In communities across the United States, new data show that cardiovascular disease remains a critical public health challenge, particularly for Black Americans who continue to face disproportionately high rates of illness and death. According to the latest 2025 Heart Disease and Stroke Statistical Update from the American Heart Association, nearly 60 percent of Black adults age 20 and older have some form of cardiovascular disease, including coronary heart disease, heart failure, stroke, or hypertension. That compares with about 49 percent of U.S. adults overall, illustrating a persistent gap in heart health outcomes.

Heart disease is the leading cause of death in the nation, with the Centers for Disease Control and Prevention reporting that more than 919,000 people died from cardiovascular disease in 2023, or roughly one in every three deaths. Heart disease takes a particularly heavy toll on Black communities, where non-Hispanic Black adults have age-adjusted heart disease death rates that are significantly higher than the general population. The CDC notes that non-Hispanic Black people die from heart disease at rates about 35 percent higher than the total U.S. population.

Experts say the reasons for these disparities are complex and rooted in both medical and social factors. Black adults have some of the highest prevalence of hypertension in the world, with nearly 58.9 percent of Black women and 57.5 percent of Black men affected. High blood pressure is a major driver of heart disease, increasing the risk for heart attack, stroke, and heart failure, especially when it is undiagnosed or poorly controlled.

“The science is clear — Black communities continue to face disproportionate risks of heart disease, stroke, and other cardiovascular conditions, leading to poorer survival outcomes,” said Dr. Keith Churchwell, chief volunteer scientific and medical officer for the American Heart Association. Churchwell highlighted that data alone are not enough to change outcomes and emphasized the need for targeted community engagement and education.

Underlying these clinical statistics are broader social determinants of health that shape who develops heart disease and who receives timely care. Living in under-resourced neighborhoods with limited access to healthy foods, safe spaces for physical activity, and quality medical services can increase the likelihood of obesity, diabetes, and poorly controlled blood pressure — all key risk factors for cardiovascular disease. Studies show that Black adults are diagnosed with high blood pressure about 26 percent more frequently than the total population, and are less likely to have their blood pressure under control once diagnosed.

Health care access and quality are also major contributors to disparities. Black patients are more likely to be uninsured or underinsured, which reduces access to preventive screenings and treatment. Even when care is accessible, research and advocacy groups have documented that bias and communication barriers in medical settings can lead to unequal treatment and delays in diagnosis, further exacerbating outcomes. The American Heart Association and other public health organizations argue that addressing these gaps requires both systemic policy changes and community-centered health initiatives.

In addition to clinical and social factors, researchers point to the role of chronic stress associated with lifelong exposure to racial discrimination and economic instability, which can contribute to high blood pressure and inflammation over time. Social scientists and clinicians have described this cumulative impact as “weathering,” a process that accelerates the onset of chronic conditions, including heart disease, in Black Americans compared with other groups. Public health efforts to mitigate stressors through supportive services, mental health resources, and economic opportunities are seen as part of a comprehensive strategy to reduce cardiovascular disparities.

Despite years of public health campaigns, data indicate that Blacks under age 50 face particularly severe outcomes. Research shows that younger Black adults are more likely to die from heart disease than their white peers, even though heart disease is often associated with older age. This trend underscores the urgency of early prevention, screening, and culturally appropriate health education beginning in young adulthood. Experts stress that building trust between health care providers and Black communities is essential for improving engagement with preventive care and reducing advanced disease at diagnosis.

Efforts to address heart health inequities have taken various forms. National organizations such as the American Heart Association have expanded community-based training in basic life support skills, such as Hands-Only CPR, and have increased advocacy for policies that improve access to healthy foods, safe physical activity environments, and equitable health care coverage. Local health departments and community organizations are also developing culturally tailored outreach programs that aim to raise awareness about risk factors and encourage regular screenings.

Public health officials and clinicians agree that reducing the burden of heart disease in the Black community will require sustained investment in both clinical care and the conditions that promote health outside traditional medical settings. Efforts to strengthen preventive care, improve treatment equity, and address social determinants are seen as critical to narrowing the heart health gap. Ending the disproportionate burden of cardiovascular disease in Black communities is not only a medical challenge but a matter of health equity and justice.

As the nation observes American Heart Month this February, health advocates are calling for renewed focus on community-centered prevention strategies, investment in equitable health care access, and expanded support for individuals at highest risk, in hopes that future years will bring measurable improvements in heart health outcomes for Black Americans and all communities disproportionately affected by cardiovascular disease.