From 2003 to 2013, death rates attributed to cardiovascular disease declined 28.8 percent, according to the American Heart Association's (AHA's) annual Heart Disease and Stroke Statistical Update released on Dec. 16.

However, cardiovascular disease still accounted for 30.8 percent of all deaths in the U.S. in 2013 and remained the leading cause of death in the U.S. Approximately 2,200 people in the U.S. died from cardiovascular disease each day.

The writing group members, who published the data online in Circulation, added that 35 percent of deaths attributed to cardiovascular disease in the U.S. occurred before age 75. In 2014, the rate of death attributed to cardiovascular disease was 222.9 per 100,000 Americans, including 269.8 for males and 184.8 for females.

The AHA mentioned the organization was expanding its focus on promoting positive cardiovascular health, health behaviors such as a healthy diet, appropriate energy balance, physical activity and not smoking and health factors such as optimal blood lipids, blood pressure and glucose levels throughout peoples’ lives.

“We need to maintain our vigor and resolve in promoting good cardiovascular health through lifestyle and recognition and treatment of risk factors such as high blood pressure, diabetes, high cholesterol and smoking,” AHA President Mark Creager, MD, director of the Heart and Vascular Center at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, said in a news release. “We’ve made progress in the fight against cardiovascular disease, but the battle is not won.”

Meanwhile, the relative rate of stroke death decreased by 33.7 percent and the actual number of stroke deaths declined by 18.2 percent from 2003 to 2013. However, approximately 795,000 people have a new or recurrent stroke each year, and stroke is still the fifth leading cause of death in the U.S. behind heart disease, cancer, chronic lower respiratory diseases, and unintentional injury.

The researchers also assessed quality of care, procedure use and cost data. They found that the number of inpatient cardiovascular operations and procedures increased 28 percent between 2000 and 2010.

They cited data that the estimated annual costs for cardiovascular disease and stroke were $316.6 billion in 2011 and 2012, including $193.1 billion in direct costs and $123.5 billion in indirect costs from lost productivity. They mentioned that estimated direct costs for all cancers in 2011 were $88.7 billion.

The mean hospital charge for a vascular or cardiac surgery or procedure in 2012 was $78,897, while cardiac revascularization cost $149,480 and percutaneous interventions cost $70,027.

The researchers mentioned Medicare data showed adverse event rates for hospitalized patients declined for MI and congestive between 2005 and 2011. However, they added that an outpatient registry found that only 66.5 percent of eligible patients with coronary artery disease received the optimal evidence-based combination of medications.

In 2014, 16.9 percent of adults said they were cigarette smokers, down from 24.1 percent in 1998. However, the researchers noted that nearly one-third of coronary heart disease deaths are attributable to smoking and exposure to secondhand smoke.

They also mentioned that only 47.0 percent of women and 53.2 percent of men met the current aerobic physical activity guidelines of at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity or an equivalent combination each week.

In addition, they said that suboptimal diet quality is the leading risk factor for death and disability in the U.S. and led to 678,000 annual deaths in 2010. They defined a suboptimal diet as insufficient intakes of fruits, nuts/seeds, whole grains, vegetables and seafood as well as an excess intake of sodium.

Further, they noted that 46.6 percent of adults and 75.7 percent of children had ideal cholesterol levels, which they defined as less than 170 mg/dL for children and less than 200 mg/dL for adults. From 2003 to 2012, the percentage of adults who were at least 40 years old and took a cholesterol-lowering medication increased from 20 percent to 28 percent.

They also cited data from 2009 to 2012 that showed approximately 80 million U.S. adults had hypertension. Of those people with hypertension, 54.1 percent had it controlled, 76.5 percent were receiving treatment, 82.7 percent were aware they had the disease and 17.3 percent were undiagnosed. From 2003 to 2013, the death rate attributed to high blood pressure increased 8.2 percent.

The Statistical Update includes information on diet, physical activity, smoking, energy balance, blood pressure, cholesterol and glucose that cardiovascular health. It also has data on diseases such as stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease and peripheral arterial disease as well as outcomes such as quality of life, procedures and economic costs.