Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity in the United States (U.S), underscoring the importance of consistent and transparent measurement to guide action. Cardiovascular statistics in the U.S, 2026, represents a comprehensive effort by the Journal of the American College of Cardiology (JACC) to assess whether the nation stands, identify persistent gaps, and evaluate progress in cardiovascular health. The report examines major CVD risk factors and conditions, drawing on nationally representative vital statistics, surveys, claims data, and clinical registries to evaluate mortality trends, burden of disease, and quality of care.
Coronary artery disease (CAD) prevalence declined from 1990 to 2015 but has risen since 2019, despite an approximately 50% reduction in CAD mortality between 2000 and 2020. Only about 50% of CAD patients receive optimal medical therapy. Although hospitalizations and mortality related to acute myocardial infarction (AMI) have declined overall, rates are increasing among younger adults, with persistent disparities by geography, sex, race, and income. About 6.7 million U.S adults have heart failure (HF), and HF-related mortality has risen since 2011, accelerating during the coronavirus disease 2019 (COVID-19). Peripheral artery disease affects one in 14 adults, with major amputation occurring in nearly 10% of chronic limb-threatening ischemia cases. Stroke affects about 7.8 million adults and accounts for around 160,000 deaths in 2023.
Low-density lipoprotein cholesterol (LDL-C) remains a critical modifiable risk factor for atherosclerotic CVD. Mean LDL-C levels declined modestly between 2009 and 2020; however, population-level control remains suboptimal. Fewer than one in four adults with established CVD achieved LDL-C levels >70 mg/dL, and fewer than 10% reached more aggressive targets <55 mg/dL. Statin therapy and newer lipid-lowering agents continue to be underused with persistent sex- and racial-based disparities in treatment.
Hypertension continues to be a major risk factor for the development of CVD. Approximately 34.3% (95% confidence interval [CI]: 32.4-36.1) of U.S. adults had hypertension (≥ 140/90 mm Hg) during 2021-2023, a prevalence largely unchanged since 2009. When applying the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline definition of ≥130/80 mm Hg, prevalence rises sharply to 47.6% (95% CI: 45.9-49.4) during 2021-2023, affecting nearly one in two adults. Black adults (58.8%, 95% CI: 54-63.7) experience the highest burden of hypertension. Rates remain elevated across rural and low-income populations. Despite effective treatments, only about 23.4% (95% CI: 21.5-25.2) of adults with hypertension receive therapies. Hypertension-related CVD mortality nearly doubled between 2000 and 2019, with the steepest increases observed among middle-aged adults.
Obesity is a central driver of cardiometabolic disease. Obesity prevalence among U.S adults increased from 34.5% (95% CI: 31.8-37.2, 2011-2012) to 40.1% (95% CI: 36.7-43.6, 2021-2023), with mean body mass index rising to nearly 30 kg/m2. Obesity disproportionately affects non-Hispanic Black adults and women, although increases have occurred across all demographic groups. Despite advances in pharmacologic therapies, including GLP-1 receptor agonists, and the proven effectiveness of bariatric surgery, treatment of obesity remains profoundly underutilized. Obesity-related mortality also increased, specifically among older adults aged 65-74 years (7.2/100,000) and Black individuals (4.3/100,000).
Cigarette smoking prevalence declined substantially from 20.3% (95% CI: 18.7-21.9) of adults in 2009-2010 to 14.5% (95% CI: 12.2-16.8) in 2021-202, reflecting major public health progress. However, smoking rates remain nearly twice as high among low-income adults, and recent increases among older adults, along with rising e-cigarette use among younger people, threaten continued progress.
The prevalence of diabetes mellitus increased steadily from 11.9% (95% CI: 10.7-13.1) in 2009-2010 to 14.1% (95% CI: 12.9-15.3) in 2021-2023, with the sharpest rises among younger adults, individuals with low income, and non-Hispanic Black populations. Although treatment rates remain near 70%, glycemic control has not improved, with only about half of adults achieving recommended targets. Alarmingly, glycemic control has worsened among young adults in recent years. Mortality related to type 2 diabetes increased markedly from 30.4 deaths/10,000 in 2009 to 54/10,000 in 2023, with persistent geographic and racial disparities.
Overall, this report emphasizes that achieving a healthier cardiovascular future requires rigorous measurement of progress and decisive action to guide policymakers, clinicians, researchers, and the public towards more effective prevention and care.
Reference: Wadhera RK, Dhruva SS, Bikdeli B, et al. Cardiovascular statistics in the United States, 2026: JACC stats. JACC. null2026:0(0). doi:10.1016/j.jacc.2025.12.027
