Cardiovascular care has become more advanced over the past two decades, giving doctors new ways to prevent deaths from heart attacks, strokes and other conditions.
But a new national study found those advances have come with rapidly rising costs while improvements in cardiovascular death rates have largely stalled.
The analysis, published in the Journal of the American College of Cardiology, found U.S. spending on cardiovascular disease more than tripled between 2000 and 2022, reaching more than $220 billion annually.
Death rates declined sharply during the first decade of the study. But they changed little after 2011.
The same trends are visible in Hampton Roads.
Virginia Department of Health data shows more than 3,100 people died from cardiovascular disease across Hampton, Newport News, Norfolk, Portsmouth and Virginia Beach in 2024.
Virginia Beach recorded the most deaths overall, with nearly 1,200. Portsmouth had the highest death rate among the five cities, at about 346 deaths per 100,000 residents, or roughly one death for every 250 residents.
The burden was not evenly distributed. Black residents had higher age-adjusted cardiovascular death rates than White residents across the region, with the widest gap in Norfolk, where the average rate was about 36% higher from 2022 to 2024.
Dr. Keith Newby, cardiology director for Bon Secours Medical Group, said factors outside the hospital have a greater influence on the disparities.
He pointed to limited access to doctors, nutritious food and safe places to exercise in Black communities, along with higher rates of hypertension, diabetes, obesity and high cholesterol.
“How do we prevent things so we don't have to spend more? That’s where lifestyle part comes in,” Newby said.
Many of the conditions that eventually cause heart attacks, strokes and heart failure do not produce noticeable symptoms early on, he said. People can have dangerously high blood pressure or blood sugar without feeling sick.
That makes it more difficult to persuade patients to take medication, change their diets or seek regular care before serious damage occurs.
“Most people are not going to address things while they feel well,” Newby said. “They’re going to wait until they’re having a problem.”
By then, patients may need emergency treatment, hospitalization or expensive procedures.
Newby said medical advances have allowed doctors to save more people who suffer heart attacks or strokes. Doctors can also replace damaged heart valves and open blocked arteries in ways that were not widely available decades ago.
Those treatments can help people live longer, but they also add to healthcare spending.
Newby said improving cardiovascular outcomes will require cooperation among healthcare providers, schools and government agencies to expand screenings, nutrition education and access to healthier food and physical activity.
Adith Arun, one of the authors of the national study, said the overall trend raises questions about whether resources are being directed toward the most effective strategies.
“Mortality rates have plateaued for cardiovascular disease,” Arun said. “Yet we continue to spend more and more money, and the question is, ‘how can we do better?’”
Arun said health systems need to reach patients earlier, before risk factors such as high blood pressure develop into serious disease. That means better screening, proven treatments and easier access to regular care.
