Heart attacks no longer the leading cause of heart disease deaths By HPN Staff Heart disease remains the leading cause of death in the U.S., but the types of heart conditions causing those deaths are changing. While deaths from heart attacks have dropped significantly over the past five decades, fatalities from other forms of heart disease — especially heart failure, arrhythmias and hypertensive heart disease — are increasing. Why it matters Since 1970, deaths from heart attacks have fallen nearly 90%, thanks to advances such as bystander CPR, stents, statins and anti-smoking efforts. Improved emergency care means more people survive acute heart attacks, but many later develop chronic heart conditions. “People now are surviving these acute events, so they have the opportunity to develop these other heart conditions,” said Dr. Sara King, lead author of a Stanford-led study. This shifting pattern highlights a new challenge: helping people age with healthier hearts and preventing chronic heart disease, not just surviving heart attacks. By the numbers According to the American Heart Association, overall heart disease deaths have declined 66% since 1970. Heart attack deaths decreased nearly 90% between 1970 and 2022. However, deaths from other heart diseases increased 81% in the same period. Of that 81%: Heart failure deaths rose 146% Deaths from hypertensive heart disease increased 106% Arrhythmia-related deaths increased 450%, rising from a rare cause in the 1970s to about 4% of all heart disease deaths today Rising obesity, diabetes, hypertension, poor diets, and inactivity contribute to these trends. Obesity prevalence rose from 15% in 1970 to 40% in 2022, and nearly half of U.S. adults now have diabetes or prediabetes. The bigger picture Significant progress in heart attack treatment and prevention has saved many lives. Medical innovations, from coronary care units to high-intensity statins, alongside public health campaigns such as smoking cessation, have driven this success. But the rising burden of chronic heart disease reflects changing risks and an aging population. Many survivors of heart attacks develop weakened hearts that fail over time. Heart failure, for example, ranges from mild to severe but can often be managed with medication. “It’s one thing to be alive, it’s another to be alive and well,” said Dr. Sara King. Experts emphasize that heart disease prevention must start early and focus on lifelong heart health. “Heart disease hasn’t gone away,” said Dr. Latha Palaniappan, a professor of cardiovascular medicine and associate dean for research at Stanford. “The focus now must be on helping people age with strong, healthy hearts by preventing events, and prevention can start as early as childhood.”
