Deaths from heart disease and stroke have declined slightly, yet both diseases remain among the leading causes of death in the United States, new federal statistics show.

A report released Thursday from the Centers for Disease Control and Prevention shows heart disease remains the leading cause of death in the U.S., and stroke still ranks fifth. The diseases also are the leading causes of death in the world.

Heart disease deaths per 100,000 people declined from 168.5 to 165.5, while stroke deaths went from 37.6 to 37.3. Other top causes of deaths also declined. Preliminary mortality statistics for 2017 show heart disease and stroke deaths continue to decrease.

“Any improvement means lives saved, and so we are encouraged to see these numbers,” said American Heart Association CEO Nancy Brown. “Yet, at the same time, this report shows we have much more work to do to save people from these devastating diseases.”

The decline is much less dramatic than the trend over several decades, when heart disease and stroke death rates both dropped more dramatically.

The increase in death rates among younger Americans may be explained in part by the earlier onset of high blood pressure, diabetes, obesity and other conditions that may lead to heart disease and stroke, said researcher Pradeep Natarajan, director of preventive cardiology at Massachusetts General Hospital in Boston.

“This may have consequences at those times, but can substantially increase the likelihood of heart disease and stroke in middle age and in the later years,” said Natarajan, who was not involved in the production of the report.

The report found life expectancy dropped slightly for the second year in a row. The mortality rates were adjusted to account for age differences in the population.

Last year’s drop in life expectancy from 78.7 years to 78.6 years may be partly explained by the slower pace in the decline of heart disease and stroke deaths, said Dr. Robert N. Anderson, the head of the mortality statistics branch at the National Center for Health Statistics.

Considering that heart disease and stroke risks often can be prevented by changing behaviors, access to healthcare and management of high blood pressure and diabetes and other risk factors, Natarajan said the reports suggests physicians and healthcare policymakers need to step up their efforts in helping people reduce their risk.

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