Heart Disease and Stroke Mortality in the Twentieth Century

Abstract Heart disease has been the leading cause of death in the United States since 1921, and stroke has been the third leading cause since 1938. Heart disease and stroke account for most cardiovascular disease (CVD) deaths in the United States. Although heart disease and stroke remain leading causes of death, age-adjusted death rates from all CVD have declined by 55% since 1950. This decline reflects an increased understanding of the causes of CVD, identification of preventable risk factors, improvements in treatment of heart disease and stroke and their antecedents such as hypertension, and implementation of intervention and prevention programs. This chapter summarizes the trends in heart disease and stroke in the 20th century, advances in the understanding of risk factors for these diseases, and development of prevention and intervention programs to reduce the risks of developing and dying from heart disease and stroke.