Obesity-Related Cardiovascular Disease Deaths Tripled in US From 1999 to 2020

Between 1999 and 2020, there was a 3-fold increase in obesity-related deaths associated with cardiovascular disease (CVD) in the United States, according to a new study published in the Journal of the American Heart Association.¹

In 2020, coronary heart disease was the leading cause of deaths at 41.2%, which was attributed to CVD in the United States, followed by stroke at 17.3%, other CVD at 16.8%, high blood pressure at 12.9%, heart failure at 9.2%, and diseases of the arteries at 2.6%. Additionally, CVD accounted for approximately 19.05 million global deaths in 2020, according to the American Heart Association’s 2023 statistics.²

“The number of [individuals] with obesity is rising in every country across the world. Our study is the first to demonstrate that this increasing burden of obesity is translating into rising heart disease deaths,” Zahra Raisi-Estabragh, MD, a clinical lecturer at the William Harvey Research Institute in London, said in a statement. “This rising trend of obesity is affecting some populations more than others, particularly Black women.”¹

In the study, investigators analyzed the race, gender, and environmental settings to determine the differences in CVD deaths where obesity was listed as a contributing factor.¹

Data were collected from The Multiple Cause of Death database from 1999 to 2020 on 281,135 deaths for which obesity was the contributing factor, including mortality and population counts from all US counties. Among the deaths, 4.3% were women, 78.1% were White, 19.8% were Black, 1.1% were Asian or Pacific Islander, and 1% were American Indian or Alaskan Native.¹

In the study, ischemic heart disease was the most common primary cause of death, with the second being hypertensive disease, which was also the most common cause of death for Black individuals at 31%.³

Investigators found that obesity-related CVD deaths tripled from 2.2 per 100,000 population to 6.6 per 100,000 population between 1999 and 2020. Additionally, deaths were higher among Black individuals compared to any other racial groups at 6.7 per 100,000 population.¹

Black women were observed to have the highest rates of obesity-related CVD deaths than in other studies whereas other racial groups had more men experiencing obesity-related CVD deaths than women.¹ Furthermore, investigators found that Black adults in urban areas had higher rates of obesity-related CVD deaths compared to Black adults living in rural areas.¹

Investigators added that these data were important to understand the racial disparities, noting that Black individuals in urban communities may be impacted more by socioeconomic deprivation and health inequities than Black individuals in rural areas.They also noted that Black individuals in urban areas did not seem to have the same benefits as other racial groups in urban areas.¹

Investigators said that the data are limited as they represent the US population, so the results might not be applicable to our regions outside of the United States.³

References

1. Obesity-related cardiovascular disease deaths tripled between 1999 and 2020. News release. American Heart Association. September 6, 2023. Accessed September 6, 2023. https://newsroom.heart.org/news/obesity-related-cardiovascular-disease-deaths-tripled-between-1999-and-2020?preview=9fc9
2. Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association Circulation. 2023. doi:10.1161/CIR.0000000000001123
3. Raisi-Estabragh Z, Kobo O, Mieres JH, et al. Racial disparities in obesity-related cardiovascular mortality in the United States: temporal trends from 1999 to 2020. J Am Heart Assoc. 2023;e028409. doi:10.1161/JAHA.122.028409