Heart disease and stroke are the first and fifth leading causes of death in the United States, according to the U.S. Department of Health and Human Services.

Each year, about 1.5 million Americans suffer a heart attack or stroke. More than 700,000 of them die. 

Heart Disease and Stroke Are Often Preventable

The good news is that many heart attacks and strokes can be prevented. The right lifestyle changes can significantly lower your risk.

That’s why DHHS, the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services are leading the Million Hearts^®  national initiative. Federal, state and local agencies and private-sector partners also provide support for the campaign.

Million Hearts encourages Americans to make lifestyle choices that could decrease their chances of suffering a heart attack or stroke:

• Use aspirin when appropriate
• Control blood pressure
• Manage high cholesterol
• Stop smoking
• Eat less salt
• Eat less trans fats
• Limit or avoid alcohol

The Role of High Blood Pressure

High blood pressure is a leading cause of heart disease and stroke and has been linked to dementia, according to the CDC.

Nearly half of American adults have hypertension, higher blood pressure than normal.

About 75 percent of adults with high blood pressure do not have their condition under control. You should have your doctor check you and your loved ones regularly for this often undiagnosed and untreated disease.

What Exactly Happens During a Heart Attack or Stroke?

A heart attack happens when blood flow to a part of the heart is blocked by a blood clot. Clots that cut off blood flow completely can cause part of the heart muscle to die. If you’ve had a heart attack, it is vital that you make some changes in your lifestyle.

Most strokes are ischemic strokes. An ischemic stroke happens when a blood vessel in the brain — not the heart — is blocked by a clot or bursts. In this case, the lack of blood and oxygen may kill brain cells. If this happens, depending on how long oxygen and blood were blocked, a person may have permanent brain damage. This can lead to long-term health problems, like not being able to walk or talk. Strokes can also be fatal.

What Are the Signs of a Heart Attack?

The most common type of heart disease is coronary artery disease (CAD), which can lead to heart attacks.

Some heart attacks may happen suddenly, with intense pain. In these cases, it may be clear what's happening.

But many heart attacks start slowly with only mild pain or discomfort. Sometimes people aren't sure what's wrong, and they may wait too long before getting help. Waiting can increase the damage to the heart muscle.

Know the major symptoms of a heart attack: 

• Pain or discomfort in the jaw, neck, stomach or back
• Feeling weak, dizzy, light-headed or faint
• Chest pain or discomfort
• Pain or discomfort in arms or shoulder
• Shortness of breath
• Nausea (an additional symptom in women)
• Unusual or unexplained fatigue

Heart attacks in women can appear much different than in men. For women, any symptoms from the waist upward, front or back of the body, including dizziness, lightheadedness, fainting,  vomiting, upper back pressure or extreme fatigue can indicate a heart attack.

Source: Centers for Disease Control and Prevention

What Can You Do?

To protect yourself, stay smart about your heart:

• Know the signs of a heart attack.
• Keep your weight, blood pressure and cholesterol in a healthy range.
• Talk to your doctor about your numbers and ask if medication is needed.
• Exercise most days of the week.
• Do not smoke or use tobacco.
• Limit or avoid alcohol.

If you think you are having a heart attack, call 911 right away.

And if you haven’t been having regular health screenings with your doctor, start today. Your health plan benefits cover many of your preventive care screenings at no cost to you.*

Need help getting started making heart-healthy lifestyle changes? Check out these resources:

• Videos about high blood pressure   — what it is and what to do about it
• DASH healthy eating plan  to keep blood pressure under control
• Move Your Way^®  tools, videos and fact sheets for adults and kids

*Preventive services at no cost applies only to members enrolled in non-grandfathered health plans. You may have to pay all or part of the cost of preventive care if your health plan is grandfathered. To find out if your plan is grandfathered or non-grandfathered, call the customer service number on your member ID card.

Sources: Costs and Consequences,  Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 2021; Heart Disease Facts,  CDC, 2024; Stroke Facts, CDC, 2024; High Blood Pressure Facts,  CDC, 2024; Cold Weather and Cardiovascular Disease,  American Heart Association, 2024

Originally published 1/13/2020, Revised 2021, 2022, 2024