• A new survey found 70% of participants were not familiar with peripheral artery disease (PAD), a common cardiovascular disease that can lead to stroke, amputation, or death.
• PAD is especially prevalent in Black and Hispanic American populations, and among people who have diabetes, high blood pressure, and those who smoke.
• The results emphasize that patients and healthcare providers should work together to boost PAD awareness, experts said.

Most Americans are unaware of peripheral artery disease (PAD), a new survey finds.¹

PAD is a cardiovascular disease that causes blockage in the vessels that carry blood from the heart to the legs, making it hard for blood to flow freely in your legs. It is a serious medical condition that can lead to stroke, heart attacks, leg amputations, and in some cases, death.²

The PAD Pulse Consumer Survey polled 2,000 Americans to learn about their level of awareness of disease symptoms, risk factors, and overall doctor-patient communications around PAD.

PAD is a common cardiovascular disease, that affects more than 12 million Americans.³ Despite the disease’s clinical prevalence, nearly 70% of survey respondents reported that they were not familiar with PAD.¹

“Honestly, while I was certain that the general public awareness of PAD was low, I did not anticipate that it was at such a dismal rate,” said Kumar Madassery, M.D., director of the Peripheral Vascular Intervention & CLI Program at the Rush University Medical Center. “This survey helps us demonstrate a critical need to find collaborative means to improve this for the sake of the general population, our patients, and the viability of healthcare as a system.”

PAD is commonly caused by atherosclerosis, which is the buildup of fat and cholesterol in your arteries. Because of this, muscles in your legs don’t get enough blood and oxygen even while resting. PAD mostly affects men over the age of 50. The three main risk factors for developing PAD are high blood pressure, smoking or tobacco use, and diabetes.⁴

“It is surprising to me that nobody knows about PAD, one of the most critical complications of diabetes,” said Anahita Dua, M.D., MBA, a vascular surgeon and co-director of the Peripheral Artery Disease Center and Limb Evaluation and Preservation Program at Massachusetts General Hospital.

While Black and Hispanic Americans Are Most at Risk, Disease Awareness Lags Behind

The survey included responses from 500 Black Americans and 500 Hispanic Americans, which is important given that these populations are at a higher risk of developing PAD and experiencing PAD-related complications in their lifetime.³

Black Americans are twice as likely to develop PAD compared to White Americans.² Approximately 30% of Black men and 27% of Black women will develop PAD in their lifetimes.³ For Hispanic Americans, cases of PAD are usually aggressive, with the risk of major amputation and death within one year of diagnosis as high as 17%.⁵

Over 70% of both Black and Hispanic survey respondents reported currently having one or more risk factors or knowing someone who had one or more risk factors for PAD. However, Black and Hispanic participants consistently responded that they felt they were at little to no risk of developing PAD.¹

“Nearly 80% of Black and Hispanic adults have never had a doctor or healthcare provider talk with them about PAD. Our survey determined that many of these discussions are not happening,” said Foluso Fakorede, M.D., an interventional cardiologist at Cardiovascular Solutions of Central Mississippi.

High rates of PAD are not limited to Black and Hispanic minority communities. “PAD also disproportionately affects Native Americans and South Asians,” said Dua. “Minority patients experience higher rates of PAD and amputation. We need to be able to get the message out to these communities that they need to be checked regularly for PAD.”

This speaks to a larger issue of healthcare outreach in minority communities.

Symptoms and the Challenges of Early Diagnosis

The early symptoms of PAD include feelings of pain, achiness, cramping, and discomfort in your feet, calves, or thighs. These symptoms happen while walking or exercising and can go away after resting.

One of the challenges of diagnosing PAD is that most people consider regular leg pain as a normal part of getting older. In the PAD survey, 91% of respondents said that leg aches and pains are common as people age; 53% also said they would go more than a week with persistent leg pain while walking before talking to a healthcare provider about it.

These survey findings reveal that patients are likely to dismiss initial symptoms, making early diagnosis challenging.

Another aspect of PAD that makes early diagnosis hard is that many people with PAD may not present explicit symptoms right away. Because of this, experts recommend reaching out to your healthcare provider immediately for a PAD screening if you have any of the three PAD risk factors (diabetes, high blood pressure, or are a smoker).

“If a patient is experiencing potential PAD symptoms or has any risk factors, it is important to talk with a doctor right away, whether it be a primary care provider, ER, or community clinic,” said Fakorede.

