A total of 312 medicines for heart disease or stroke are under clinical development by pharmaceutical and biotechnology companies in the US or awaiting approval from the Food and Drug Administration, a new report reveals.

The tally compares with just 146 medicines in development for these diseases in 2005, notes the Pharmaceutical Research and Manufacturers of America (PhRMA). Heart disease and stroke are two of the three leading causes of death in the US.

The leading development category in heart disease/stroke is thrombosis, with 40 medicines either in clinical trials or awaiting US approval, the PhRMA report shows (some drugs are listed in more than one category). Other leading categories are hypertension with 36 medicines in development, heart failure with 33, peripheral vascular disease with 27, lipid disorders with 26 and stroke with 22.

According to the National Center for Health Statistics, heart disease has headed the list of fatal diseases in the US every year but one since 1900 – the exception was 1918, when an influenza epidemic killed more than 450,000 Americans. In 2002, cancer overtook heart disease as the leading killer of Americans under the age of 85 years, who make up 98.4% of the US population. The third most common fatal disease in the US is stroke.

American Heart Association data indicate that nearly 80 million Americans have one or more types of cardiovascular disease, running up annual costs of more than US$448 billion.