Heart disease: A serious health risk for a growing number of people

The number of people in the U.S. and around the world diagnosed with heart disease is growing. In the U.S., in 2021, the most recent year for which data is available, heart disease and stroke caused more deaths than all types of cancer and chronic lower respiratory diseases like COPD and emphysema combined, a total of 931,578 deaths. That makes heart disease the number one cause of death in this country. And the trend is not slowing. New research published in the journal Circulation projects that by 2050, more than 61% of Americans will be living with some form of heart disease.

Sun Life’s 12th annual High Cost Claims and Injectable Drug Trends Analysis also highlights the growing impact of cardiovascular disease. For the first time since the report started being produced, cardiovascular disease has moved into the #2 spot for highest reimbursement cost over a four-year period, surpassing blood cancers.

Why is the number of people affected by cardiovascular disease increasing?

There are several factors driving the increase in the incidence of cardiovascular disease. “The population in the U.S. is aging, and with age there’s a natural increase in the number of people who are diagnosed with cardiovascular disease,” explains Dr. Miles J. Varn, Head of PinnacleCare and Sun Life U.S. Chief Medical Officer. “And on a population level, the U.S. is an increasingly unhealthy nation. More people are overweight or obese, more people are being diagnosed with type 2 diabetes, more are inactive and choosing a less than healthy diet. All of these factors increase the risk of developing a range of cardiovascular diseases, as well as other diseases.”

Dr. Varn also points out that recent studies have found evidence that exposure to the virus that causes COVID-19 also significantly increases the risk of developing heart disease. One study, published in the Journal of the American Heart Association, gathered data on more than 23 million adults aged 20 or older from a health insurance database. This information was compared with control groups of people who had not reported a COVID infection. The researchers found that patients diagnosed with COVID had a significantly higher risk of a wide range of cardiovascular disorders including stroke, heart rhythm problems, heart attacks, blood clots, narrowing of the arteries, and inflammatory heart disease (myocarditis). Even when the uninfected control group had type 2 diabetes, the risk for heart disease was still higher in the group that had been infected with the virus that causes COVID.

Another study used databases from the U.S. Department of Veterans Affairs to explore the longer term impact of COVID infection on cardiovascular disease risk. Previous research had shown that people with severe infections who were hospitalized had an increased heart disease risk during the first 30 days from infection. This new study looked at a longer period (one-year post-infection) and at people who had a milder infection and did not need to be hospitalized in addition to those who had severe disease.

The findings surprised the research team. At one-year post-infection, regardless of disease severity, people had an increased risk of a wide range of heart problems, including stroke, blood clots in the legs and lungs, irregular heart rhythms, heart failure, and heart attacks. This held true even for people who did not have other risk factors for heart disease, like smoking, type 2 diabetes, obesity, a previous diagnosis of heart disease, or kidney disease. The risk increase occurred regardless of race, sex, or age. There is some evidence that the risk is higher in people who had more severe symptoms.

“COVID is an inflammatory disease,” says Dr. Varn. “It attacks blood vessels, including those in the cardiovascular system, which can cause persistent vascular problems that increase risk for this wide range of heart conditions. As COVID becomes an endemic disease, the high number of mild infections could lead to a long-term widespread increase in the rates of cardiovascular events and disease.”

Researchers who have explored the impact of the effect of COVID infection on the body found an association between inflammation and an increased risk of cardiovascular problems. There is evidence that SARS-CoV-2 infects a number of tissues outside of the respiratory system, including heart tissue, and the presence of the virus has been documented for weeks to months after the initial infection. This infection would stimulate an immune response and a subsequent extended inflammatory state in multiple systems in the body.

There is direct evidence that individuals with post-COVID symptoms have a higher level of pro-inflammatory molecules and between 10% and 73% of people with long-COVID have been found to have elevated inflammatory molecules two months or more after infection. Extended periods of inflammation have been shown to lead to progressive damage of multiple systems, including the blood vessels and heart tissue.

COVID has also been shown to cause long-lasting disruption of the function of cells that line the vascular system, causing stiffening of blood vessels. Stiffening of the arteries that supply blood to the heart increases the strain on the heart, and stiffening of blood vessels can also lead to a cycle of further damage.

Strategies to lower your risk of cardiovascular disease

There are several strategies that can help you manage your cardiovascular health and lower your risk of developing heart disease or, if you’re already living with heart disease, lower the risk of your condition becoming more severe.

“Awareness of the health of your heart and your risk factors is the first step towards mitigating your risk,” notes Dr. Varn. “It’s important to see your primary care physician or cardiologist for assessment and follow-up. If you don’t know that you have heart disease, it can advance over time and the first presentation of your condition could be a heart attack or stroke. But when you receive treatment and ongoing management at an earlier stage, you’re lowering your risk of a severe outcome.”

While a shortage of cardiologists, especially in rural areas and small towns, can make accessing the quality, consistent care you need to manage your heart health, your PinnacleCare Health Advisor can help. Your Advisor can help to find and connect you with experienced cardiologists and other specialists, helping you navigate the increasingly complex healthcare landscape.

Another key element of risk management and mitigation is knowing your family history of heart disease. If a family member was diagnosed with any type of heart disease, your risk for developing heart disease is higher than average. If your biological mother, father, sister, or brother had a heart attack before the age of 50, your risk of heart disease, heart attack, and stroke increases.

Making lifestyle changes can also help lower your risk. Being active on a regular basis, choosing a healthy diet, not smoking or vaping, limiting your consumption of alcohol, getting enough good quality sleep, managing stress, and reaching and maintaining a healthy weight can all help lower your risk of heart disease. GLP-1 receptor agonists, medications used to lower blood sugar and reduce weight like semaglutide, have also recently been found to reduce the risk of heart attacks and strokes in people with pre-existing cardiovascular disease who are overweight.

Get the expert support of a PinnacleCare Health Advisor

Connect with a PinnacleCare Relationship Manager today to learn how a personal Health Advisor can help to support you through heart disease prevention or management—connecting you with leading specialists and helping to coordinate care.