Cardiovascular disease is the leading cause of death in Washington state. Cardiovascular diseases are caused by heart muscles and vessels narrowing or being blocked. Risk factors for cardiovascular disease include:  

• Air pollution 

• Diet 

• Exercise 

• Smoking 

• High blood pressure 

• Diabetes 

People with cardiovascular disease experience greater loss of life when exposed to pollution. Historically minoritized populations are the most impacted by this because they experience more heart disease. Non-Hispanic Black people experience the highest rates of cardiovascular disease.  

Evidence 

Long-term exposure to pollution reduces life expectancy in people with cardiovascular disease [1]. People with heart disease have a higher risk of death when exposed to pollution [2, 3]. 

Short-term exposure to air pollution is linked to acute coronary events [4, 5]. Survivors of acute coronary events have a higher death rate when exposed to higher levels of air pollution [6].  

Non-Hispanic Black people face the highest cardiovascular disease death rates [7]. 

Data source 

Washington State Department of Health, Center for Health Statistics, death certificate data 

Methods 

This measure uses cardiovascular disease death data from DOH’s Center for Health Statistics. The Center for Health Statistics collects information on the deaths of Washington state residents from their death certificates. It includes the deaths of Washington state residents that died in other states or in Canada. A medical provider or examiner determines the underlying cause of death and records it on the death certificate. The underlying cause of death is the disease or injury that started the course of events that led directly to death. Deaths from cardiovascular diseases include major cardiovascular diseases, which is a group of the 113 selected causes of death list from the National Center for Health Statistics. This group of causes of death includes codes 100-178 from the International Classification of Diseases, 10^th revision. 

This measure shows the age-adjusted rate of deaths per 100,000 people due to cardiovascular disease. We use the age-adjusted rate to account for differences in population age. Older people are more likely to experience cardiovascular events, and communities have different age distributions. Age-adjusted rates ensure that the differences we see between communities are not due to differences in the ages of their populations.  

Caveats 

Not everyone with cardiovascular disease dies from it. Therefore, death data underestimates the true population with heart disease. This measure serves as a proxy for the prevalence of cardiovascular disease. 

The Center for Health Statistics estimates that death certificate data is 99% complete. 

Sources 

1. Brook, R., Rajagopalan, S., Pope, A., Brook, J., Bhatnagar, A., Diez-Roux, A., et al. (2010). Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation, 121(21), 2331-78. 

2. Bateson, T., & Schwartz, J. (2004). Who is sensitive to the effects of particulate air pollution on mortality? A case-crossover analysis of effect modifiers. Epidemiology, 15(2), 143-9. 

3. Chen, H., Burnett, R., Copes, R., Kwong, J., Villeneuve, P., Goldberg, M., et al. (2016). Ambient fine particulate matter and mortality among survivors of myocardial infarction: population-based cohort study. Environmental Health Perspectives, 124(9), 1421-8. 

4. Pope, C., Muhlestein, J., May, H., Renlund, D., Anderson, J., & Horne, B. (2006). Ischemic heart disease events triggered by short-term exposure to fine particulate air pollution. Circulation, 114(23), 2443-8. 

5. Von Klot, S., Gryparis, A., Tonne, C., Yanosky, J., Coull, B., Goldberg, R., et al. (2009). Elemental carbon exposure at residence and survival after acute myocardial infarction. Epidemiology, 20(4), 547-54. 

6. Berglind, N., Bellander, T., Forastiere, F., Von Klot, S., Aalto, P., Elosua, R., et al. (2009). Ambient air pollution and daily mortality among survivors of myocardial infarction. Epidemiology, 20(1), 110-8. 

7. Centers for Disease Control (CDC). (2019). Spotlight, Racial and Ethnic Disparities in Heart Disease. Racial and Ethnic Disparities in Heart Disease. 

Citation

Washington Tracking Network, Washington State Department of Health. Web. "Death from Cardiovascular Disease". Data obtained from the Washington State Department of Health, Center for Health Statistics, 2019-2023 Death Certificate Data. Published September 2025.