Reaching out to a healthcare provider can quickly help you get a diagnosis. Healthcare providers test for PAD using an ankle-brachial index (ABI) test. This test is “a simple, low-cost and non-invasive test that can help determine if a patient has PAD. This is simply a test comparing blood pressure at the arm and the ankle,” said Madassery.

As the disease worsens, symptoms become more severe. Symptoms of advanced PAD include:⁴

• Numbness
• Loss of hair in the lower legs
• Very thickened toenails
• Feet that are cool to the touch
• Skin becoming pale or blue
• Sores and injuries in the feet that won’t heal
• Gangrene (dead body tissue due to lack of blood supply)

If left untreated, severe cases of PAD can result in a leg amputation and, along with it, high mortality rates. According to Dua, 50% of patients who have to undergo a leg amputation due to complications of PAD pass away within the first two years after amputation.

Additionally, Dua explained that amputations can severely impact patients’ mental health, citing numerous studies about the increased rates of depression in patients who have had an amputation. “The physical and mental toll this takes on patients and family members is immense,” added Madassery.

Treating PAD

Treatment includes addressing the underlying conditions that increase your risk of developing PAD. If you are a smoker and are diagnosed with PAD, quitting smoking can reduce the risk of your disease progressing. Additionally, managing blood pressure and diabetes is key for people with PAD to improve their condition. Some of the ways PAD is treated include:⁴

• Managing your blood pressure and blood sugar with the help of medications as prescribed by your doctor
• Developing a structured exercise regimen alongside your healthcare provider to improve circulation in your legs
• Avoiding cuts and scrapes on your feet
• Taking medications to avoid blood clots
• Taking medications that help widen your arteries
• Taking medications that can help lower your cholesterol

It is important to note that any medications prescribed to manage your blood pressure and diabetes should be taken as indicated by your healthcare provider.

In some severe cases, surgery might be required. These surgical procedures can include opening a blocked blood vessel or rerouting the blood supply around a blocked artery to provide blood flow to the legs.⁴

A Need to Improve Awareness

The PAD survey findings highlight the large gap in public awareness of PAD as a leading cardiovascular disease. This lack of awareness is more pronounced when it comes to Black and Hispanic communities, which are at a higher risk.

There is a need for patients, physicians, insurance providers, and government entities to work together to improve PAD awareness and patient outreach.

“I think all of us in healthcare have done a poor job of educating patients, providers, and governing bodies as to the importance of primary PAD prevention, detection, and early conservative management,” said Madassery. “I strongly believe that with everyone involved in healthcare working together for the common goal of reducing this preventable disease burden, we can achieve a significant benefit not only for patients themselves but also for the entire healthcare system.”

“Medical care in this country has advanced in multiple areas over the last 50 years, but we have not, with it, advanced our education and engagement with our patients so that they know what to be looking for,” said Dua.

The PAD Pulse Consumer Survey hopes to be a step in the right direction to improve PAD awareness in the public eye and improve patient outcomes.

“It’s important for patients to be engaged with this information so they can help us take care of their health,” said Dua, “and we can make sure they live the happiest and healthiest lives they can.”

SOURCES

1. PR Newswire. New data: 70% of Americans unaware of common vascular disease that is one of the leading causes of amputation.
2. National Heart, Lung, and Blood Institute. Facts about peripheral artery disease (P.A.D.).
3. American College of Cardiology. Health disparities in peripheral artery disease: key points.
4. National Library of Medicine: MedlinePlus. Peripheral artery disease - legs.
5. Kalbaugh CA, Witrick B, Sivaraj LB, et al. Non-Hispanic Black and Hispanic patients have worse outcomes than White patients within similar stages of peripheral artery disease. J Am Heart Assoc. 2022;11(1):e023396. doi:10.1161/JAHA.121.023396

Black Americans have a 30% greater chance of dying from heart disease than White Americans.¹ But, according to statistics from the American Heart Association, fewer Black Americans are affected by high cholesterol than White Americans.²

Despite the lower total cholesterol levels, researchers report that African Americans are still at greater risk of dying of heart disease. According to the Office of Minority Health at the U.S. Department of Health and Human Services, African Americans are actually less likely to be diagnosed with heart disease than Whites.³ This may point to one of the reasons behind the disparity.

