Heart disease remains leading cause of death in US, new report finds
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(NEW YORK) — Heart disease remains the leading cause of death in the United States, according to a new report.
The American Heart Association (AHA) report, published Monday in the journal Circulation, found that 941,652 Americans died from cardiovascular disease in 2022, the most recent year for which data is available. That’s an increase of more than 10,000 from the just over 931,500 reported to have died from cardiovascular disease in 2021.
It also means that a person in the U.S. dies of cardiovascular disease every 34 seconds, or nearly 2,500 people every day, according to the AHA report.
“The stats are pretty sobering from this report,” Dr. Tara Narula, ABC News chief medical correspondent and a board-certified cardiologist, said on ABC’s “Good Morning America” on Monday. “In fact, cardiovascular disease kills more Americans than all forms of cancer and accidents combined.”
Cancer and accidental deaths continue to remain the second and third leading causes of death, respectively, according to the latest data from the Centers for Disease Control and Prevention (CDC).
The AHA report also found racial and ethnicity disparities, with Black Americans having the highest prevalence of cardiovascular disease. Between 2017 and 2020, 59% of non-Hispanic Black females and 58.9% of non-Hispanic Black males had some form of the disease, according to the report.
In addition, the report showed several heart disease risk factors continue to rise, with nearly 47% of American adults having high blood pressure and more than half, 57%, diagnosed with type 2 diabetes or prediabetes.
Additionally, 72% of U.S. adults have an unhealthy weight, with nearly 42% of adults having obesity, which also is a risk factor for developing cardiovascular disease, according to the AHA report.
In an accompanying editorial, Dr. Dhruv Kazi, associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center In Boston, said risk factors for cardiovascular disease are expected to rise over the next several years.
“Although we have made a lot of progress against cardiovascular disease in the past few decades, there is a lot more work that remains to be done,” Kazi wrote. “If recent trends continue, hypertension and obesity will each affect more than 180million U.S. adults by 2050, whereas the prevalence of diabetes will climb to more than 80 million.”
Overall, cardiovascular-related deaths have begun plateauing after ticking upward during the COVID-19 pandemic, according to the AHA. The report found death rates dropped during the survey period for all 10 leading causes of death except kidney disease, which increased by 1.5%.
The good news is that 80% of cardiovascular disease is preventable, according to Narula. Ways to lower the risk include eating a heart-healthy diet, getting regular exercise, quitting smoking, managing stress, and getting adequate sleep every night.
(WASHINGTON) — During his confirmation hearings two weeks ago to lead the Department of Health & Human Services (HHS), Robert F. Kennedy Jr. repeated several unfounded claims about autism.
Kennedy, an environmental lawyer who has made money through books, speeches and lawsuits while sharing vaccine skepticism, refused to say that vaccines don’t cause autism despite many high-quality studies finding no such link.
He stated during the hearing that autism rates have “have gone from 1 in 10,000 … and today in our children, it’s one in 34.” His claims have been repeated by President Donald Trump on Truth Social.
It’s unclear where Kennedy got his 1 in 10,000 statistic. In 2000, approximately 1 in 150 children in the U.S. born in 1992 were diagnosed with autism compared with 2020, during which one in 36 children born in 2012 were diagnosed, according to data from the Centers for Disease Control and Prevention.
Some psychiatrists and autism experts told ABC News it’s important to highlight the rising rates of autism, and that at least Kennedy is putting a spotlight on it.
“On the bright side, I think it is really important to place an emphasis on these very high rates, it’s kind of great putting a spotlight on autism, these increased rates,” Dr. Karen Pierce, a professor in the department of neurosciences at the University of California, San Diego and co-director of the UCSD Autism Center of Excellence, told ABC News. “We need more funding. We need more infrastructure to support everybody who is now recognized as on the spectrum. So, I think that that’s actually a really good thing.”
However, the experts said Kennedy and others are missing important context about why autism rates are increasing. They say reasons may include a combination of widening of the definition of the spectrum and of types of symptoms associated with autism spectrum disorder (ASD) as well as people having children at older ages, better awareness and access to diagnostic testing.
“With the rates increasing, there certainly are valid reasons for that,” Pierce said. “There’s better awareness, and doctors can find autism a lot easier than they could before in the past…. and I think a very big reason is just better record keeping nowadays and easier access to reviewing records.”
