Obesity is indirectly the number 1 cause of death in America

It may be Americas No. 1 killer, but people aren’t scared enough of heart disease says a top U.S. research cardiologist.

We’ve done a good job of advertising to people that were doing better with heart disease, so people tend to sort of feel good about it, said Dr. Robert Califf, vice chancellor for clinical research at Duke University Medical Center. We have bypass surgery and stents and drugs that work; the [mortality] rates are declining.

It’s true that U.S. heart disease deaths overall are down. From 1993 to 2003, cardiovascular disease death rates dropped 22.1 percent.

But more than 910,000 Americans still die of heart disease annually, according to the American Heart Association. And more than 70 million Americans live every day with some form of heart disease, which can include high blood pressure, cardiovascular disease, stroke, angina (chest pain), heart attack and congenital heart defects.

It’s sort of accepted as part of the background noise, even though it’s far and away the most likely reason that you or I will die, Califf said.

And it will get more likely, he said. We are just on the front end of the baby boomer epidemic, where the projections on the amount of cardiovascular disease are climbing steadily over the next 10 years, he said.

We are delaying the disease, but were not preventing it, said Dr. Steven Nissen, president of the American College of Cardiology and chairman of cardiovascular medicine at the Cleveland Clinic in Ohio.

Prevention is key, the experts agree, and Americans know what to do: Eat a healthy diet, keep their weight in check, exercise and don’t smoke. But instead, obesity and diabetes rates continue to rise. Roughly two-thirds of Americans are overweight or obese, according to the National Center for Health Statistics. And the epidemic is spreading to teenagers and children.

We can’t expect significant change until it becomes a cultural mandate, said Dr. Leslie Cho, director of the Cleveland Clinics Women’s Cardiovascular Center. When society as a whole makes conscious decisions to eat better and as a default plan be more active, then were going to do better.

But could that happen anytime soon?

I don’t know, she said. If you had asked me if New York City was going to be smokeless, I would have said no a couple of years ago. The city’s proposed ban on trans fat in restaurant food is another potential advance, she said.


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