heart disease has been the leading cause of death in the United States since 1910, with cancer and stroke among the 5 leading causes of death every year since 1924. During the first decade of the 21st century, HD mortality declined at a much greater rate than cancer mortality and it appeared that cancer would overtake HD as the leading cause of death. The decrease in HD mortality in the U.S. has been attributed to expanded use of evidence-based medical therapies as well as changes in risk factors and lifestyle modifications. For this study, researchers used the data system of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research to determine national trends in age-adjusted mortality rates due to all CVD, HD, stroke, and cancer from January 2000 to December 2011 and January 2011 to December 2014, overall, by sex, and by race/ethnicity.
The researchers found that the rate of the decline in all CVD, HD, and stroke mortality decelerated substantially after 2011, and the rate of decline for cancer mortality remained relatively stable. The annual rates of decline for 2000-2011 were 3.79 percent, 3.69 percent, 4.53 percent, and 1.49 percent for all CVD, HD, stroke, and cancer mortality, respectively; the rates for 2011-2014 were 0.65 percent, 0.76 percent, 0.37 percent, and 1.55 percent, respectively.
The authors write that if the rates of decline from 2000 to 2011 had persisted, HD mortality in the United States would have been below that of cancer mortality in 2013, but the pattern of HD and cancer being the first and second leading causes of death, respectively, has endured.
“Given the high absolute burden and associated costs of HD and stroke, continued vigilance and innovation are essential in our efforts to address the ongoing challenge of CVD prevention. However, the recent deceleration in the rate of decline in HD mortality is alarming and warrants expanded innovative efforts to improve population-level CVD prevention.”