Hawaiʻi Health Data Warehouse

Cardiovascular Disease

Cardiovascular disease is a term for a variety of conditions affecting the heart and blood vessels. The most common forms of cardiovascular disease are:

  • Heart disease (or coronary artery disease) caused by plaque buildup on the arteries. These blockages can limit the amount blood and oxygen the heart receives causing cause chest pain or angina.
  • Heart attack (or acute myocardial infarction) happens when the blood flow to a part of the heart is blocked by plaque. Symptoms include pain or discomfort in one or both arms, the back, neck, jaw or stomach; shortness of breath; uncomfortable pressure, squeezing, or pain in the chest; breaking out in a cold sweat, nausea or light headedness.
  • Stroke Ischemic stroke occurs when a blood vessel leading to the brain is blocked by a clot. Hemorrhagic stroke occurs when a blood vessel within the brain ruptures. Stroke symptoms include trouble speaking or understanding; blurry vision; trouble walking, dizziness, loss of balance or coordination, and severe headache. Timely, effective treatment for heart attacks and strokes can reduce the risk for long-term disability and death.

Why It’s Important

Cardiovascular disease is the leading cause of death for both men and women in the United States (US) and in Hawaiʻi. Annually, about 697,000 deaths in the US and 3,550 deaths in Hawaiʻi are due to cardiovascular disease.1 There are many types of cardiovascular disease, with coronary artery disease being the most common. In the US someone has a heart attack every 40 seconds.2 When considered separately, stroke is the fifth leading cause of death and the leading cause of disability in the US.

The estimated cost of heart disease and stroke, including health care services, medicine and lost productivity due to death, is about $282 billion each year in the US – $229 for heart disease and $53 billion for stroke (2017-2018).3

What Is Known

Heart disease can develop over many years and may not cause any symptoms until it has reached a later stage. High blood pressure, high blood cholesterol, and smoking are key risk factors for heart disease, but diabetes, overweight and obesity, unhealthy diet, lack of physical activity and excessive alcohol use also increase the risk of heart disease.3 Heart disease is fairly common with

  • 31,900 Hawaiʻi adults (2.4%) reporting ever being diagnosed with heart disease,
  • 37,400 (2.8%) with heart attack, and
  • 32,100 (2.5%) with stroke (BRFSS 2018-2020, age-adjusted prevalence).

But the at-risk population is much greater. In Hawaiʻi —

  • 338,500 Hawaiʻi adults (27.4%) have ever been diagnosed with high blood pressure,
  • 277,300 (25.5%) with high blood cholesterol (BRFSS 2019), and
  • 123,800 (11.6%) are current cigarette smokers, and
  • 274,500 (25.7%) are former smokers (BRFSS 2020)

Who Is at Risk

There are many identified risk factors for cardiovascular disease. Some risks can be managed while others cannot.

Risk Factors That Cannot Be Managed

  • Age–people ages 65 and older are at a higher risk
  • Sex–men are more likely to develop CVD than women
  • Heredity–children of parents with heart disease are more likely to develop it themselves.

Risk Factors That Can Be Managed

  • Tobacco smoke–both smoking and secondhand smoke can increase the risk of CVD.
  • High blood pressure–unmanaged high blood pressure can cause elasticity loss in the arteries, but this condition can be managed with diet, exercise and medication.
  • Blood Cholesterol Levels–cholesterol can be managed through diet and exercise.
  • Diabetes–people with diabetes are about twice as likely to have heart disease as those without diabetes.
  • Obesity–has been linked to high cholesterol levels, high blood pressure and diabetes.
  • Physical inactivity–increases CVD risk.
  • Unhealthy diet–diets that are high in saturated fats, trans fats and cholesterol have been linked to CVD and too much salt (sodium) can raise blood pressure levels.
  • Alcohol consumption–drinking too much alcohol can raise blood pressure and triglycerides (a form of cholesterol) which can harden your arteries.

How To Reduce Risk

There are steps that each person can take to reduce their risk of CVD.

  • Stop smoking tobacco. Heart attack risk drops dramatically within a year and stroke risk is nearly that of a non-smoker within 5 years. If you do not smoke, avoid exposure to secondhand smoke.
  • Manage blood pressure, blood cholesterol and diabetes through diet, exercise, and medication.
  • Be physically active. Moderate physical activity (30 minutes/day on 5 days/week) reduces CVD risk along with other risk factors such as obesity, high blood pressure, high cholesterol and diabetes.
  • Strive to eat a healthy diet of minimally processed food that includes a variety of fruits and vegetables, whole grains, lean meat and dairy, fish, nuts and legumes.
  • Limit alcohol consumption. Those who drink should limit their alcohol consumption to no more than 2 drinks per day among men and 1 drink per day among women.

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Page last updated July 29, 2022.


1 Heart Disease. Center for Disease Control and Prevention. https://www.cdc.gov/heartdisease/facts.htm Updated July 15, 2022. Accessed July 25, 2022.
2 Tsao CW, Aday AW, Almarzooq ZI, Beaton AZ, et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart AssociationCirculation. 2022;145(8):e153–e639.
3 Agency for Healthcare Research and Quality. Medical Expenditure Panel Survey (MEPS): household component summary tables: medical conditions, United States. Accessed April 8, 2021.