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Due to a change in the definition of hypertension, nearly half of U.S. adults now have some form of cardiovascular disease, according to a report from the American Heart Association (AHA).

Cardiovascular disease (CVD) comprising coronary heart disease, heart failure, stroke, and hypertension had a prevalence of 48.0% overall in 2013-2016 -- or 121.5 million people in 2016, researchers found from National Health and Nutrition Examination Survey (NHANES) data, according to the report in .

Adjusted for age, the prevalence of high blood pressure alone was estimated to be 46.0% when using 130/80 mm Hg as the new blood pressure threshold. The CVD rate excluding hypertension plummeted to 9.0% overall, wrote Emelia Benjamin, MD, of Boston University School of Medicine, and chair of the AHA writing group.

"That might seem like good news, but 9% of the U.S. adult population represents more than 24.3 million Americans with coronary artery disease, heart failure, or stroke," Mariell Jessup, MD, AHA chief science and medical Officer, said in a statement.

The 2017 American College of Cardiology/AHA guidelines redefined hypertension such that its prevalence went up from 31.9% (according to Joint National Committee 7 guideline thresholds) to 45.6% in NHANES data from 2011-2014.

The new report supports the notion that risk factors are changing over time.

Data from 2015-2016 suggested that 39.6% of adults were obese, up from 36.3% in 2011-2014. However, tobacco use continued its decades-long decline in the U.S., with now just over 15% of adults and 3% of adolescents reporting having smoked cigarettes in the past month (e-cigarette use among high school students at 11.3%).

"Beginning in 2020, we'll chart our progress with a metric called healthy life expectancy. Also known as health-adjusted life expectancy (HALE), it captures the number of years a person can expect to live in good health based on current patterns of mortality and morbidity. The lay public may find HALE a more meaningful and relatable metric than statistics about death rates and risk factors," according to Jessup.

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