Figures suggest that heart disease in the United States has more than doubled, despite a drive to low fat, cholesterol lowering diets.
New statistics show that 187.1 out of every 100,000 Americans will die from heart disease, compared with previous estimates of just 86.7 deaths per 100,000.
But the old estimates were based on a profile of the population drawn in 1940, when far fewer people were living beyond 65. The new estimates, prepared on 1996 data, have been age adjusted.
So although the problem has dramatically worsened, it has not truly doubled.
The figures, prepared by the American Heart Association (AHA), show that each year about 400,000 Americans develop congestive heart failure.
In all, one fifth or 58.8 million of Americans are suffering from cardiovascular disease.
Nearly one in five cardiovascular deaths is caused by smoking, and more than half of all Americans have above average total cholesterol concentrations.
The new figures have been prepared for the AHA's 1999 Heart and Stroke Statistical Update (BMJ, 1999; 318: 79; Lancet, 1999; 353: 126).