"Cardiovascular disease produces immense health and economic burdens in the United States and globally," the authors wrote.
The 48% prevalence of cardiovascular disease – nearly 121.5 million adults – is a significant uptick over the rate cited last year, although this was mainly driven by the way the high blood pressure is defined. Hypertension guidelines were updated so that people whose blood pressure is 130/80 or above are now considered "hypertensive"; previously, the definition was 140/90.
Excluding high blood pressure, prevalence of cardiovascular disease among US adults is 9% overall, with a decline of 11.5% in 2015.
"Overall, we have made a lot of progress," said Zhao, who was not involved in the report. Still, "we have not yet made substantial advances in obesity, diabetes, and unhealthy behavior," which includes smoking, not exercising, poor diet and being overweight. About 8 of every 10 cases of cardiovascular disease can be prevented by controlling high blood pressure, diabetes and high cholesterol and maintaining a healthy lifestyle, according to the heart association.
The scorecard also shows some terrific gains. Self-reported inactivity among adults has been declining since 1998, with the trend escalating in recent years. Passivity plummeted from 40.1% to 26.9% between 2007 and 2016, the report shows.
Over the past five decades, smoking rates have also declined: About 51% of males and 34% of women smoked in 1965, compared to only 16.7% of males and 13.6% of females in 2015.
"We really need to work harder to reduce all risk factors in order to reduce rates of cardiovascular disease," Zhao said, highlighting obesity. Nearly 4 out of 10 US adults and nearly 1 out of 5 youths are obese, while 7.7% of adults and 5.6% of youth are severely so, the report finds.
Additionally, not all groups have made equal strides in quitting or never smoking cigarettes.
"Substantially higher tobacco prevalence rates are observed in American Indian / Alaska Natives and lesbian, gay, bisexual and transgender populations, as well as among individuals with low socioeconomic status, those with mental illness, individuals with HIV who are receiving medical care, and those who are active-duty military, "the report notes. "Over the past 6 years, there has been a sharp increase in e-cigarette use among adolescents."
Overall, Zhao believes that "lots of work still needs to be done."
We may be seeing downward trajectory in some risk factors and cardiovascular disease itself, "but we're not there yet," he said. "That's all we need to start thinking about: What can we do together to really improve our health, our healthy behavior, and reduce our weight?"