Monday December 18 5:16 PM ET
Decline Slowing in Heart And Strokes Deaths

By Amy Norton

NEW YORK (Reuters Health) - Although there has been a consistent decline in cardiovascular disease deaths in the US since the 1960s, that trend has had a recent slowdown. And, according to experts, the upswing in obesity and diabetes in the 1990s bodes ill for the future.

During the 1970s and 1980s, the rates of death from heart disease or stroke fell yearly in the US. Heart disease deaths fell by more than 3% annually over the two decades, and stroke deaths dropped by nearly 5% per year in the 1970s and 3.5% in the 1980s. From 1990 to 1997, however, the declines began to level off--particularly for stroke, which declined just 0.7% per year.

A possible explanation lies in the rise in certain cardiovascular disease risk factors, particularly obesity and the obesity-related disease type 2 diabetes. According to a report in the December 19/26 issue of Circulation: Journal of the American Heart Association (news - web sites), Americans have become increasingly overweight since the 1960s. The greatest jump in overweight occurred between 1980 and 1994.

Researchers led by Dr. Richard Cooper of Loyola University in Chicago, Illinois, base their report on the conclusions of the national conference on cardiovascular disease held last year.

Besides the death-rate slowdown, the study authors also note a racial disparity in Americans' death rates from heart disease and stroke. The diseases kill a disproportionate number of black Americans, and their death-rate decline has lagged behind that of whites.

According to Dr. Lawrence Friedman of the National Heart, Lung and Blood Institute in Bethesda, Maryland, these trends show more needs to be done to prevent cardiovascular disease and to treat the conditions.

Everyone has heard over and over about two keys to prevention, healthful diet and regular exercise. But, according to Friedman, the message may not be getting through.

``We eat an awful lot and don't exercise enough,'' he told Reuters Health. ``We've cut down on fat, but the number of calories we eat are going up.''

Indeed, according to the report, Americans are consuming less saturated fat and cholesterol. But they are also gaining weight and increasingly being diagnosed with type 2 diabetes, a major risk factor for cardiovascular disease. According to current estimates, about 60% of adult men in the US are overweight, as are half of women. Moreover, 20% of men and one quarter of women are obese.

One of the problems may be the rise in eating out, Friedman noted. ``We eat out a lot and have less control over the portions and what's in it,'' he said.

People need to focus on eating in moderation--limiting calories, and not just fat, according to Friedman. Regular exercise, like walking for 30 minutes on most days of the week, is another tactic most Americans are not taking. Only 28% of adults meet recommendations for regular exercise, according to the report.

If the current lifestyle trends continue, the decline in cardiovascular disease deaths may come to an end. ``What we see now,'' Friedman said, ``may be just a taste of what we'll see down the road.''

SOURCE: Circulation 2000;102.