AHA 2026 Heart Disease and Stroke Statistics: Progress and Pitfalls, With Latha Palaniappan, MD, MS

Although heart disease- and stroke-related mortality has declined in the wake of a 5-year upward trend during the COVID-19 pandemic, these conditions still kill more Americans annually than any other cause, according to the 2026 Heart Disease and Stroke Statistics from the American Heart Association (AHA).1

Heart failure, long since the leading cause of death in the US and representing 22% of all deaths, and stroke, which has replaced COVID as the 4th leading cause of death at 5.3%, accounted for >25% of all deaths in 2023. The statistics committee has attributed this significant toll to overall declines in core health behaviors, including smoking, physical activity, nutrition, sleep, and obesity, as well as health factors like cholesterol, blood pressure, glucose control, and cardio-kidney-metabolic syndrome (CKM).1

“In terms of younger adults, we’re seeing a real signal of rising incidence in the Southeast, sometimes referred to as the ‘stroke belt’, and broader evidence suggests stroke incidence trends are diverging by age, with less favorable trends at younger ages,” Latha Palaniappan, MD, MS, associate dean for research at Stanford University and chair of the statistics committee, told HCPLive in an exclusive interview. “These are likely due to more severe exposure to high blood pressure, obesity, diabetes, prediabetes, high cholesterol, and tobacco and nicotine, along with sedentary behavior.”

According to an article from Eurekalert, key statistics from the report include the following:

1. A total of 915,973 deaths from cardiovascular disease, including stroke, hypertension, heart failure, and heart disease, occurred in 2023, which was down from 941,652 in 2022. The age-adjusted rate of cardiovascular disease deaths in 2023 was 218.3 per 100,000 individuals, versus 224.3 per 100,000 in 2022.
2. Coronary heart disease was the underlying cause for 349,470 deaths in 2023, down from 371,506 in 2022.
3. Stroke was the underlying cause for 162,639 deaths in 2023, down from 165,393 in 2022.1

Additionally, the document includes a new chapter on CKM syndrome, which includes patients both at risk for and with existing cardiovascular disease due to the presence of metabolic risk factors, CKD, or both. CKM is categorized into stages 0 to 4 to mark different degrees of cardiovascular risk. This new chapter highlights a substantial prevalence of CKM among adolescents 12-18 years old. The prevalence of stages 0, 1, and 2 were 56.3% (95% CI, 52.4-60.2%), 26.7% (95% CI, 33-40.4%), and 6.9% (95% CI, 5.3-8.5%, respectively. The prevalence was much lower in adults and did not display any significant temporal changes over the study period for the guidelines.2

The document also emphasizes the importance of monitoring Life’s Essential 8, a construct developed to comprehensively and operationally define cardiovascular health. Life’s Essential 8 includes the AHA’s 8 major components of cardiovascular health, including a healthy diet, participation on physical activity, avoidance of nicotine, healthy sleep, healthy weight, and healthy levels of blood lipids, blood glucose, and blood pressure.3

The report’s findings on Life’s Essential 8 include the following:

1. Optimal Life’s Essential 8 scores could prevent <40% of annual all-cause and cardiovascular disease deaths in the US.
2. Better cardiovascular health was associated with better brain health, including less subclinical vascular disease, slower cognitive decline, and reduced dementia risk.
3. Individuals with ideal cardiovascular health had a 74% lower risk of cardiovascular events compared to those with poor health.1

However, adherence to the measures is still low, as only 1 in 4 of US adults meet national physical activity guidelines. Additionally, diet scores are the lowest of all 8 measures among both adults and youth, and <50% of Americans being treated for type 2 diabetes have their condition under control.1

“The most important thing is to focus on the Life’s Essential 8 health behaviors and pick 1 or 2 actions that can improve multiple downstream risks,” Palaniappan said. “For instance, focusing on excess weight by improving nutrition, improving caloric intake, and exercise. Improving this can help with cholesterol and diabetes, and focusing on lifestyle can help improve clinical risk factors.”

Editor’s Note: Palaniappan reports no relevant disclosures.

References

1. American Heart Association. Heart disease, stroke deaths down, yet still kill more in US than any other cause. Eurekalert! January 21, 2026. Accessed January 22, 2026. https://www.eurekalert.org/news-releases/1113054

2. Palaniappan LP, Allen NB, Almarzooq ZI, et al. 2026 heart disease and stroke statistics: A report of US and Global Data from the American Heart Association. Circulation. Published online January 21, 2026. doi:10.1161/cir.0000000000001412

3. Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s essential 8: Updating and enhancing the American Heart Association’s construct of Cardiovascular Health: A presidential advisory from the American Heart Association. Circulation. 2022;146(5). doi:10.1161/cir.0000000000001078