Despite these declines, heart disease remains the number one and stroke the third leading causes of death. Lifestyle improvements by the American public and better control of the risk factors for heart disease and stroke have been a major factor in this decline.
Cardiovascular disease is of multifactorial etiology.
Modifiable risk factors include high blood pressure, high blood cholesterol, obesity, smoking, diabetes, and physical inactivity. In contrast to the positive trends observed with the reduction of high blood pressure and high blood cholesterol, overweight and physical inactivity have been on the increase. In light of this, the accumulating evidence of the risk of cardiovascular disease associated with a sedentary lifestyle and the role of physical activity in the prevention and treatment of CVD and other CVD risk factors needs to be examined. Data from the 1990 Youth Risk Behavior Survey suggest that adolescents are less active than they were a decade ago. Only 37 percent of teenagers in grades 9 through 12 reported performing at least 20 minutes of vigorous exercise at least three or more times per week.