Cardiovascular diseases are a group of conditions affecting the heart and blood vessels, and collectively they are the leading cause of death worldwide. An estimated 19.8 million people died from them in 2022, accounting for roughly 32% of all global deaths. In the United States alone, 919,032 people died from cardiovascular disease in 2023. The term covers a wide range of conditions, from clogged arteries and weakened heart muscles to strokes and defects present from birth.
Coronary Artery Disease
Coronary artery disease is the most common type of heart disease, affecting about 1 in 20 American adults age 20 and older. It develops when fats, cholesterol, and other substances build up inside the walls of the arteries that supply blood to the heart. This buildup, called plaque, gradually narrows the arteries and restricts blood flow. Over time, plaque can also rupture and trigger a blood clot, which is what causes most heart attacks.
The hallmark symptom is chest pain known as angina. People often describe it as squeezing, pressure, heaviness, or tightness in the middle or left side of the chest, sometimes compared to the feeling of someone standing on your chest. Physical activity and strong emotions are common triggers. Some people, particularly women, experience less obvious symptoms like shortness of breath, fatigue, or pain in the jaw, neck, or back. Coronary artery disease can develop silently over decades before symptoms appear.
Heart Failure
Heart failure doesn’t mean the heart stops beating. It means the heart can no longer pump blood efficiently enough to meet the body’s needs. Doctors measure heart function using ejection fraction, the percentage of blood the heart pushes out with each beat. A normal ejection fraction falls between 55% and 70%.
There are two main forms. In one, the heart muscle doesn’t contract with enough force, so less oxygen-rich blood reaches the body. This is called heart failure with reduced ejection fraction, and it’s typically diagnosed when that measurement drops below 40%. In the other form, the heart contracts normally but the chambers don’t relax properly between beats, so they can’t fill with enough blood. This is heart failure with preserved ejection fraction. Both types lead to similar symptoms: fatigue, shortness of breath, swelling in the legs and ankles, and difficulty with everyday activities like climbing stairs or carrying groceries.
Stroke and Cerebrovascular Disease
Strokes happen in the brain rather than the heart, but they are classified as cardiovascular disease because they involve blood vessels. There are two main types, and they work in opposite ways.
An ischemic stroke occurs when blood flow to part of the brain is blocked, starving brain tissue of oxygen and nutrients. The blockage typically comes from a blood clot, often related to plaque buildup in the carotid arteries (the major blood vessels in the neck). This is by far the more common type, accounting for the large majority of strokes. A hemorrhagic stroke happens when a blood vessel in the brain bursts. Blood pools in the surrounding brain tissue, creating pressure that damages nearby cells.
Both types cause sudden symptoms: numbness or weakness on one side of the body, confusion, trouble speaking, vision problems, severe headache, or loss of coordination. The key word is “sudden.” Strokes are medical emergencies where minutes matter, because brain tissue dies quickly without blood flow.
Peripheral Artery Disease
Peripheral artery disease is essentially the same plaque-narrowing process as coronary artery disease, but it affects the arteries in the legs rather than those supplying the heart. The signature symptom is called claudication: cramping, aching, or fatigue in the calf muscles that reliably shows up during walking and goes away within about 10 minutes of rest. As the disease progresses, pain can occur even at rest, and wounds on the feet or legs may heal very slowly.
Doctors screen for it using a simple, painless test called the ankle-brachial index, which compares blood pressure at the ankle to blood pressure in the arm. A ratio between 1.0 and 1.3 is normal. A reading between 0.7 and 0.9 indicates mild disease, 0.4 to 0.7 is moderate, and anything below 0.4 is severe. As many as 30% of people who have symptoms will show normal results at rest but abnormal results after exercise, so a walking test is sometimes needed to catch the problem.
Congenital Heart Disease
Congenital heart defects are structural problems with the heart that are present from birth. They range from simple holes between heart chambers to complex combinations of defects.
The most common simple defects include ventricular septal defects (a hole in the wall between the lower chambers), atrial septal defects (a hole between the upper chambers), and patent ductus arteriosus, where a connection between the aorta and the pulmonary artery that should close after birth stays open. In each case, blood flows where it shouldn’t, forcing the heart and lungs to work harder than normal. Small holes sometimes close on their own; larger ones may require surgical repair.
The most common complex congenital heart defect is tetralogy of Fallot, which combines four problems: a narrowed pulmonary valve, a large hole between the lower chambers, a displaced aorta, and a thickened right ventricle. Together, these defects allow oxygen-rich blood to mix with oxygen-poor blood, meaning less oxygen reaches the body. Most children with this condition undergo surgery in infancy and go on to live active lives, though they typically need lifelong cardiac follow-up.
Rheumatic Heart Disease
Rheumatic heart disease is caused by something most people wouldn’t connect to the heart: untreated strep throat. In some people, the immune response to a streptococcal throat infection goes haywire and attacks the body’s own tissues, including the heart valves. This reaction, called rheumatic fever, can inflame and scar heart valves. Repeated episodes cause cumulative damage, eventually leaving valves too stiff to open fully or too scarred to close properly.
The disease affects an estimated 55 million people worldwide and kills roughly 360,000 each year. It has been largely eradicated in wealthy countries through routine antibiotic treatment of strep throat, but it remains common in sub-Saharan Africa, the Middle East, central and south Asia, and the south Pacific. In high-income countries, it still appears among Indigenous populations, immigrants, and older adults.
Shared Risk Factors
Most cardiovascular diseases share a common set of risk factors, and many of them are within your control. High blood pressure is the single biggest one: it forces the heart to work harder and damages artery walls over time. High LDL cholesterol (the “bad” kind) contributes directly to plaque buildup, while higher HDL cholesterol (the “good” kind) offers some protection. Diabetes significantly raises the risk, because elevated blood sugar damages blood vessels. Adults with diabetes face a higher risk of dying from heart disease than those without it.
Obesity compounds many of these risks, as it tends to raise LDL cholesterol and triglycerides, lower HDL cholesterol, and increase the likelihood of developing both high blood pressure and diabetes. Smoking damages the heart and blood vessels directly: nicotine raises blood pressure, and carbon monoxide from cigarette smoke reduces the oxygen-carrying capacity of blood. Even secondhand smoke exposure raises cardiovascular risk. Drinking too much alcohol raises blood pressure and triglyceride levels.
Some risk factors, like age and family history, you can’t change. But the modifiable ones work together, so addressing even one of them creates a ripple effect. Losing weight, for example, often improves blood pressure, cholesterol, and blood sugar simultaneously.
Prevention Through Lifestyle
The 2025 guidelines from the American Heart Association emphasize that lifestyle changes are the foundation for preventing cardiovascular disease. The physical activity target is at least 150 minutes of moderate exercise per week (brisk walking counts) plus resistance training on two or more days. For diet, the recommended approach is a pattern like DASH (Dietary Approaches to Stop Hypertension), which emphasizes fruits, vegetables, whole grains, and lean proteins while limiting saturated fat, trans fat, and sodium. The ideal sodium limit is no more than 1,500 milligrams per day for most adults, with 2,300 milligrams as the upper boundary. Potassium intake of 3,500 to 5,000 milligrams per day, mostly from foods like bananas, potatoes, and leafy greens, also helps keep blood pressure in check.
Regular screening matters too, especially for blood pressure, cholesterol, and blood sugar. These conditions often cause no symptoms until damage is well underway. Annual lab work is recommended for anyone already being treated for high blood pressure, and routine screening should be standard for all adults.