Data published in the Journal of the American Heart Association show that heart attack deaths among U.S. adults have fallen by 89 percent since 1970.
However, fatalities from arrhythmias, heart failure and hypertensive heart disease have risen sharply over the same period.
Researchers reviewed CDC mortality data for Americans aged 25 and older from 1970 through 2022 and found that overall heart disease deaths declined by 66 percent, driven primarily by advances in the treatment and early recognition of acute ischemic events. In 1970, more than half of heart disease fatalities stemmed from heart attacks; by 2022 that share had dropped below one-third.
“This evolution over the past 50 years reflects incredible successes in the way heart attacks and other types of ischemic heart disease are managed,” said Dr. Sara King, the study’s first author and a second-year internal medicine resident at Stanford University School of Medicine. She noted that improved bystander CPR rates, wider public awareness of early warning signs, more precise imaging, and stronger public health measures, such as no-smoking laws, have all played a role.
Despite this progress, the study warns that three other cardiac conditions now account for a larger share of cardiovascular deaths than ever before. Deaths from arrhythmias grew by 450 percent, reflecting an aging population and rising prevalence of risk factors such as obesity and diabetes. Heart failure mortality climbed 146 percent, while deaths tied to long-term high blood pressure rose 106 percent.
“These conditions are likely fueled, at least in part, by a growing number of Americans with cardiovascular risk factors,” said Dr. Latha Palaniappan, associate dean for research at Stanford’s School of Medicine and senior author of the paper. She pointed to obesity rates doubling since the 1970s, nearly half of adults now living with type 2 diabetes or prediabetes, and an increase in hypertension from roughly 30 percent to nearly 50 percent of the population.
The researchers also highlighted that people are living longer, reaching ages when chronic heart conditions become more common. Life expectancy in the U.S. rose from about 70.9 years in 1970 to 77.5 years in 2022, giving more time for non-ischemic cardiac diseases to develop and progress.
“The next frontier in heart health must focus not only on preventing heart attacks but also on helping people age with stronger, healthier hearts,” Dr. King said. The American Heart Association’s “Life’s Essential 8”—which covers diet, weight management, smoking cessation, physical activity, sleep quality and control of cholesterol, blood pressure and blood sugar—offers a blueprint for reducing the burden of all forms of heart disease.