Cholesterol Levels in Black Americans

According to the American Heart Association, Black men and women tend to have slightly lower total cholesterol levels than Whites. The Association reports that 44.8% of Black men and 42.1% of Black women have high or borderline high total cholesterol levels. By comparison, 47.9% and 49.7% of White men and women have high or borderline high levels.

Black men did have slightly higher reported levels of LDL, low-density lipoprotein, the "bad cholesterol," levels. The association reports that 32.4% of Black men and 31.7% of white men have borderline high or high LDL levels. Both Black men and women had somewhat higher HDL, or high-density lipoprotein, known as "good cholesterol."

Racial Disparity Theories

Scientists aren't completely sure why some ethnic groups are at higher risk for cardiovascular disease, but there are ways in which genetics and other factors may play a role.

Genetics

Your genetics influence how your food is metabolized and how much cholesterol your body produces. Cholesterol isn't just found in food; your liver actually creates about 75%  of your blood cholesterol. Your genetic makeup can influence how much cholesterol is created and what your ratio of LDL to HDL is.

Researchers are narrowing in on genes that may be the cause of high cholesterol, high blood pressure, and other cardiovascular disease factors, but they aren't there yet.

Obesity

Obesity is one predictor of cardiovascular disease that is more prevalent among African Americans. According to data collected in 2017 and 2018, rates of obesity were highest among African Americans (49.6%). However, rates for White Americans were not much lower (42.2%).⁴

A CDC report found that 48.7% of African Americans had two or more risk factors for heart disease, compared to 35.5% of Caucasian Americans. The risk factors studied included diabetes diagnosis, smoking habits, sedentary lifestyles, obesity, hypertension, and high cholesterol.

Disparities in Care

Statistics from the Office of Minority Health indicate a healthcare disparity within U.S. hospitals. Research indicates that African Americans are less likely to receive a non-aspirin antiplatelet drug when hospitalized in regions including Maryland, North Carolina, Mississippi, and Minnesota.⁵ These statistics may represent a larger problem.

Disparities in the way Black Americans and White Americans are treated in medical settings are well-documented. These disparities may help explain the differences in heart disease outcomes for each race.

Lowering Cholesterol and Heart Disease Risk

It's important to take personal responsibility for your cardiovascular risk factors. The National Institutes of Health offers the following tips for lowering cholesterol and cardiovascular risk:⁶

• Quit smoking.
• Reach and maintain a healthy weight.
• Focus on eating at least five servings of fruits and vegetables daily.
• Choose poultry, fish, and plant-based foods instead of red meat.
• Make 30 minutes of exercise a daily routine.

It's also important to communicate with your physician. Most healthy adults over 21 should have their cholesterol checked every four to six years. Those with heart disease or diabetes or who have a family history of high cholesterol should have it checked more often.⁷

If your cholesterol is high, your physician can advise lifestyle changes and possibly medication to help lower cholesterol levels and overall cardiovascular risk.

Summary

African Americans are at greater risk of dying of heart disease, despite lower rates of cholesterol and rates of obesity that are not significantly higher than rates of obesity among White Americans. Researchers are unsure why the disparity exists, although there are well-established differences in the quality of care received in medical settings for Black Americans and White Americans.

You can take charge of your health by lowering your risk of health diseases with lifestyle changes. Try to increase your intake of heart-healthy fruits and vegetables and incorporate physical activity into your routine. Also, work with your healthcare provider to evaluate and manage other risk factors.

SOURCES

1. University of Chicago Medicine. Heart disease and racial disparities: Why heart disease is more common in Black patients and how to prevent it
2. American Heart Association. Ethnicity a 'risk-enhancing' factor under new cholesterol guidelines
3. U.S. Department of Health and Human Services Office of Minority Health. Heart Disease and Black/African Americans
4. Lofton H, Ard JD, Hunt RR, Knight MG. Obesity among African American people in the United States: A review. Obesity (Silver Spring). 2023 Feb;31(2):306-315. doi:10.1002/oby.23640
5. American Heart Association. Differences remain in heart attack treatments for black patients
6. National Heart Lung and Blood Institute. Therapeutic Lifestyle Changes (TLC) To Lower Cholesterol
7. Centers for Disease Control and Prevention. Testing for cholesterol.

Many Black Americans experience high levels of stress. This may be due to racism, prejudice, institutional inequities, income inequality, and unfair treatment in school, healthcare, and workplace environments.

Chronic stress can deteriorate your health over time, and sometimes its damaging effects are only noticed after it’s too late. 

