Heart attack fatalities in the US have dramatically decreased over the last five decades, while deaths from chronic heart diseases have surged, potentially due to increased longevity.

“Significant strides have been made in reducing cardiac mortality, and we’re witnessing this transformation,” says Sarah King from Stanford University in California.

She and her team analyzed heart disease mortality data from 1970 to 2022, utilizing the American disease control and prevention database to monitor all recorded deaths nationwide.

In 2022, they discovered that heart disease constituted 24% of all US deaths, a decrease from 41% in 1970, significantly aided by nearly a 90% drop in heart attack fatalities, previously the deadliest form of heart disease.

“We’ve made remarkable progress in reducing heart attack deaths over the past half-century,” remarks King. This includes innovations such as cardiac stents, coronary artery bypass surgery, and cholesterol-lowering therapies. King also believes that public health initiatives, including Bystander CPR training and efforts to decrease smoking rates, have contributed to these improvements.

Nonetheless, the rise in mortality from other types of cardiac ailments has surged by 81%, indicating that many chronic conditions are leading to increased deaths. For instance, fatalities from heart failure, arrhythmias, and hypertensive heart disease have surged by 146%, 106%, and 450%, respectively.

“Many of these issues are related to aging,” explains King. “Those who survive heart attacks seem to live longer, giving them more time to develop these chronic heart conditions.”

However, the statistics might overstate changes in cardiac mortality. “Various factors can lead to a person’s death, resulting in potential misclassification and oversimplification,” King warns. For instance, many patients succumb to heart failure following a heart attack. “It’s not a straightforward issue because the underlying reason for that heart failure is often a blockage in the coronary arteries,” she adds.

Still, the majority of heart disease fatalities aren’t directly caused by heart attacks. “Addressing these other causes of increased mortality will be crucial,” King states. “Discovering healthier aging methods will be the next frontier for heart disease.”