What is autism?
ASD is a developmental disability caused by differences in the brain, according to the CDC.
People with ASD often communicate, interact, behave and learn differently, the CDC says. ASD symptoms typically begin before age 3 and can last a lifetime, although symptoms may change over time.
“There can be differences in how one is reading social cues and interpreting them, and then there’s also certain behaviors that we see,” Dr. Anna Krasno, clinical director of the Koegel Autism Center at the University of California, Santa Barbara, told ABC News.
“So those include a preference for sameness, a difficulty with transitioning, some cognitive and behavioral rigidity,” she continued. “We also see intense interests, so topics that people are super, super into and want to research, repetitive speech and motor movements. And then we also see really significant sensory differences as well.”
ASD is a spectrum, which means symptoms vary by person — some need little support in their daily lives and some may need a great deal of support in performing day-to-day activities. Some may have advanced conversation skills and others may be nonverbal.
Wider recognition, better understanding
Experts told ABC News there is a wider recognition and a better understanding of what is now understood as autism/ASD.
Traits of what is now known as ASD are built on early observations in the 1940s from Austrian-American psychiatrist Dr. Leo Kanner and Austrian physician Dr. Hans Asperger.
A 1943 paper from Kanner described 11 children who presented with “inborn autistic disturbances of affective contact” while Asperger’s 1944 report focused on boys who had marked social difficulties; unusual, circumscribed interests; and good verbal skills.
It was not until 1978 that autism was recognized as a developmental disorder distinct from schizophrenia by the World Health Organization. It was also in the 1970s that psychologists and psychiatrists first came to describe autism as a spectrum.
“When autism was first described, it was new to people understanding that there was a condition that included social communication difficulties and restricted and repetitive behavior, and people primarily only recognized it when it was at its most extreme,” Dr. Jeremy Veenstra-VanderWeele, division director in child and adolescent psychiatry at Columbia University, told ABC News.
“And so, if you go back and read the initial descriptions today, those are kids who we would recognize in the waiting room, recognize in the grocery store, in whom autism would be very obvious and would not require much assessment in order to diagnose,” he continued.
Better diagnostic tools
Experts say another reason for the increase in rates is having better diagnostic tools than what was available decades ago.
There is no single tool used as the basis of an ASD diagnosis. Typically, tools rely on descriptions from parents or caregivers of a child’s development and a professional’s observation of a child’s behavior, according to the CDC.
Currently, the Autism Society encourages all children to be screened for signs of autism by their family pediatrician three times by the age of three — at nine, 18, and 24 or 30 months. If a child shows symptoms of ASD, more rigorous diagnostic testing can be carried out by a specialist including a full neuropsychological exam.
Additionally, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides standard criteria for helping diagnose autism.
Under DSM-5, a child meets the criteria if they have deficits in three areas of social communication and interaction and at least two of four types of restricted, repetitive behaviors.
While the first edition of DSM came out in 1952, it was not until the third edition, DSM-3, in which autism was listed under an entirely new “class” of conditions — the Pervasive Developmental Disorders.
Veenstra-VanderWeele said the change in the criteria is another reason why the number of those diagnosed with autism rose. He likened it to changing the definition of what it means to be tall.
“To just use a crude example, if you would define somebody as tall if they were over six-foot-six, and then 30 years later, say that somebody is tall if they’re over five-foot-10, you’d get very, very different numbers, and that’s part of what’s happened here,” he said.
Pierce added that because of limited knowledge and awareness in the past, there may have been many children who were underdiagnosed and misdiagnosed.
“It’s understandable that people wouldn’t even necessarily think that somebody has autism, because nobody knew what really autism was,” she said. “So, you know, large numbers of people were just put in the books as just having special education needs, maybe as a language delay or of having a cognitive impairment.”
Older reproductive age
Some studies have suggested that people who become pregnant at an older age have an increased risk of giving birth to a child with autism.
A 2012 review and meta-analysis of 16 papers from researchers in New York, London, Israel and Sweden found an association between advanced maternal age and the risk of autism.
Advanced paternal age may also be a risk factor. A 2006 study conducted jointly by researchers in New York, London and Israel found that men who were above age 40 were 5.75 times more likely to have a child with ASD compared to men younger than age 30 after controlling for other factors.
