The American Heart Association's 2026 Heart Disease and Stroke Statistics Update reports a decline in cardiovascular disease deaths following a five-year upward trend likely impacted by the COVID-19 pandemic, yet heart disease remains the leading cause of death in the United States with stroke now ranking fourth. Together, these conditions accounted for more than a quarter of all U.S. deaths in 2023, the most recent year with available data, killing more Americans annually than all forms of cancer and accidental deaths combined.
According to the report published in Circulation, the peer-reviewed flagship journal of the American Heart Association, there were 915,973 total deaths from cardiovascular disease in 2023, down from 941,652 in 2022. The age-adjusted rate of cardiovascular deaths decreased to 218.3 per 100,000 people from 224.3 per 100,000. Coronary heart disease, the most common form, caused 349,470 deaths, while stroke was responsible for 162,639 fatalities. On average, someone died of cardiovascular disease every 34 seconds in 2023.
"It's encouraging to see that total deaths from heart disease and stroke declined. The past five years appear to have been an anomaly given the huge impact the pandemic had on all health during that time," said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "The fact remains that heart disease and stroke continue to take the lives of too many of our loved ones each and every day."
While overall stroke deaths decreased for the first time in several years, concerning trends emerged in specific age groups. The crude stroke death rate increased by 8.3% among people aged 25 to 34 between 2013 and 2023, and by 18.2% among those older than 85 during the same period. "These numbers should ring alarm bells, particularly among young adults because that's a snapshot into our future," said Sadiya S. Khan, M.D., M.Sc., FAHA, volunteer vice-chair of the statistical update writing group.
The report highlights persistent increases in common conditions that drive cardiovascular risk. About 125.9 million U.S. adults now have high blood pressure, nearly 29.5 million have diagnosed diabetes, and approximately 50% of adults have obesity or severe obesity. Alarmingly, obesity rates increased from 25.4% to 28.1% among youth aged 2 to 19. For the first time, the Statistics Update includes a chapter on cardiovascular-kidney-metabolic syndrome, revealing that nearly 90% of U.S. adults have some level of this interconnected health disorder.
Research cited in the update indicates that following the American Heart Association's Life's Essential 8™ healthy lifestyle guidance can significantly reduce cardiovascular risk. A review of 59 studies found that people with ideal cardiovascular health had a 74% lower risk of cardiovascular events compared to those with poor cardiovascular health. Optimal adherence to these measures could prevent up to 40% of annual all-cause and cardiovascular deaths among U.S. adults.
However, data shows poor adherence to these preventive measures. Diet scores are the lowest among the eight measures, only 25.3% of adults meet physical activity guidelines, and while cigarette smoking rates appear to be declining, e-cigarettes are now the most used tobacco products among youths. "We know that as much as 80% of heart disease and stroke is preventable with lifestyle changes and many chronic health conditions that contribute to poor cardiovascular health are manageable," Rosen said.
The statistics update serves as a critical resource for understanding the impact of cardiovascular disease and shaping awareness efforts and policy. "As the world's leading cause of death, cardiovascular disease demands global attention, and the insights uncovered in this report help steer the Association's lifesaving work around the world," said American Heart Association CEO Nancy Brown.
