From rising obesity and diabetes to stubborn health inequities, the AHA’s latest statistics reveal why cardiovascular disease remains the dominant threat to population health and what must change to reverse the trend.
Report: 2026 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Image Credit: crystal light / Shutterstock
The 2026 American Heart Association (AHA) report, recently published in the journal Circulation, provides updated statistics on heart disease (HD), stroke, and cardiovascular risk factors, including core health behaviors and health factors that contribute to cardiovascular health (CVH). Each year, the document is revised to include the newest available data, additional relevant findings, new chapters or sections, and remove older information.
The report provided the latest data on major circulatory and HD conditions and related outcomes. The 2026 edition, a product of a year of efforts by volunteers, scientists, clinicians, government personnel, and AHA staff, includes an expanded chapter on nicotine and tobacco use and exposure, as well as a new chapter on cardiovascular, kidney, and metabolic (CKM) syndrome.
CVH trajectories and tobacco and nicotine use and exposure
According to the AHA report, hypertension, diabetes, and obesity were projected to increase to 61%, 26.8%, and 60.6% by 2050 among adults in the United States (US). Only hypercholesterolemia was projected to decline in prevalence from 45% to 24%. Health behaviors were projected to decrease to varying degrees, except for inadequate sleep, which was projected to increase.
A 2010 to 2022 meta-analysis indicated that an ideal CVH was associated with a 74% reduced risk of cardiovascular disease (CVD) events compared with a poor CVH. People who smoke have a three times greater mortality risk than never smokers. Although smoking prevalence declined among American adults, e-cigarette prevalence quadrupled, as per National Health Interview Survey (NHIS) data from 2017 to 2023.
Physical activity and sleep health
Only 20% of individuals aged 6 to 17 were physically active for at least 60 minutes daily, and one-third of adults across 163 countries did not meet sufficient activity levels. National Health and Nutrition Examination Survey (NHANES) data from 2017 to 2020 indicated that 30% of adults had at least 1 hour of sleep debt, defined as the difference in sleep duration between work and free days. Poor sleep was associated, in observational analyses, with higher odds of type 2 diabetes, hypercholesterolemia, and hypertension.
Obesity, lipids, blood pressure, and diabetes
Obesity prevalence is growing among youth and adults in the US. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) study estimated that over 15 million individuals aged 5 to 14 years, 21 million people aged 15 to 24 years, and 172 million adults aged 25 years or older were living with overweight or obesity in the US in 2021. The prevalence and high total cholesterol decreased, with the global CVD mortality rate attributable to an increase in low-density lipoprotein cholesterol, according to GBD data from 2021, at 43.7 per 100,000 people.
While hypertension prevalence was stable between 2013 and 2023, blood pressure control decreased from 54.1% in 2013 to 2014 to 48.3% in 2017 to 2020, although control improved among non-Hispanic Black adults between 2017 to 2020 and 2021 to 2023. According to NHANES, 29.5 million adults had diagnosed diabetes, 96 million had prediabetes, and 9.6 million had undiagnosed diabetes between 2021 and 2023. Among those diagnosed with diabetes, glycated hemoglobin levels increased significantly from 2017 to 2020, then from 2021 to 2023, while glycemic control rates declined.
Kidney disease, CKM syndrome, and pregnancy outcomes
The prevalence of end-stage kidney disease almost doubled from 2002 to 2019, before leveling off in subsequent years. Across 114 cohorts, albuminuria and reduced kidney function were associated with higher kidney failure and mortality. NHANES data from 2011 to 2020 suggest that most US adults, approximately 90%, were in CKM syndrome stage 1 or higher. Underrepresented ethnic and racial populations had a higher burden of advanced stages of the CKM syndrome.
Advanced CKM syndrome stages were significantly associated with CVD mortality. In Japan, pregnant individuals with a healthy lifestyle score, calculated based on adherence to pre-pregnancy lifestyle factors, had a one-third lower risk of adverse pregnancy outcomes than those with the lowest score. Maternal mortality rates have declined for all ethnic and racial groups from 2021 to 2022, although racial disparities persist.
CVDs, stroke, dementia, and congenital cardiovascular diseases
CVD prevalence was nearly 49% overall among adults aged 20 years or older, increasing with age in both sexes, according to NHANES data from 2021 to 2023. Greater adherence to healthy eating patterns was associated, at the population level, with lower CVD risk. Stroke incidence decreased between 1993 and 2015 in Black and White adult populations, with consistently higher rates in Black adults. Dementia prevalence in older adults decreased between 2011 and 2021, although evidence varied by study design and population, with high-intensity training reported in selected intervention studies to slow cognitive decline.
The prevalence of congenital cardiovascular defects in high-income groups in North America was estimated as 1 in 80 babies, and globally, more children with congenital HD survived into adulthood between 1990 and 2019. Limited prenatal care, neighborhood poverty, and air pollution were associated, in population-based analyses, with an elevated risk of heart defects, worse outcomes, and later diagnosis.
Heart rhythm disorders, cardiac arrests, and heart failure
The current prevalence of atrial fibrillation in US adults was 10.55 million, representing 4.48% of the adult population. Opioid-related out-of-hospital cardiac arrests, which accounted for less than 1% of cardiac arrests in 2000, increased to between 7% and 14% in 2023. The prevalence of coronary HD was 5.2% in adults aged 20 years or older in the US between 2021 and 2023. Further, heart failure prevalence increased from 6.7 million in 2017 to 2020 to 7.7 million in 2021 to 2023 in Americans.
Overall, the 2026 Heart Disease and Stroke Statistics Report highlights the growing burden of CVD affecting approximately 50% of adults, with significant global health and economic repercussions. Despite considerable advances in diagnostics, prevention, and treatment, aging populations, widening health disparities, and increasing cardiometabolic risk factors continue to challenge healthcare systems. The report underlines the importance of coordinated efforts focused on prevention, early intervention, and equitable care to reverse current trends and improve long-term cardiovascular outcomes.