Most People Don't Know the Leading Cause of Death in America

More than half of American adults aren’t aware that heart disease is the leading cause of death, according to a new report — a fact that experts say could prove deadly.

Heart disease has been the leading cause of death in the United States since 1921 — for more than a century — according to the Centers for Disease Control and Prevention, and yet more than half of the U.S. population isn't aware of this fact.

A new Harris Poll survey, conducted on behalf of the American Heart Association and published in Circulation, found that 51% of Americans are unaware that heart disease is the top killer.

This is despite the fact that heart disease and stroke, which is the fifth leading cause of death, together claimed more lives in the U.S. than all forms of cancer and chronic lower respiratory disease combined in 2021. There are about 1,905 deaths from heart disease every day in the U.S., and someone has a heart attack approximately every 40 seconds.

The importance of awareness

Dr. Norman Lepor, a cardiologist and the Director of the National Heart Institute in Beverly Hills, California, tells Healthnews, "Being aware of your personal risk for cardiovascular disease is key to determining your need for treatments and preventing complications such as sudden death, heart attack, and stroke."

Just 49% of survey respondents were able to identify heart disease as the leading cause of death, with 16% saying they didn’t know the answer and 18% listing cancer as the top cause.

"Despite advancements in therapies, cardiovascular disease (CVD) is still the leading cause of death in the U.S," says Lepor. "This is likely due to a general lack of awareness of the disease."

And yet, almost half of the U.S. population — or 48.6% — has some type of cardiovascular disease (CVD), according to the report, including coronary heart disease, heart failure, stroke, and high blood pressure. Perhaps most concerning is the fact that 46.7% of U.S. adults have high blood pressure, but 38% of those with hypertension are unaware that they have it.

Rates are high but on the decline

While deaths from cardiovascular disease remain high, they have decreased significantly over the years. Death rates from the disease have declined by 60% since 1950, though they’ve begun to trend upward in recent years as a result of the prominence of high blood pressure and obesity.

Lepor advises people to eat foods rich in fiber and low in saturated or trans fats. "I also recommend my patients to limit their consumption of red meats, processed foods, and food and beverages with added sugar or salt," he says.

Since many cardiac events happen again, Lepor says, changes in diet, physical exercise, and overall management of your lifestyle are crucial post recovery. But oftentimes, lifestyle changes don't manage your health completely.

"Statins are the most common cholesterol-lowering medication, but up to 80% of statin-treated ASCVD patients are unable to reach their LDL-C level goals on statins alone. However, there are other cholesterol-lowering agents in our arsenal, such as an injectable medication called Leqvio (inclisiran), which is taken with a statin to help lower bad cholesterol. This treatment, administered by a health care provider twice-yearly (after just two initial doses), can help lower bad cholesterol by 50% and helps keep it low through each six-month dosing interval," he says.

Still, thanks to improved diagnosis and treatment options, the number of people dying of a heart attack in the U.S. each year has dropped from one in two in the 1950s to one in 8.5.

"Maintaining healthy lifestyle habits such as a good diet and exercise is a lifetime endeavor when it comes to mitigating your heart disease risk, so it should not be taken lightly," Lepor says. "Many cardiovascular deaths happen without warning, but they oftentimes are preventable. It is critical for everyone, especially those who have had a recent heart event or are at risk, to make managing heart health a top priority. I encourage everyone to take the time to talk with their doctor and work together to find the best treatment plan."