Heart attack deaths in the US drop 90% as new heart risks rise

Over the past 50 years, the number of people dying from heart disease in the U.S. has dropped dramatically—especially from heart attacks. But while one chapter of this public health story is closing with hard-won success, another is just beginning.

A new study led by researchers at Stanford Medicine reveals how America’s heart disease battle has changed shape over time. Once dominated by ischemic causes like acute myocardial infarctions (heart attacks), the landscape is now shifting toward chronic and complex conditions such as heart failure, arrhythmias, and hypertensive heart disease.

In 1970, about 41% of all deaths in the U.S. were due to heart disease. Fast forward to 2022, and that share has fallen to 24%. That decline reflects a major victory in the treatment and prevention of ischemic heart disease—conditions caused by narrowed arteries that block blood flow to the heart. Most notably, deaths from heart attacks have dropped nearly 90% since 1970.

Stanford’s team, led by medical resident Dr. Sara King and cardiovascular professor Dr. Latha Palaniappan, examined death data collected by the National Vital Statistics System. Their findings, published in the Journal of the American Heart Association, track over 119 million adult deaths from 1970 to 2022. About 37 million of those were from heart-related causes.

In 1970, ischemic heart disease—mostly heart attacks—accounted for 91% of heart-related deaths. Today, that number has fallen to 53%. The change reflects both medical progress and a changing population, as Americans now live longer and manage early heart problems better, only to face other types of heart conditions later in life.

The steep decline in heart attack deaths didn’t happen overnight. It came from decades of innovation, emergency care improvements, and lifestyle changes.

In the 1970s, just 60% of older patients survived a heart attack. Now, over 90% do. For younger patients, survival rates are even better. These outcomes stem from improved emergency response, better hospital care, and major public health efforts.

Over the decades, many tools became widely used: CPR bystanders could perform, portable defibrillators, and the growth of coronary care units. Imaging and surgical techniques like bypass surgery and balloon angioplasty further raised survival rates. In the '80s and '90s, stents and blood-thinning drugs such as aspirin helped keep arteries open and reduced risks.

In more recent years, new cholesterol-lowering medications and diabetes treatments added more protection. Statins, in particular, became a staple in heart disease prevention.

Public health campaigns also played a critical role. Starting with the 1964 Surgeon General’s report linking smoking to health issues, anti-smoking efforts gained steam. In 1970, 40% of Americans smoked. By 2019, that number had fallen to 14%.

All these changes worked together. Age-adjusted heart attack mortality fell from 354 per 100,000 people in 1970 to just 40 in 2022. That’s an 89% drop. Chronic ischemic heart disease deaths also dropped—down 71% from 343 per 100,000 in 1970 to 98 in 2022.

While deaths from ischemic heart disease have declined, deaths from other heart-related issues are rising. Heart failure, hypertensive heart disease, and arrhythmias are now becoming more common causes of death.

The researchers found that age-adjusted deaths from other heart conditions grew from 68 per 100,000 people in 1970 to 123 in 2022—an 81% increase. Heart failure deaths rose 146%, hypertensive heart disease deaths climbed 106%, and arrhythmia deaths surged 450%.

What’s driving this shift? Several factors play a role.

People are surviving heart attacks but are now living long enough to develop chronic heart issues. The U.S. population is aging—life expectancy rose from 70.9 years in 1970 to 77.5 in 2022—and more people now live with long-term health conditions that can lead to heart failure or arrhythmias.

Obesity and diabetes are also more common than before. Today, about half of American adults have diabetes or pre-diabetes, and 40% are obese. Physical inactivity and high blood pressure remain widespread issues. These risk factors contribute to many non-ischemic heart diseases.

Dr. King explained, “People now are surviving these acute events, so they have the opportunity to develop these other heart conditions.”

The total number of heart-related deaths hasn’t changed much—733,000 in 1970 compared to 701,000 in 2022—but the mix of causes has shifted. In 1970, heart attacks made up more than half of ischemic deaths. In 2022, they made up only 29%.

Age-adjusted death rates provide even more clarity. While overall heart disease deaths dropped 66% since 1970, and ischemic heart disease deaths fell 81%, deaths from other heart conditions increased steadily. Rheumatic heart disease was the only exception, dropping by 85%.

This evolving pattern calls for a new approach to heart health.

“We’ve seen a remarkable 90% decline in heart attack deaths, a medical miracle made possible by the synergistic power of science, medicine and public health,” Dr. Palaniappan said. But she and her team also recognize that the fight is far from over.

Preventing ischemic heart disease required a combination of medical advances and public policy. Tackling non-ischemic heart disease may need the same effort.

“Fortunately, people are dying less from ischemic disease. Now, we need to expand our efforts to non-ischemic causes of heart disease death,” Dr. King said.

This next chapter will likely focus on aging well and managing chronic conditions earlier. As Dr. King pointed out, “Often it’s the passage of time that can lead to conditions such as atrial fibrillation or heart failure. Finding ways to age healthily is going to be the next frontier of heart care.”

The study’s authors also note that national data may not capture how heart disease affects specific communities. Social and economic factors, access to health care, and racial disparities all shape risk. King hopes to study these subgroups next.

Heart disease remains the top killer in the U.S., but the tools and knowledge to fight it continue to grow. “We have so many tools in our toolbox now,” King said, “but still, there’s a lot more that can be developed and improved.”

Note: The article above provided above by The Brighter Side of News.

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