And after decades of decline, deaths from cardiovascular disease are rising again, with 840,678 deaths recorded in 2016, up from 836,546 in 2015, according to the association's annual report. Statistics on heart disease, published Thursday in the medical journal Circulation.

"Cardiovascular disease causes enormous health and economic problems in the United States and around the world," the authors wrote.

The prevalence of 48% of cardiovascular diseases – nearly 121.5 million adults – is a significant increase over the rate cited last year, although it is mainly related to the definition of hypertension. The hypertension guidelines have been updated so that people with blood pressure equal to or greater than 130/80 are now considered "hypertensive"; Previously, the definition was 140/90.

Excluding high blood pressure, the prevalence of cardiovascular disease among US adults is 9% overall, up from 11.5% in 2015.

Dr. David Zhao, chief of the cardiology department and executive director of the Wake Forest Baptist Health Cardiovascular Center in Winston-Salem, North Carolina, described the new report as a "painful reminder" that heart disease is still the leading cause of death and death. of death the disease in the nation.

"Overall, we have made a lot of progress," said Zhao, who was not involved in the report. Nevertheless, "we have not yet made significant progress on obesity, diabetes, and unhealthy behaviors," including smoking, non-exercise, poor nutrition, and overweight. According to the heart association, it is possible to prevent about 8 cases of cardiovascular disease by controlling hypertension, diabetes and hypercholesterolemia and maintaining a healthy lifestyle.

The dashboard also shows tremendous gains. Adult-reported inactivity among adults has been declining since 1998, with an increasing trend in recent years. Passivity dropped from 40.1% to 26.9% between 2007 and 2016, the report says.

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Over the past five decades, smoking rates have also declined: about 51% of men and 34% of women smoked in 1965, compared to only 16.7% of men and 13.6% of women in 2015.

The new report includes a new recommendation that adults sleep at least seven hours a night to promote optimal health. A recent study found that too much or not enough – more than eight hours or less than seven hours a night – was associated with a higher risk of all-cause death.

"We really have to work harder to reduce all risk factors to reduce cardiovascular disease rates," Zhao said, pointing to obesity. According to the report, nearly four out of ten American adults and nearly one in five are obese, while 7.7% of adults and 5.6% of young people are obese.

In addition, not all groups have progressed in the same way by stopping or never smoking.

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"Substantially higher smoking prevalence rates are observed among Native Americans and lesbian, gay, bisexual and transgender populations, as well as among people with low socio-economic status, people with mental illness, HIV-positive people who receive medical care, and those who are on active duty, "notes the report. "In the last six years, there has been a sharp increase in the use of e-cigarettes among teens."

Overall, Zhao believes that there remains "a lot of work to be done".

We may be seeing a downward trajectory of some risk factors and cardiovascular disease itself, "but we are not there yet," he said. "It's an issue we all need to start thinking about: what can we do together to actually improve our health, our healthy behavior and reduce our weight?"