Cortisol is the main stress hormone in the body, governing the fight or flight response when you feel like you are in danger, as well as a plethora of bodily functions, including mediating the stress response, immune function, metabolism, and inflammatory response. Increases in cortisol are helpful over a short period of time, but high levels over a long period of time can heighten blood cholesterol, triglycerides, blood sugar, and blood pressure to increase the risk of heart disease over time.¹

This article addresses how stress affects heart disease risk in Black people.  

Race, Racism, and Stress

Stress can come from many different sources, including the effects of racism.

Prevalence 

Race is a human-derived social construct used to categorize people.

While the concept of race and the classification of people based on physical characteristics has been around for centuries, the idea that a discrete group of people can be defined by specific genetic and biological differences has been used as a tool to marginalize, oppress, and even abuse certain groups of people over others.

The Stress of Prejudice and Hate

The institution of slavery and mass genocide are two race-based events that characterize the magnitude of hate, prejudice, and moral blindness that Black and Indigenous Americans have had to endure throughout U.S. history. 

The trauma of events like slavery, coupled with institutional racism, continues to negatively impact Black people to this day.

A recent Kaiser Family Foundation poll found that over 70% of Black Americans report having experienced some form of racial discrimination or mistreatment during their lifetimes, with nearly half saying that they felt that their life was in danger at some point in their life because of their race.²

Even more, Blacks were much more likely than Latinx and White respondents to report feeling like they had been denied a job for which they were qualified (40%, 15%, and 8%, respectively) or denied housing they could afford due to their race (26%, 8%, and 3%, respectively).²

Stressors Can Be Race-Related 

Racism is a special kind of stress that impacts many Black, Indigenous, and other people of color, but especially Black Americans.

Exactly how the stress of racism deteriorates health remains a mystery, but some research finds that repeated exposure to discrimination and systemic inequity is associated with the biological aging of the cells.³

The genetic changes that lead to aging and lower functioning cells is a phenomenon called biological weathering, and its impact comes as a result of repeated exposure to:

• Socioeconomic adversity
• Political marginalization
• Racism
• Perpetual discrimination

Another study found that anticipating prejudice can lead to cardiovascular stress responses, which can also increase the risk of heart disease in Black people.⁴

Why Stress Is a Risk Factor for Heart Disease 

The effect of stress is frequently underestimated.

Stress can be caused by financial troubles, divorce, loss of a loved one, or chronic illness.

Chronic stress increases cortisol, which raises your blood pressure and lowers your HDL (good cholesterol).⁵

Chronic stress is also associated with many health-compromising behaviors that may affect your heart in a more indirect way. When you’re worried, you tend to:⁶

• Sleep poorly
• Exercise less
• Make poor food choices
• May not watch your weight

These lifestyle changes put your heart health at increased risk.

Underlying Cause of Chronic Stress Disparities

Some of the most common chronic stressors associated with health disparities include:

• Perceived discrimination
• Neighborhood stress
• Daily stress
• Family stress
• Acculturative stress (stress that occurs when one culture comes into contact with another culture)
• Environmental stress
• Maternal stress

Current research shows that these stressors are more commonly experienced by Black people and lead to chronic stress in addition to long-term feelings of hurt and hopelessness.⁴

Social determinants of health—such as education, access to quality care, neighborhood safety, and proximity to pollution, to name a few—... impact health and well-being and play a role in race-based differences in health.⁷

Discussing Stress With Your Healthcare Provider

It is more important than ever to know how to discuss stress with those who may have the power to help you change it—namely, your provider.

Finding a provider that you trust and respect opens the door for an honest and open discussion about the best ways for you to cope with your stress and implement heart-healthy lifestyle changes. 

Finding a Trustworthy Provider 

Seeking out empathic, equitable, and unbiased medical care as a Black person in the United States takes time, attention, and intention.

Many Black people report that they are more likely to feel comfortable with Black healthcare providers and more likely to adhere to certain preventive measures delivered by Black healthcare providers.

While Black healthcare providers are more likely to practice in underserved communities—often concentrated in urban areas—more rural areas may have few if any.

As of 2024, 5.4% of physicians identified as Black despite Black Americans making up 13.4% of the U.S. population.⁸

Finding a Black Healthcare Provider

There are websites that help you connect with Black healthcare providers. These include:

• Blackdoctor.org
• Findablackdoctor.com

For many Black people, finding a trustworthy provider is often centered around finding a Black provider, period. That alone raises the chances you might get the quality of care you need.

