In a remarkable shift over the past five decades, the survival rate for heart attack patients in the United States has soared. In 1970, individuals over 65 hospitalized for a heart attack had a mere 60% chance of survival. Today, that figure exceeds 90%, with even better outcomes for younger patients. This improvement has contributed significantly to a decrease in overall heart disease mortality, according to a new study led by Stanford Medicine researchers.
The study reveals that in 1970, heart ailments accounted for 41% of all deaths, a statistic that has since dropped to 24% by 2022. Most notably, deaths from acute myocardial infarctions, commonly known as heart attacks, have plummeted by nearly 90% during this period.
Life-Saving Innovations and Public Health Efforts
The decline in heart attack fatalities is a testament to advancements in medical treatments and public health initiatives. From the widespread adoption of bystander CPR and artery-opening stents to cholesterol-lowering statins, these innovations have played a pivotal role. Additionally, public health campaigns have significantly reduced tobacco use, a major risk factor for heart disease.
“People now are surviving these acute events, so they have the opportunity to develop these other heart conditions,” said Dr. Sara King, a medical resident and lead author of the study, which is set to be published in the Journal of the American Heart Association on June 25.
The senior author, Dr. Latha Palaniappan, highlighted the success of these efforts, stating,
“Thanks to sustained public investment, 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.”
The Rise of Chronic Heart Conditions
While the reduction in heart attack deaths is a success story, the study also notes an increase in deaths from other types of heart disease, such as heart failure, hypertensive heart disease, and arrhythmias. This shift is partly due to more patients surviving acute events like heart attacks, allowing chronic conditions to develop over time.
Dr. King explained, “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.”
Contributing factors to the rise in chronic heart diseases include obesity, diabetes, hypertension, and physical inactivity. An estimated 50% of adults have diabetes or pre-diabetes, and 40% are obese. The aging U.S. population, with a life expectancy increase from 70.9 years in 1970 to 77.5 years in 2022, also plays a role in this trend.
Implications and Future Directions
The study analyzed data from the National Vital Statistics System, covering 119 million adult deaths from 1970 to 2022. Of these, 37 million were attributed to heart disease, categorized into ischemic and non-ischemic causes. While ischemic heart disease deaths have decreased by 81%, non-ischemic conditions now account for roughly half of heart disease deaths.
Dr. King emphasized the need to focus on these non-ischemic causes, stating, “Fortunately, people are dying less from ischemic disease. Now, we need to expand our efforts to non-ischemic causes of heart disease death.”
The researchers acknowledge that national trends may mask differences among subgroups, with factors such as sex, race, and socioeconomic status influencing heart disease risk and access to care. Dr. King plans to explore these patterns further to develop more tailored interventions.
Despite the progress, heart disease remains the leading cause of death in the U.S. “We have so many tools in our toolbox now, but still, there’s a lot more that can be developed and improved,” Dr. King remarked. “I hope the numbers just keep getting better.”
The study received contributions from researchers at Beth Israel Deaconess Medical Center, the National Heart, Lung, and Blood Institute, the American Heart Association, and Johns Hopkins University School of Medicine. Funding was provided by the National Institutes of Health, the American Heart Association/Harold Amos Medical Faculty Development program, and the Doris Duke Foundation.
