Despite Steep Decline in Fatal Heart Attacks, Deaths from Cardiovascular Diseases Still Rising

A major new study spotlights a striking shift in the impact of heart disease in the U.S. Since 1970, deaths from heart attacks have plummeted by almost 90 percent—a statistic “made possible by the synergistic power of science, medicine and public health,” according to a news release by researchers at Stanford University School of Medicine in California.

Yet, as U.S. adults survive heart attacks at unprecedented rates, more are succumbing to other chronic forms of heart disease, such as heart failure, arrhythmias, and hypertensive heart disease, according to researchers at Stanford, who analyzed government data on deaths from heart disease between 1970 and 2022.

During this time, the age-adjusted death rate from all other types of heart disease, including heart failure, hypertensive heart disease and arrhythmia, increased by 81 percent, accounting for 9 percent of all heart disease deaths in 1970 and 47 percent of all heart disease deaths in 2022, according to the study published in the Journal of the American Heart Association.

 

Andrea Vitello, M.D., cardiologist at Baptist Health Miami Cardiac & Vascular Institute.

“These declines in heart attack deaths are one of the great success stories in medicine,” explains Andrea Vitello, M.D., cardiologist at Baptist Health Miami Cardiac & Vascular Institute. “They’re proof that coordinated efforts — from research breakthroughs to public awareness — can genuinely save lives.”

A Stunning Decline in Heart Attack Deaths

In 1970, a person hospitalized over age 65 for a heart attack had about a 60 percent chance of leaving the hospital alive. Today, that chance is over 90 percent, and even higher for younger patients.

Overall, heart attack deaths—formally called acute myocardial infarctions—have dropped nearly 90 percent in just over five decades. As noted by Latha Palaniappan, M.D., a professor of cardiovascular medicine and associate dean for research at Stanford, this success is the result of sustained public investment, research, and powerful collaborations among scientists, medical professionals, and public health leaders.

“It’s not just technology or medication — it's a combination of faster emergency response, more people recognizing symptoms, and better prevention efforts that has moved the needle,” emphasizes Dr. Vitello. “But we can’t afford to let our guard down; heart health must remain a lifelong priority, not just a concern during a crisis.”

How Did We Get Here?

Medical Innovations: With each decade, new life-saving advancements have reshaped heart attack care. In the 1970s, bystander CPR and portable defibrillators began saving lives before patients even reached the hospital. Coronary care units, improved cardiac imaging, bypass surgery, and later, balloon angioplasty gave doctors powerful new tools. The 1980s and 1990s saw the rise of stents, aspirin, and other anti-platelet therapies, while recent decades brought high-intensity statin therapy and breakthroughs in cholesterol and diabetes medications.

Faster Response: Recognizing heart attacks as medical emergencies that require immediate action has slashed treatment response times. Hospitals now strive to restore blood flow within 90 minutes of a patient’s arrival, giving more people a chance at full recovery.

Public Health Wins: Few risk factors are as potent as smoking. Since the U.S. Surgeon General’s landmark report in the 1960s, public health campaigns dramatically reduced smoking rates from 40 percent in 1970 to just 14 percent in 2019, protecting millions of hearts.

Lifestyle Changes: Education around healthy eating, exercise, and routine medical checkups has helped many Americans reduce their personal risk.

“We need to celebrate these victories, but also recognize that they happened because of widespread education and commitment across all sectors—healthcare, government, and individuals,” says Dr. Vitello. “That spirit of collaboration must now be extended to address every kind of heart disease.”

The Rising Toll of Chronic Heart Disease

While progress in fighting heart attack deaths is clear, the study’s authors warn of a shifting challenge: as more people survive acute heart events, deaths from other forms of heart disease are rising. Today, about half of all heart disease deaths are due to non-ischemic causes—including heart failure, arrhythmias, and hypertensive heart disease.

“Many of my patients are living longer after heart attacks, which is inspiring,” Dr. Vitello notes. “But as a result, we’re now seeing more chronic conditions that require lifelong management. This is the next frontier for heart health.” 

Why Are These Numbers Climbing?

Aging and Survival: As life expectancy increases (from 70.9 years in 1970 to 77.5 in 2022), more individuals accumulate risks or develop chronic heart problems over time.

Growing Risk Factors: Obesity, diabetes, hypertension, and physical inactivity are all on the rise. Experts note that over 40 percent of U.S. adults have obesity, and nearly 50 percent have diabetes or pre-diabetes—powerful drivers of chronic heart conditions.

“Chronic heart diseases don’t make headlines the way heart attacks do, but their impact is just as serious,” warns Dr. Vitello. “Rising rates of obesity and diabetes mean we all need to be even more vigilant—prevention and early detection have never been more important.”

Gaps in Early Detection and Treatment: Many chronic heart diseases begin silently, making them harder to detect until they’re well advanced. Unlike heart attack protocols, treatments for chronic conditions such as heart failure or arrhythmias don’t always halt or reverse the damage.

Access to Care: Social and economic barriers mean some communities lack access to heart-healthy resources, regular screenings, or advanced treatments. Disparities in outcomes persist, highlighting the need for targeted interventions for at-risk groups.

Where Do We Go From Here?

The dramatic reduction in heart attack mortality proves that progress is possible—but the fight is far from over. While heart attack deaths have dropped 90 percent, overall heart disease remains the nation’s leading cause of death, claiming 24 percent of all lives in 2022 compared to 41 percent in 1970.

“Heart disease remains the No. 1 killer in America. That means our work isn’t done,” says Dr. Vitello. “We all need to invest in heart health every day, whether it’s for ourselves, our families, or our communities.”

To turn the tide on all forms of heart disease, the study’s authors urge both individuals and policymakers to redouble efforts in prevention, early detection, and equitable care. Here’s how you can support your own heart health and advocate for wider change:

• Schedule Regular Checkups: Routine health screenings can identify silent risks before they become serious.
• Adopt a Heart-Healthy Lifestyle: Consistent exercise, a balanced diet, not smoking, and controlling conditions like high blood pressure or diabetes go a long way.
• Support Research and Public Health: Progress depends on continued funding for research, advances in care, and effective public health initiatives.
• Stay Informed and Share Knowledge: Talk to loved ones about heart health, recognize the signs of heart trouble early, and encourage others to seek regular medical advice.

Dr. Vitello offers this encouragement: “Small changes today can have a huge impact. Don’t underestimate the power of knowing your numbers, celebrating progress, and taking proactive steps for your heart.”