However, questions still swirl about whether or not there is a risk from the age of parents, and not all researchers are convinced.
“I know that there is some research looking at maternal and paternal age with regard to autism, and there’s research around environmental causes,” Krasno said. “I think where I always firmly land is that it is inherited, and it is genetic. So, I don’t know the exact correlation between age and diagnostic rate, but we do know that genetics are highly associated with diagnosis.”
Environmental risk factors
Researchers are also divided over whether or not environmental risk factors play a role in causing autism.
The National Institute of Environmental Health Sciences says the “clearest evidence” involves events before and during birth, including prenatal exposure to air pollution or pesticides; maternal obesity or diabetes; extreme prematurity; and periods of oxygen deprivation to the brain during birth.
“But these factors alone are unlikely to cause autism. Rather, they appear to increase a child’s likelihood for developing autism when combined with genetic factors,” NIEHS states on its website.
Pierce said from the studies she’s read, evidence suggests autism is a genetic condition. She added the environmental factors may play a role but “to a small degree.”
Myth that vaccines cause autism
The myth that vaccines cause autism was born out of a fraudulent 1998 study, hypothesizing that the measles, mumps, rubella vaccine caused intestinal inflammation, which, in turn, led to the development of autism.
The paper has since been discredited by health experts, retracted from the journal in which it was published, and its primary author, Andrew Wakefield, lost his medical license after an investigation found he had acted “dishonestly and irresponsibly” in conducting his research.
More than a dozen high-quality studies have since found no evidence of a link between childhood vaccines and autism.
However, Kennedy has held fast to this claim, saying during a 2023 interview on Fox News that he believes autism comes from vaccines.
During the HHS confirmation hearings, Kennedy said he was not “anti-vaccine” but “pro-safety.” At the same time, Kennedy repeatedly refused throughout the hearings to say that vaccines were not linked to autism, while still insisting he supports vaccination in general.
Experts told ABC News there is no evidence to suggest a link between vaccines and autism, and perpetuating the myth can be dangerous.
“Once there’s a lie and it’s spread, it doesn’t matter that it’s a lie. Once people hear it, then they believe that it’s true despite all of the Herculean efforts to disprove it and debunk it,” Pierce said. “There’s no evidence for it whatsoever, and there’s actually extremely, as far as scientific evidence is concerned, there’s extremely strong evidence to suggest absolutely not.”
Christopher Banks, president and CEO of the Autism Society of America, said the false claim that vaccines cause autism can divert financial resources from much-needed research.
“Instead of advancing support and therapies, time and funding are wasted disproving a debunked theory,” he said. “This misinformation also fuels stigma, implying that autism is something to be feared rather than understood and supported, leading to discrimination against autistic individuals.”
ABC News’ Dr. Jade Cobern, Cheyenne Haslett and Will McDuffie contributed to this report.
(SAN FRANCISCO) — A child in San Francisco was recently confirmed to be the third human case of bird flu in the United States in which it’s unclear how the person got infected.
Most human cases have occurred after coming into contact with infected cattle, infected poultry farms or other culling operations.
The CDC and other public health officials say there is currently no evidence of human-to-human transmission and the risk to the general public is low.
Doctors tell ABC News they agree but, with few cases that have an unknown — or unclear — source of infection, there may be evidence of some cases slipping through the cracks.
“There are reassuring factors here, which is the child appears to have had mild disease recovered…and kind of mild symptoms,” Dr. Tony Moody, a professor of pediatrics and infectious diseases specialist at Duke University, told ABC News.
Moody added, “That’s reassuring on the one hand, but it’s also concerning, because we don’t know, does this represent the only case, or is it one of 10,000 cases that just haven’t made their way into the health care system?”
Health officials in San Francisco first reported the bird flu case in the child earlier this month before it was confirmed by the CDC.
The child experienced symptoms of fever and eye irritation, and has since fully recovered, officials said. Investigators said they’re looking into how the child was exposed to the virus.
A CDC spokesperson confirmed this is the second child infected with bird flu in the country, the first case being in late November in California, also with unknown exposure.
The agency noted this is the third time that an exposure source has not been identified for a bird flu case with most other cases directly linked to exposure by infected livestock.
Moody said it’s hard what to make of the case because, while the CDC has bumped up surveillance, there are still gaps.
