Epidemiology and Risk Factors of Cardiovascular Disease

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EP: 1.Epidemiology and Risk Factors of Cardiovascular Disease

Cardiovascular disease (CVD), particularly atherosclerotic CVD (ASCVD), remains the leading cause of death among men and women in the United States. ASCVD includes coronary heart disease, cerebrovascular disease such as stroke, and peripheral arterial disease. Currently, an estimated 20 million people in the U.S. are living with ASCVD. Despite significant efforts in public awareness and clinical management, mortality remains high. The burden is expected to increase, driven by rising rates of obesity and diabetes. Projections indicate that by 2050, the prevalence of CVD could rise from approximately 12% to nearly 15% of the population — a 50% relative increase over 30 years — highlighting the potential for a significant public health crisis.

The disease trajectory is heavily influenced by both nonmodifiable and modifiable risk factors. Nonmodifiable risks include age, genetics, race and family history, all of which play critical roles in determining an individual’s baseline risk. However, a substantial portion of the burden is driven by modifiable factors, which include high blood pressure, high cholesterol, obesity, tobacco use, physical inactivity, poor diet, stress and excessive alcohol consumption. Recent guidelines emphasize lifestyle changes as the foundational approach to reducing cardiovascular risk, with medical therapies added as needed. Despite the challenges in altering behaviors, even modest improvements in these risk factors can lead to meaningful reductions in disease incidence and severity.

Efforts to mitigate CVD must increasingly focus on prevention. This includes primordial prevention (stopping risk factors from developing in the first place) and primary prevention (managing risk factors once they are present). The Life’s Essential Eight framework from the American Heart Association provides a practical tool for guiding both patients and clinicians in risk factor optimization. Encouraging individuals to understand and monitor their blood pressure, blood sugar, cholesterol, weight and related metrics can empower early intervention and improve long-term outcomes.