Heart Disease is the Leading Cause of Death in the United States
Heart disease remains the leading cause of death in the United States, accounting for approximately 26.2% of all deaths as of 2022. 1
Evidence Overview
The evidence consistently identifies heart disease as the top killer in the United States:
- According to the most recent 2024 NCCN guidelines, heart disease continues to be the leading cause of death in the United States, followed by cancer 2
- The American Heart Association's 2023 scientific statement confirms cardiovascular disease as the leading cause of death and disability in the United States and globally 2
- 2022 mortality data shows heart disease responsible for 26.2% of all deaths, followed by malignant neoplasms (22.7%), unintentional injuries (8.5%), and COVID-19 (6.9%) 1
Demographic Variations
While heart disease remains the overall leading cause of death, there are important demographic variations:
- Heart disease is consistently the leading cause of death for non-Hispanic white and non-Hispanic black populations 3
- Cancer has become the leading cause of death for non-Hispanic Asian or Pacific Islander and Hispanic populations 3
- There is a socioeconomic gradient in the epidemiologic transition from heart disease to cancer as the leading cause of death:
- Higher-income counties have experienced a faster shift toward cancer as the leading cause of death
- In lower-income counties, heart disease remains the predominant cause of death across all racial/ethnic groups 4
Historical Trends
The gap between heart disease and cancer mortality has fluctuated over time:
- The gap widened from 1950-1968
- Narrowed from 1968-2012
- Slightly widened again from 2012-2014 3
Preventable Risk Factors
Many heart disease deaths are preventable through risk factor modification:
- Tobacco smoking and high blood pressure are responsible for approximately 467,000 and 395,000 deaths respectively, accounting for about one in five or six deaths in US adults 5
- Overweight/obesity (216,000 deaths) and physical inactivity (191,000 deaths) each contribute to nearly 1 in 10 deaths 5
- Dietary factors including high salt intake, low omega-3 fatty acids, and high trans fatty acids consumption significantly contribute to cardiovascular mortality 5
Implications
The persistence of heart disease as the leading cause of death despite advances in treatment highlights the critical importance of preventive strategies. Efforts should focus on:
- Smoking cessation
- Blood pressure control
- Healthy diet and physical activity
- Early detection of coronary artery disease through methods like coronary artery calcium scoring in appropriate risk groups 2
The economic impact is substantial, with cardiovascular disease costs estimated at $368.4 billion in 2004 2, with continued increases expected.
Heart disease mortality has been decreasing over time (28% decrease from 2003-2015), but these improvements have been uneven, with high-income counties experiencing greater reductions (30%) compared to low-income counties (22%) 4.