“It’s not universal surveillance. We’re not able to capture all of the cases that we might like to catch,” Moody said. “And so, it’s kind of hard to know what to do with isolated data points like this, when you get a report of, yes, this is a confirmed case. But it’s also like, what is the actual denominator here? How many cases are there really out there? And it’s kind of hard to tell.”
“So, I’m not sure that the identification of this case tells us a whole lot, other than, yep, it’s circulating,” Moody added.
Dr. Meghan Davis, an associate professor of environmental health and engineering at Johns Hopkins Bloomberg School of Public Health, told ABC News that because many of the cases have been mild, people with similarly mild symptoms may not be getting tested for bird flu.
For example, someone with pink eye, also known as conjunctivitis, may not associate it with bird flu, even with recent exposure to cattle.
“I’m certain that we’re missing some cases, because not everybody is going to even go to a health care provider if they’re sick and get swabbed,” she said. “There may be people who have more mild symptoms, and it doesn’t graduate to the level of ‘I need to go to urgent care’ or ‘I need to go to the hospital.'”
Both Moody and Davis said more surveillance needs to be conducted to catch cases that fly under the radar. Davis points out that the CDC is already doing this, announcing Thursday it is calling for a shortened timeline for subtyping all tests that are positive with influenza A to identify non-seasonal influenza.
The CDC said it is reminding clinicians and laboratories to test for influenza in patients with suspected cases and to expedite subtyping to determine if they have bird flu rather than seasonal flu.
“The reason this is important is that what you do for someone who has seasonal flu may be a little bit different than what you do when you’re dealing with a virus that’s novel and you don’t know entirely what to expect clinically, and you don’t know entirely what to expect in terms of its potential to continue to spread,” Davis said.
Moody added that it’s reassuring the recent pediatric case in California did not occur within a cluster of cases, such as an entire family becoming infected.
He explained it would be much more jarring to have a cluster of cases with unconfirmed infection compared to an isolated case.
“When we see a report of a cluster of cases, that’s when my blood pressure is going to go up,” Moody said. “Given everything else we know, I think let’s keep our worry proportional for now.”
ABC News’ Youri Benadjaoud contributed to this report.
(GAINES COUNTY, Texas) — The number of measles cases associated with an outbreak in western Texas has grown to 146, according to new data released Friday.
Almost all of the cases are in unvaccinated individuals or individuals whose vaccination status is unknown, with 79 unvaccinated and 62 of unknown status. At least 20 people have been hospitalized so far, according to the Texas Department of State Health Services (DSHS).
Just five cases have occurred in people vaccinated with one dose of the measles, mumps, rubella (MMR) vaccine.
Children and teenagers between ages 5 and 17 make up the majority of cases with 70, followed by 46 cases among children ages 4 and under.
So far just one death has been reported in an unvaccinated school-aged child, according to DSHS. It marks the first measles death in the U.S. in a decade, according to data from the Centers for Disease Control and Prevention.
Gaines County is the epicenter of the outbreak, with 98 cases confirmed among residents, according to DSHS. State health data shows the number of vaccine exemptions in the county have grown dramatically.
Roughly 7.5% of kindergarteners in the county had parents or guardians who filed for an exemption for at least one vaccine in 2013. Ten years later, that number rose to more than 17.5% — one of the highest in all of Texas, according to state health data.
The CDC as separately confirmed 93 cases in eight states so far this year in Alaska, California, Georgia, New Jersey, New Mexico, New York, Rhode Island and Texas.
The total, however, is an undercount due to delays in reporting from states to the federal government.
The majority of nationally confirmed cases are in people who are unvaccinated or whose vaccination status is unknown. Of the cases, 4% are among those who received one dose of the measles, mumps, rubella (MMR) shot.
Measles is one of the most contagious diseases known to humans. Just one infected patient can spread measles to up to nine out of 10 susceptible close contacts, according to the CDC.
Health officials have been urging anyone who isn’t vaccinated to receive the MMR vaccine.
The CDC currently recommends that people receive two vaccine doses, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective. Most vaccinated adults don’t need a booster.
Measles was declared eliminated from the U.S. in 2000 due to the highly effective vaccination program, according to the CDC. However, CDC data shows vaccination rates have been lagging in recent years.
ABC News’ Youri Benadjaoud contributed to this report.