A history of biased and substandard care from White providers is one reason why Black people are more trusting of Black providers.⁹

What Is Implicit Bias?

Implicit bias—a type of prejudice in which racial stereotypes are formed without conscious intention—is often experienced by Black people, unbeknownst to the non-Black provider, compromising care.¹⁰

Black providers are also more likely to provide culturally specific care.

Questions to Ask

Choosing the right healthcare provider isn’t easy. It requires you to ask many important self-reflective and open-ended questions to yourself and the office staff to ensure that they are right for you. 

Some introspective questions you might ask yourself include:

• How far am I willing to travel to see my provider?
• How important is it that my provider looks like me? Will a healthcare provider who does not look like me but provides culturally competent care suffice?
• How does this healthcare provider fit into my schedule? Do they have after-hours services?
• What kind of healthcare provider am I looking for?
• I really like this healthcare provider, but they do not take my insurance. Am I willing to pay out of pocket?

Some questions you may want to ask your healthcare provider directly include:

• Have you worked with Black people before? 
• What does culturally competent care mean to you? How do you ensure that your care is culturally competent?
• Do you provide genetic testing?
• How long is a typical appointment?

You may also want to ask the staff and other people who have previously worked with your potential provider about their experience. While you cannot, and should not, base your decision solely on the opinion of others, sharing what you know can add perspective to this very important decision. 

An Integrative Treatment Approach

Identifying the underlying cause of your stress and addressing it is the single most important measure you can take to mitigate your heart disease risk.

The following are the components of an integrative approach that address the many factors that contribute to your stress.

Medication

Any illness—whether mental or physical—can cause stress and maladaptive changes in the body.

Some of these conditions—like heart disease, diabetes, depression, or anxiety—can be made better with the help of medication.

Medication use is sometimes taboo in the Black community, but research shows that using medication as prescribed by your healthcare provider can help manage your underlying health conditions and is a great way to alleviate stress and promote healing.¹¹

Therapy 

Black people are just as likely as any other group to experience mental illness. Oftentimes, mental illness stems from stress and the constant need to fight against oppressive systems. Mistrust in the healthcare system, mental health stigma, and lack of access to care are only a few of the reasons why only half of Black adults with mental illness get treatment.¹²

A professional therapist can help you understand what feelings are typical for your circumstances and offer strategies to support your immediate and long-term needs.

Therapy sessions also give you a safe space to get things off your chest and the added benefit of not only helping you to understand yourself better but also understanding other people. You may not feel the positive impacts of therapy immediately, but over time many people come to consider therapy as a powerful tool and a gift that you give yourself.

Lifestyle 

Healthy habits protect you against stress you haven't even experienced yet. Making lifestyle changes aimed at curbing overwhelming levels of stress is a part of any comprehensive stress relief plan.

Finding healthy ways to calm down not only helps you to avoid the negative effects of chronic stress, especially indolent conditions like type 2 diabetes and high blood pressure that silently damage the heart, but also brings added health benefits like the release of endorphins that heighten brain and body function.

The following healthy habits may greatly prevent or reduce your stress, protecting your heart in the process:¹³

• Regular exercise
• Eating a heart-healthy diet
• Never smoking and limiting alcohol
• Getting quality sleep
• Enjoying activities and talking with supportive groups of friends and family

Stress Management 

Taking breaks at work, talking to supportive friends, eating healthy, and going for a run after work or school are some ways that you can manage your stress.

The goal isn’t to avoid stress at all costs—that’s nearly impossible to do—but to find ways to address stressful situations in a healthy way and limit the amount of negative stress that you experience in your life.

Resources

There are many resources you can tap into to help you manage stress in your life. Some options are listed below.

Support Groups

Whether you’re seeking support for coping with an illness, a new diagnosis of heart disease, caregiving, depression, or simply trying to overcome the uneasiness of your current situation, attending a support group can be a valuable step toward healing.

The Association of Black Cardiologists specializes in the prevention and treatment of cardiovascular disease in Black people and has created Mended Hearts, a support group that sets out to inspire hope and improve the quality of life of people with heart disease and their families. 

Finding a local support group may be the first step in your journey towards recovery. Many other local support groups exist, providing immense value to many Black people who are in the midst of the healing process. Attending these sessions with openness and a positive spirit are integral to getting the most out of this experience, but it’s important to note that everyone’s healing process is different, so take your time and move at your own pace. 

