Obesity continues to take a dramatic toll on the hearts of men, according to a recent report from the American Heart Association. The rate of deaths from ischemic heart disease related to obesity nearly tripled in the U.S. over a two-decade span, according to new research. The rate for men more than tripled.
Dr. Mohammad Kashef, a cardiologist at Saint Mary's Hospital, said the results were discouraging but not surprising.
"What we know is that there are some health conditions that put individuals at risk for this type of heart disease. Those are obesity, high blood pressure, high cholesterol, diabetes, smoking and diet and lifestyle," he said. In ischemic heart disease, narrowed arteries reduce the flow of blood and oxygen to the heart muscle, which can lead to a heart attack. Lifestyle changes can lessen the risk, though those modifications are often easier suggested than incorporated.
"Obesity is a serious risk factor for ischemic heart disease, and this risk is going up at an alarming rate along with the increasing prevalence of obesity," the study's lead researcher Dr. Aleenah Mohsin said in a news release. She is a postdoctoral research fellow at Brown University in Providence, R.I.
Obesity also contributes to other risk factors for heart disease, including high cholesterol, high blood pressure, Type 2 diabetes and sleep disorders.
In the study, researchers analyzed age-adjusted data from 226,267 deaths attributed to obesity-related ischemic heart disease. The data from the Centers for Disease Control and Prevention's Wonder database was collected from 1999 to 2020. Overall, the rate of heart disease deaths associated with obesity increased by about 180%. Researchers also looked into whether specific demographics - race, age, gender or place of residence - had higher death rates.
For all men, the rate jumped from 2.1 deaths per 100,000 people in 1999 to 7.2 in 2020 - a 243% increase. For men ages 55 to 64, the rate increased 165%, from 5.5 deaths per 100,000 people in 1999 to 14.6 in 2020.
For women, the rate went from 1.6 deaths per 100,000 people in 1999 to 3.7 in 2020 - a 131% increase.
"It's our lifestyle," said Preventive Cardiologist Dr. John Glenn Tiu of UConn Health. "Unfortunately, our diets are not the healtiest and, number two, the lack of exercise and physical activity. I think as a whole we become a more sedentary society and havemore processed foods rather than fresh fruits and vegetables." Tiu said nearly 80% of heart disease is preventable, either by controlling risk factors or combining that with medical interventions, like surgery or weight-loss drugs.
Compared to other races, Black adults had the highest death rate at 3.93 per 100,000 people in 2020.
Kashef and Tiu say a complex interplay of reasons, including metabolic risk factors like diabetes and high blood pressure, combined with the adverse social determinants related to access to health care, are likely behind the higher rates of heart deaths among Blacks. "This study brings attention to social disparities that exist in health care," Kashef said. In 2019, Blacks were 30 % more likely to die from heart disease than non-Hispanic whites, according to the Department of Health and Human Services. It noted that although Blacks are 30% more likely to have high blood pressure, they are less likely than non-Hispanic whites to have their blood pressure under control.
By one estimate, one out of every five Black households is situated in a food desert, with few grocery stores, restaurants and farmers markets.
"lt's easier to purchase processed foods, which contain either more salt or more sugar," Tiu said. "Many people live in food deserts wherein there's not a grocery store within a number of miles, so it may be easier for people to access processed foods rather than fresh fruits and vegetables....It's cheaper or less expensive to buy fast food from McDonald's than fresh fruits and vegetables."
The researchers acknowledged that they did not measure non-fatal cases of heart disease, which means the analysis may underestimate the true impact of obesity.
Kashef emphasized that the prevention of obesity should begin in childhood. Nearly 20% of all American children are classified as obese, according to the Trust for American Health. It notes that these rates have more than tripled since the mid-1970s, and Black and Latino youth have substantially higher rates of obesity compared to their white peers.
"Habits formed (in childhood) will stay with a person," he said. "We should work on promoting healthy diet and physical activity at a young age, childhood. When they get to adulthood, individuals need to have a screening test, especially those at higher risk, for example those that have a history of heart disease in their family or a history of diabetes or high blood pressure, or those who are overweight or obese."
The increase in obesity-related ischemic heart disease deaths might also be the result of greater awareness, Dr. Sadiya S. Khan said in the news release. Khan is an associate professor of cardiology, medical social sciences and preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.
"It may just be that people are more aware of obesity as a risk factor or are more likely to treat obesity, and, therefore, it is more likely to be included on death certificates, which were the basis of these data," said Khan, who was not involved in the new research. "The important thing is that we know we need to do more to identify, manage and treat obesity-related risk."
"I tell patients, 'I know it's so easy for me to say lose weight, but it's never as simple and they've heard that a million times already," Tiu said. He recommends patients find an activity they enjoy doing that they can do consistently 30 minutes a day, five days a week.