Poor exercise and eating habits could be the game-changer in the fight against heart disease and stroke deaths, according to the American Heart Association's (AHA) "Heart Disease and Stroke Statistical Update 2013."

Between 1999 and 2009, the rate of deaths from cardiovascular disease (CVD) fell 32.7%, but still accounted for nearly 1 in 3 deaths in the nation. However, according to projections in the 2013 report, heart health may only improve by 6% if current trends continue. The biggest barriers to success are projected increases in obesity and diabetes, and only modest improvements in diet and physical activity. On a positive note, smoking, high cholesterol, and high blood pressure rates are projected to decline.

Among heart disease and stroke risk factors, the most recent data show:

• 68.2% of adults are overweight or obese; 34.6% are obese; 31.8% are normal or underweight.
• 31.8% of children ages 2-19 are overweight or obese.
• 32% of adults report no aerobic activity.
• 17.7% of girls and 10% of boys, grades 9-12, report fewer than 1 hour of aerobic activity in the past week.
• 13.8% of adults have total cholesterol of 240 mg/dL or higher.
• 33% of adults have high blood pressure; African-Americans have among the highest prevalence of high blood pressure (44%) worldwide.
• 8.3% of adults have diagnosed diabetes; 8.2% have undiagnosed diabetes; 38.2% have prediabetes.

AHA says it plans to focus on population-based ways to improve health factors for all Americans. Some of these include:

• Working with health care systems to support and reward providers who help patients improve their health behaviors and manage their health risk factors.
• Working with insurers to cover preventive health services and reward positive health behaviors and medication adherence.
• Working with the education community to make changes in schools that support healthy diets and physical activity for children.
• Building comprehensive worksite wellness programs.
• Building healthier communities with improved access to healthier foods and green space for physical activity.

"Americans need to move a lot more, eat healthier and less, and manage risk factors as soon as they develop," said Alan S. Go, MD, chair of the report's writing committee. "If not, we’ll quickly lose the momentum we've gained in reducing heart attack and stroke rates and improving survival over the last few decades."

Free full text of the article is available in Circulation.