Just before 10, officials received a call about a car that drove into Northshore Lake on New Hope Church Road near Deana Lane.
Police said Robert Lee Sparks, the driver, was the only person in the car.
Police said Sparks, of Andover Glen Road in Raleigh, suffered a medical emergency causing him to lose control and strike a curb and then a concrete barrier. The vehicle, a 2016 Cadillac, went airborne and landed in the water.
The vehicle flipped and became submerged.
An eyewitness told ABC11 a male driver was heading down the road when it appeared he blew a tire.
She said it appeared he lost control and plunged into the water.
"All I heard was the explosion and then not even like three minutes later a big splash."