The investigation, led by the health plan company Kaiser Permanente, has found that the number of Americans dying from heart disease climbed by 8.5 percent (51,000) between 2011 and 2017. The increase was 38 percent when looking just at heart failure, a condition where the heart isn’t pumping as well as it should. Of the 647,000 heart disease deaths in 2017, about 1 in 8 had heart failure as an underlying cause. And about 9 out of 10 of these heart disease deaths were among individuals over the age of 65. “We are now in the midst of a ‘silver tsunami’ of heart disease and heart failure,” says Jamal Rana, MD, PhD, chief of cardiology at Kaiser Permanente East Bay in Oakland, California, and senior author of the study. “This will require both innovation in clinical care for our patients and urgent policy initiatives at the healthcare systems level to be better prepared for its impact.” RELATED: Heart Health In Your 20s, 30s, 40s, 50s, and 60s Age is a major risk factor for heart disease, according to the American Heart Association, and, according to the study, the 65-and-up population increased 22.9 percent from 41.4 million to 50.9 million between January 1 and December 31, 2011. This older population is expected to keep growing, and jump up another 44 percent between 2017 and 2030. On the other hand, the population of adults younger than 65 years edged up by only 1.7 percent in the six-year period. Stephen Sidney, MD, lead study author and director of research clinics at Kaiser Permanente Northern California Division of Research in Oakland, suggests that soaring rates of hypertension (high blood pressure), diabetes, and obesity among this older population may be driving factors behind the uptick in heart disease mortality. “An epidemic of obesity and diabetes began in the United States in the mid-1980s, so that currently about 40 percent of adults are categorized as being obese and 30 million people have diabetes,” he says. “About 116 million people have hypertension, but less than half of them have it under control.” Sarah Samaan, MD, a cardiologist with Baylor Scott & White Legacy Heart Center in Plano, Texas, who is not connected with the study, adds that obesity may also lift the likelihood of developing arthritis, chronic lung disease, and a multitude of other health conditions that lead people toward a more sedentary lifestyle. “Lack of regular exercise also contributes to stiffening of the heart muscle, which can be associated with heart failure,” she says. “In addition, people are surviving heart attacks now that in the past would likely have been fatal. Sometimes, despite adequate treatment, a heart attack may weaken the heart, which also contributes to heart failure.” RELATED: Obesity and Heart Disease, What’s the Connection?
Steps Toward Pumping Up Heart Health
Older adults are advised to literally not take their heart health sitting down. Dr. Rana advises that older adults stay physically active and eat healthy. “It may sound simple, but a healthy lifestyle remains cornerstone of the prevention of risk factors for heart disease, such as diabetes, obesity, smoking, and hypertension,” he says. “If medications are needed to treat these chronic conditions, then adherence to such medications is important.” Dr. Samaan underscores that prevention is key because heart failure is a chronic condition that in most cases is not fully reversible. “Exercise, maintaining a healthy weight, and address underlying conditions to improve your chances for a long, healthy, and vibrant life,” she says.
More Research in the Pipeline
For this study, scientists analyzed publicly available national data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research system. Rana notes that this national-level surveillance data may have had limitations in regards to how accurately the causes of death were defined. The national data also lacked specifics regarding types of heart failure. Study authors say that next they would like to evaluate the role of social determinants in contributing to deaths due to heart failure. “We want to understand how factors such as geography, economic background, and environment may contribute to this debilitating disease,” says Rana.
