Heart disease, long a leading cause of death in the United States, is undergoing a significant shift. According to a recent study, heart attacks are no longer the primary cause of heart disease-related deaths. The report, published in the Journal of the American Heart Association, reveals that fatalities from heart attacks, or acute myocardial infarctions, have decreased by 89% from 1970 to 2022.
This decline in heart attack deaths is attributed to advancements in medical science and emergency care. However, while heart attacks have become more survivable, other heart conditions are on the rise, contributing to the overall death toll from heart disease.
The Changing Landscape of Heart Disease
Despite the overall decrease in heart disease deaths by 66% since 1970, it remains the leading cause of death among Americans. The study highlights that ischemic heart disease, which accounted for 91% of heart disease-related deaths in 1970, has decreased to 53% by 2022. This shift indicates that while fewer people are dying from heart attacks, other heart-related conditions are becoming more prevalent.
Dr. Jayne Morgan, a cardiologist and vice president of medical affairs for Hello Heart, explains that the report does not necessarily mean fewer heart attacks are occurring. “I did not note a decline in myocardial infarctions themselves, but rather a decline in heart attacks being the primary cause of death,” she said. “Our strength has been in the science and application of medicine.”
“The inference is that more and more heart attacks are survivable now as compared to 55 years ago,” Dr. Morgan added.
Rising Fatalities from Other Heart Conditions
As heart attack fatalities decrease, deaths from other heart disease subtypes now represent 81% of heart-related deaths. These include:
- Heart failure, with fatalities increasing by 81%
- Hypertension-related heart disease deaths, rising by 106%
- Arrhythmia-related fatalities, which have increased by 450%
Dr. Cheng-Han Chen, a board-certified interventional cardiologist, notes that non-fatal heart attacks often lead to long-term chronic heart conditions such as heart failure and arrhythmias. “Patients who otherwise would have passed from their heart attack are now surviving, and then living longer dealing with the consequences,” he said.
Heart failure, for instance, does not mean the heart has completely failed but that it is not functioning as well as it once did. “Heart failure is a spectrum in which the heart just doesn’t work perfectly,” Dr. Chen explained. “You can actually live with mild heart failure for the remainder of your life.”
Lifestyle Factors and Heart Health
The typical American lifestyle plays a significant role in the risk of developing heart failure, hypertension, and arrhythmia. Dr. Morgan points out that factors such as obesity, sedentary lifestyles, and poor diet contribute to these conditions. “Socioeconomic issues complicate lifestyle risk factors and make addressing them especially difficult for many,” she noted.
Despite these challenges, the decline in heart attack fatalities suggests progress is being made against some risk factors. However, the sharp increase in arrhythmia-related deaths remains a concern. Arrhythmias, which are disorders of the heart rate, can be fatal if they interfere with the heart’s ability to maintain blood flow.
“Reducing the risk of arrhythmias after a myocardial infarction is crucial, as these irregular heart rhythms — especially ventricular arrhythmias — can be life-threatening,” Dr. Morgan emphasized.
Prevention and Management Strategies
The American Heart Association (AHA) offers a framework for maintaining heart health, known as the Essential Eight:
- Eat healthy
- Be more active
- Quit tobacco
- Get healthy sleep
- Manage your weight
- Control your cholesterol
- Regulate your blood sugar
- Manage your blood pressure
For heart attack survivors, interventions such as statins, cardiac rehab, and lifestyle changes are crucial in preventing complications like arrhythmia. The AHA’s Essential Eight provides guidance for both adults and children to maintain heart health.
Looking Ahead
The evolving landscape of heart disease in the U.S. highlights the importance of continued research and public health initiatives. As medical advancements continue to improve survival rates for heart attacks, attention must also be given to preventing and managing other heart conditions that are on the rise.
For more information on heart health and prevention strategies, individuals are encouraged to consult healthcare professionals and resources like the AHA’s website. As the fight against heart disease continues, awareness and proactive measures remain key to reducing its impact on American lives.
