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• Posted September 6, 2023

U.S. Heart Deaths Linked to Obesity Have Tripled in 20 Years

Obesity taxes many parts of the body, but new research suggests the heart might take the hardest hit of all.

Between 1999 and 2020, deaths from heart disease linked to obesity tripled in the United States, and some groups were more vulnerable than others.

Specifically, Black adults had some of the highest rates of obesity-related heart disease deaths, with the highest percentage of deaths seen in Black women.

The new study was published Sept. 6 in the Journal of the American Heart Association.

"Our study is the first to demonstrate that this increasing burden of obesity is translating into rising heart disease deaths,"study author Dr. Zahra Raisi-Estabragh, a cardiologist and clinical lecturer at the William Harvey Research Institute in London, said in a journal news release.

About 42% of Americans are now obese, an increase of almost 10% from the last decade, according to the American Heart Association.

For the study, researchers analyzed data on more than 281,000 deaths from 1999 to 2020 in which obesity was listed in a contributing cause of death in a database. They also looked at race, gender and whether people lived in urban or rural areas.

Overall, obesity-related heart disease deaths jumped from 2.2 per 100,000 people in 1999 to 6.6 per 100,000 people in 2020, the study showed. The rate of heart disease deaths not related to obesity decreased during the same period.

Deaths in obese people were mainly from hardening of the arteries, heart attacks and high blood pressure-related conditions.

Obesity-related heart disease deaths were higher among Black people compared with any other racial group, followed by American Indian adults and Alaska Native adults.

While Black women had the highest rates of obesity-related heart disease deaths in the study men experienced more obesity-related heart disease deaths than women in other racial groups.

Black adults who lived in urban communities experienced more obesity-related heart disease deaths than those living in rural areas, but the reverse was true for all other racial groups.

Exactly why such disparities exist is not fully understood, but Black people are known to have higher rates of obesity than folks in other racial groups. In addition, social factors such as unemployment, low income and lack of access to health care may also play a role.

The new findings reinforce the need for targeted public health programs to help reverse these alarming trends, according to two experts not involved with the study.

Heart disease is among the most concerning downstream complication of obesity, and it takes decades to develop, said Dr. Scott Kahan, director of the National Center for Weight and Wellness in Washington, D.C.

"While there has long been high attention to obesity rates and some of the nearer-term risks from obesity, such as diabetes, we should now expect to see greater development of cardiovascular disease complications culminating from increasing numbers of Americans living with obesity for increasing numbers of years and decades," he said.

Several groups of people, including Black Americans and American Indians appear to have even greater risk.

"While this is partly driven by higher obesity rates in these groups, other factors are also relevant, including poorer access to medical care and other social determinants of health,"Kahan said. "We need to continue to devote attention and resources to addressing obesity, [including] prevention in those at risk and intervention among those already affected -- and this should particularly be focused on those groups at greatest risks."

Calling the findings "concerning though largely consistent with other studies,"Dr. Deepak Bhatt said rising rates of obesity can be attributed to less physical activity and cheaper high-calorie foods. He is the director of Mount Sinai Heart and professor of cardiovascular medicine at the Icahn School of Medicine in New York City.

"Obesity-related cardiovascular disease is a major and growing problem in both sexes and all racial groups,"said Bhatt. "The findings are, in part, related to the fact that there is more obesity everywhere and the pandemic helped fuel already rising rates of obesity."

Greater emphasis on public health measures to encourage healthy eating and more physical activity would help turn these statistics around.

"Potentially, some newer medications that lead to weight loss but also provide cardiovascular benefit could be useful,"Bhatt added.

More information

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SOURCES: Scott Kahan, MD, MPH, director, National Center for Weight and Wellness, Washington, D.C.; Deepak Bhatt, MD, MPH, director, Mount Sinai Heart, Dr. Valentin Fuster Professor of Cardiovascular Medicine, Icahn School of Medicine, Mount Sinai, New York City; Journal of the American Heart Association, study and news release, Sept. 6, 2023