A year after receiving its biggest boost in federal funding in more than a decade, the National Institutes of Health once again came out a winner in late 2016, receiving an increase of nearly $5 billion in funding over the next decade.

But funding for cardiovascular disease – the nation’s No. 1 and most-expensive cause of death – failed to keep pace. NIH invests just 4 percent of its budget on heart research and 1 percent on stroke research.

The new 10-year funding came as part of the 21st Century Cures Act, signed into law by President Obama in December. It includes $1.8 billion for cancer research, $1.5 billion for the BRAIN Initiative, nearly $1.5 billion for the Precision Medicine Initiative and $30 million for regenerative medicine using adult stem cells.

Yet the future looks bleak for cardiovascular disease patients if necessary investments in heart and stroke research are not made, according to a recent statement from American Heart Association CEO Nancy Brown.

A 2011 report from the AHA projects that by 2030, 40.5 percent of Americans will have cardiovascular disease. As of 2012, 35 percent had at least one form of cardiovascular disease at a cost of $316.6 billion — a price tag expected to rise to nearly $1 trillion a year by 2030, according to AHA statistics.

“More research dollars must be devoted to this burdensome disease if we are to save lives, prevent disability and reverse this terrible projection,” said Brown. During the past half-century, research led to a 70 percent increase in life expectancy because of reductions in deaths from cardiovascular disease, according to the NIH.

But medical research funding remains unpredictable at a time when continuity and reliability of funding are desperately needed, said Steven Houser, Ph.D., president of the AHA.

“As new ideas are brought forward, they can only be tested if there is funding available,” said Houser, senior associate dean of research, chairperson of the Department of Physiology and director of the Cardiovascular Research Center at Temple University in Philadelphia.

But the current lack of stability in the health research market “stifles innovative approaches,” he said. “If we cannot develop new knowledge into new therapies, at best we will be stagnant in our goal to reduce death and disability from heart disease and stroke.”

Houser said appropriate funding would also make it easier for NIH to address health disparities and increase participation of women, racial and ethnic minorities, and the elderly in clinical research.