Yes, heart disease is the leading cause of death both in the United States and worldwide. In 2024, heart disease killed 683,491 Americans, outpacing cancer by roughly 64,000 deaths. Globally, ischemic heart disease (the most common form) is responsible for 13% of all deaths, claiming 9.1 million lives in 2021.
The Numbers in the U.S. and Worldwide
In the United States, heart disease has held the number one spot for decades. The 2024 figures from the National Center for Health Statistics confirm the ranking: heart disease killed 683,491 people, cancer killed 619,876, and unintentional injuries came in third. That gap of roughly 64,000 deaths between heart disease and cancer has remained relatively consistent year to year.
Globally, the picture is similar but even more dramatic. The World Health Organization reports that ischemic heart disease is the world’s biggest killer, and its toll has been growing. Deaths from this single condition rose by 2.7 million between 2000 and 2021, reaching 9.1 million. Stroke ranks third globally (after COVID-19 surged into the number two spot in 2021), and chronic obstructive pulmonary disease ranks fourth.
What “Heart Disease” Actually Includes
Heart disease is an umbrella term covering several conditions that damage the heart or its blood vessels. The most common and deadliest form is coronary heart disease, where plaque builds up inside the arteries supplying blood to the heart muscle. In the U.S., coronary heart disease alone killed 371,506 people in 2022. It’s also the condition behind most heart attacks. Someone in the United States has a heart attack every 40 seconds, totaling about 805,000 per year. Of those, around 605,000 are first-time heart attacks, while 200,000 occur in people who have already had one.
Other conditions grouped under the heart disease umbrella include heart failure, arrhythmias (irregular heartbeats), and diseases of the heart valves. When public health agencies report heart disease as the leading cause of death, they’re counting all of these together.
Death Rates Have Been Falling, but Slowly
Despite holding the top spot, heart disease death rates have actually declined over the past several decades thanks to better treatments, wider use of preventive medications, and public health campaigns around smoking and blood pressure. Between 2009 and 2019, the age-adjusted death rate in the U.S. dropped from about 183 per 100,000 people to 162 per 100,000. For men specifically, the rate fell from 229 to 205 per 100,000 over the same period. For women, it went from 147 to 126.
That progress has been uneven, though. After an initial decline between 2009 and 2012, the rate of improvement slowed considerably through 2019. And the COVID-19 pandemic disrupted care for many chronic conditions, raising concerns about a reversal in some of those gains.
Who Is Hit Hardest
Heart disease does not affect all groups equally. Black Americans face the highest heart disease death rates of any racial or ethnic group in the U.S., at 208 deaths per 100,000 people in 2017. That’s more than twice the rate for Asian or Pacific Islander Americans (86 per 100,000) and substantially higher than the rate for white Americans (169 per 100,000) or Hispanic Americans (114 per 100,000).
The good news is that death rates have fallen across all racial and ethnic groups since 1999. The decline has been especially steep for Black Americans, whose rate dropped from 337 per 100,000 in 1999 to 208 in 2017. Still, that gap remains significant. Men also die from heart disease at higher rates than women across every demographic group.
Geography matters too. Globally, the highest heart disease death rates are concentrated in Eastern Europe and Central Asia, while high-income countries tend to have the lowest rates. Low- and middle-income countries now account for more than 80% of all heart disease deaths worldwide, and working-age adults in those countries die from it at markedly higher rates than their counterparts in wealthier nations.
Most Heart Disease Deaths Are Preventable
Perhaps the most striking statistic about heart disease isn’t how many people it kills, but how many of those deaths didn’t have to happen. The National Heart, Lung, and Blood Institute estimates that 80% of cardiovascular disease is preventable. The major modifiable risk factors are well established: high blood pressure, high cholesterol, smoking, physical inactivity, poor diet, obesity, and uncontrolled diabetes.
That 80% figure means the vast majority of heart disease develops not from unavoidable genetic destiny but from risk factors that respond to changes in behavior or medical management. Controlling blood pressure and cholesterol, staying physically active, not smoking, and maintaining a healthy weight collectively eliminate most of the risk. The challenge is that these risk factors tend to accumulate gradually and silently over years, which is part of why heart disease remains so deadly despite being so preventable.