Family and Peers

Family and friends are great sources of social support. These are the people who know you the best and can understand what you’re going through.

Sometimes you may feel like you have the weight of the world on your shoulders but stress is made worse when you bottle it up inside. Talking things out with people you trust is a good way of getting things off your chest and freeing your mind of negative thoughts that can eat away at your health. 

Summary

Black people are disproportionately impacted by stress and stress-related disease due to systemic inequality. High levels of cumulative stress put many Black people at high risk of heart disease which can lead to heart attack and stroke. 

A Word From Verywell 

Chronic stress can stem from poverty, a dysfunctional marriage or family, or a deeply dissatisfying job, but the causes are truly endless. Limiting stress and living a healthy lifestyle are surefire ways to lower your heart disease risk. The importance of taking every measure possible to curb stress cannot be understated, especially in Black communities that have been historically marginalized. 

Frequently Asked Questions

What’s the link between race and stress in America?

High levels of stress over a long period of time ages your cells causing them to malfunction. As a result, many Black Americans are at high risk of developing diseases of adaptation, namely high blood pressure, high blood sugar, type 2 diabetes, and weight gain.³

When does stress become chronic?

There is no timeframe that designates stress as acute or chronic, but generally speaking, stress is considered chronic when it occurs for months or years and the frequency or intensity is such that the autonomic nervous system does not have an adequate chance to activate the relaxation response on a regular basis.

How can Black people find better mental health services?

There is a growing number of Black specific mental health services and providers. Information on where to find these places can be found on social media, the local paper, and on websites like:

• Blacktherapistsrock.com
• Blackmentalhealth.com
• BorislHensonfoundation.org
• SurvivorsHaveHeart.com

What does stress do to the heart?

Chronic stress can lead to maladaptive changes that decrease the heart cells’ ability to function normally. Constantly dealing with stress also increases the likelihood of engaging in poor health behaviors linked to increased risk for heart disease and stroke, such as:¹⁴

• Smoking
• Overeating
• Lack of physical activity
• Poor sleep hygiene
• Unhealthy diet, and 
• Not taking your medications as prescribed

SOURCES

1. Oakley RH, Cidlowski JA. The biology of the glucocorticoid receptor: new signaling mechanisms in health and disease. J Allergy Clin Immunol. 2013 Nov;132(5):1033-44. doi:10.1016/j.jaci.2013.09.007
2. Kaiser Family Foundation. Poll: 7 in 10 Black Americans say they have experienced incidents of discrimination or police mistreatment in their lifetime, including nearly half who felt their lives were in danger.
3. Chae DH, Wang Y, Martz CD, et al. Racial discrimination and telomere shortening among African Americans: the coronary artery risk development in young adults (Cardia) study.Health Psychology. 2020;39(3):209-219. doi:10.1037/hea0000832
4. Sawyer PJ, Major B, Casad BJ, Townsend SSM, Mendes WB. Discrimination and the stress response: psychological and physiological consequences of anticipating prejudice in interethnic interactions. Am J Public Health. 2012;102(5):1020-1026. doi:10.2105/AJPH.2011.300620
5. Steptoe A, Kivimäki M. Stress and cardiovascular disease. Nat Rev Cardiol. 2012;9(6):360-370. doi:10.1038/nrcardio.2012.45
6. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: a review. EXCLI Journal; 16:Doc1057; ISSN 1611-2156. Published online 2017. doi:10.17179/excli2017-480
7. Islam MM. Social determinants of health and related inequalities: confusion and implications. Front Public Health. 2019;0. doi:10.3389/fpubh.2019.00011
8. Association of American Medical Colleges. Diversity in medicine: facts and figures 2019.
9. ClinicalTrials.Gov. The Oakland men's health disparities study.
10. Alsan, Marcella, Owen Garrick, and Grant Graziani. 2019. Does diversity matter for health? Experimental evidence from Oakland. American Economic Review, 109 (12): 4071-4111. doi:10.1257/aer.20181446
11. Alvarez C, Hines AL, Carson KA, et al. Association of perceived stress and discrimination on medication adherence among diverse patients with uncontrolled hypertension. Ethn Dis. 2021;31(1):97-108. doi:10.18865/ed.31.1.97
12. Mental Health America. Black and African American communities and mental health.
13. Can YS, Iles-Smith H, Chalabianloo N, et al. How to relax in stressful situations: a smart stress reduction system. Healthcare. 2020;8(2):100. doi:10.3390/healthcare8020100
14. American Heart Association. Stress and heart health.

