Heart disease still US top killer as downward death rate trend levels off

Experts said causes of the slowing trend may include increases in obesity and diabetes.
Experts said causes of the slowing trend may include increases in obesity and diabetes.PHOTO: AFP

MIAMI (AFP) - Heart disease remains the top killer in the United States as a long-term trend of declining mortality has levelled out in recent years, possibly due to rising obesity and diabetes, researchers said on Wednesday.

The findings, published in the Journal of the American Medical Association (Jama) Cardiology, showed that the US national heart-and stroke-related mortality rate declined at an average of 3.8 per cent per year between 2000 and 2011.

The decline has slowed to less than 1 per cent a year since 2011, however.

Although the study did not investigate reasons for the slowdown, experts said causes may include increases in obesity and diabetes.

"Despite significant improvements in heart health over the past century, the increase in these chronic health conditions in epidemic proportions may be driving the recent slowdown," said senior author Jamal Rana, a Kaiser Permanente cardiologist.

Heart disease has been the leading cause of death in the United States since 1921.

The mortality rate has declined in recent decades due to advances in medical treatment and prevention, the increased use of statins and aspirin, fewer people smoking and more getting adequate exercise and controlling their blood pressure, the study said.

Researchers had expected cancer to overcome heart disease as the top US killer sometime around 2013, but the latest research shows that has not happened, and may not happen anytime soon.

"From 2000 to 2011, cancer was on track to bypass heart disease as the leading cause of death in the United States," Rana said. "Based on the current findings, this may not happen."

"Given this startling trend, the cardiovascular health care community needs to reaffirm its commitment to developing innovative ways to improve heart disease prevention at the population level," he added.

The rate of decline would have to reach an annual 2 per cent in order to achieve the American Heart Association's strategic goal of reducing deaths from both cardiovascular disease and stroke by 20 per cent between 2010 and 2020, said lead author Stephen Sidney, director of research clinics at the Kaiser Permanente Northern California Division of Research.

Mortality from cancer has declined at a steady rate of 1.5 per cent annually from 2000 to 2014, according to the study.