Cardiovascular disease, the leading cause of death among people 65 and older, is expected to become increasingly widespread in the coming decades, with Black and Hispanic communities bearing the brunt of this public health crisis.

A new study from researchers at Harvard and other institutions projects that by 2060, ischemic heart disease will rise by 31%, heart failure by 33%, heart attacks by 30%, and strokes by 34% compared to 2025 levels. The most dramatic surge is anticipated between 2025 and 2030.

This spike stems largely from the rapid growth of the aging U.S. population and rising rates of conditions that raise cardiovascular risk—including high blood pressure, diabetes, and obesity. These risk factors are especially prevalent among Black and Hispanic populations, foreshadowing an even greater health burden in these communities.

Without targeted efforts to improve prevention, health education, and access to treatment, “disparities in the burden of cardiovascular disease are only going to be exacerbated,” warned experts from Stony Brook University and Baylor University Medical Center in an editorial accompanying the study.

Clyde Yancy, chief of cardiology at Northwestern University’s Feinberg School of Medicine, underscored the urgency: “Whatever focus we’ve had before on managing [cardiovascular] disease risk in Black and Hispanic Americans, we need to redouble our efforts.”

Cardiovascular deaths among those 65 and older have already been steadily rising. While there was a 22% decline in cardiovascular deaths between 1999 and 2010 (thanks to medical advances, better treatments, and decreased smoking) that trend reversed between 2011 and 2019, with deaths rising 13%.

The COVID-19 pandemic accelerated this trend, introducing new complications such as blood clots and discouraging millions of seniors from seeking medical care. Older adults from low-income households, particularly non-Hispanic Black and Hispanic individuals, suffered disproportionately high death rates from the virus.

“The pandemic laid bare ongoing health inequities,” said Dr. Nakela Cook, executive director of the Patient-Centered Outcomes Research Institute. These disparities have spurred new research into the root causes of health inequity across various diseases, especially cardiovascular conditions.

One comprehensive study published in JAMA Cardiology examined cardiovascular mortality trends by race and location from 1990 to 2019. It revealed that Black men, particularly those in the South and northern Midwest, remain at the highest risk of dying from cardiovascular disease. In 2019, the age-adjusted death rate for Black men was 245 per 100,000, compared to 191 for White men and 135 for Hispanic men. Rates for women were lower in each group.

Progress in reducing cardiovascular deaths among Black men has slowed significantly. Between 2000 and 2010, deaths dropped by 28%. But from 2010 to 2019, the decrease was just 13%, and in places like Mississippi and Michigan, the decline was barely noticeable—or even reversed, as in Washington, D.C., where deaths rose nearly 5%.

While personal lifestyle choices contribute to cardiovascular risk, systemic factors also play a key role. The American Heart Association notes that perceived racial discrimination and chronic stress contribute to hypertension, obesity, and inflammation, which raise the risk of heart disease. Other social determinants (such as income, education, housing, and neighborhood environments) further influence health outcomes.

Cardiologist Michelle Albert, president of the American Heart Association, emphasized that medical education must better address these social determinants to prepare clinicians to meet the needs of vulnerable populations.

The lack of data on other racial groups, including Asian Americans and Native Americans, also highlights gaps in research that must be addressed.

Different regions may require tailored solutions, said Alain Bertoni, a professor at Wake Forest University School of Medicine, given the significant geographic disparities in health outcomes. Community outreach and culturally specific health education will be vital.

Cardiologist Natalie Bello suggested expanding community-based efforts, such as deploying health workers to underserved neighborhoods or bringing pharmacists into Black-owned barbershops to educate men about blood pressure management.

“There’s a clear need to go where people are and meet them with information and care,” she said.

Despite the grim outlook, there is hope. “Now, more than ever, we have the medical therapies and technologies in place to treat cardiovascular conditions,” said Dr. Rishi Wadhera of Beth Israel Deaconess Medical Center. The challenge lies in connecting all older adults (especially those in underserved communities) with screening, preventive care, and high-quality treatment.