Your weight and your risk for heart disease are connected. But that doesn't mean being overweight guarantees that you'll have heart problems. There are ways to reduce your risk for a cardiac event and weight loss may be one of them. But first, it's important to learn the facts about heart disease and weight loss.

What is heart disease?

Heart disease is a number of abnormal conditions that affect the heart and the blood vessels in the heart. There are many different types of heart disease, but common forms include coronary artery disease, heart failure, and arrhythmia. The most common form of heart disease is coronary artery disease, a narrowing or blockage of coronary arteries, which is the major reason people have heart attacks.¹

Heart disease facts and figures

The American Heart Association statistics compiled in 2018 include the following figures.² Cardiovascular disease accounts for nearly 836,546 deaths, or about 1 of every 3 deaths in the U.S. It remains the leading cause of death in this country. Roughly 2,300 Americans die of cardiovascular disease each day, an average of 1 death every 38 seconds.

Approximately every 40 seconds, an American will have a heart attack. The average age for a first heart attack is 65.6 years for males and 72.0 years for females.

The report also notes that someone in the U.S. has a stroke about once every 40 seconds. Stroke accounts for one out of every 19 deaths in the U.S. each year.

About 92.1 million American adults are currently living with some form of either cardiovascular disease or after-effects of a stroke. Nearly half of all Black adults have some form of cardiovascular disease, 47.7 percent of females and 46.0 percent of males.

The heart disease and weight loss connection

Heart disease and weight loss are closely linked because your risk for heart disease is associated with your weight. If you are overweight or obese, you may be at higher risk for the condition.

Medical experts consider obesity and being overweight to be a major risk factor for both coronary heart disease and heart attack. Being 20 percent overweight or more significantly increases your risk for developing heart disease, especially if you have a lot of abdominal fat. The American Heart Association has found that even if you have no other related health conditions, obesity itself increases risk of heart disease.^2

Heart disease and weight distribution

Your risk of developing heart disease may be higher depending on where you carry fat on your body. If you are overweight or obese and carry most of your excess weight in your abdominal area (apple-shaped), your risk for heart disease is higher than that of a person who carries fat in the hips and thighs (pear-shaped). Apple-shaped individuals may also have other increased health risks including high blood pressure, high blood cholesterol, diabetes, and stroke.³

To find out if your waistline increases your risk of heart disease, you can measure yourself with a measuring tape. You may need a partner to help you measure accurately. The measurement should be taken at the belly line. A high-risk waistline is 35 inches or higher for women and 40 inches or higher for men.³

Decrease your heart disease risk

You can't change certain risk factors for heart disease. For example, you can't change your family history. But you can work on your weight. If you reduce your weight by 10 percent with diet and exercise, you can begin to lower your risk of developing heart disease and other obesity-related health problems.³

In addition to managing your weight, you can reduce your chances of developing heart disease by controlling other related risk factors. Talk to your healthcare provider about controlling your blood pressure, lowering your cholesterol, quitting smoking, and getting enough exercise.

A healthy diet is also an important part of lowering your risk of heart disease. The American Heart Association recommends avoiding trans fats and limiting saturated fats to less than 6% of total calories.⁴

A word from Verywell

Hearing that you have heart disease or that you are at risk for heart disease can feel scary when you hear it from a medical professional. But there are things you can do to manage or decrease your risk. Work together with your healthcare team, including your primary care provider, cardiologist, nutritional staff, and other support professionals (such as a physical therapist or behavioral health specialist) to get the care that you need to take small steps towards wellness. You may find that living a more active life and eating a nutritious diet will benefit you many ways—including reducing your risk for heart disease.

Citations

1. MedlinePlus. Coronary artery disease.
2. Benjamin EJ, Virani SS, et al. Heart disease and stroke statistics—2018 update: A report from the American Heart Association. Circulation. 2018;137:e67–e492 doi:10.1161/CIR.0000000000000558
3. National Institute of Diabetes, Digestive, and Kidney Disease. Health risks of being overweight.
4. Van horn L, Carson JA, Appel LJ, et al. Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) guidelines: A scientific statement from the American Heart Association. Circulation. 2016;134(22):e505-e529. doi:10.1161/CIR.0000000000000462