• Posted August 8, 2023

U.S. Heart Disease Death Rates Have Fallen Sharply in Past 30 Years

Fatal heart disease in the United States dropped about 4% a year between 1990 and 2019, but Americans need to quit smoking, drinking and overeating or those gains could be wiped out, according to new research.

The declining rates of fatal heart disease have stalled, according to the research from Rutgers University-New Brunswick in New Jersey.

“The overall numbers are good. We saw a substantial decline in deaths from all types of coronary heart disease for both females and males,” said study lead author Cande Ananth, chief of the Division of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School.

“However, because we examined how these three modifiable risk factors affected mortality rates, we can see that there is room for considerable improvement,” he said in a Rutgers news release.

Among people ages 25 to 84, deaths from heart disease fell from more than 397,000 deaths in 1990 to about 237,000 in 2019, even while Americans' median age increased from 33 to 38, the researchers found.

Among men, the death rate dropped 3.7% a year, while women saw a 4% annual decline during those years.

Those declines, however, slowed significantly between 2011 and 2019. People born after 1980 were even at slightly increased risk of dying from coronary heart disease at any age than people from the previous generation, the researchers said.

Future advances in treatment could continue reducing fatal heart disease, but lifestyle modifications are also important: Eliminating smoking, drinking and obesity would have prevented half of the deaths observed during the study period, the authors said.

A bright spot is that tobacco usage is trending downward, with the percentage of smokers falling from 26% to 14% during those years.

Yet, obesity rates rose sharply from 12% in 1990 to 43% in 2019. Alcohol use also rose slightly during the study period.

Besides reduced tobacco use, researchers credited cholesterol-lowering statins and better diagnostic tests with the reduction in heart deaths.

“Although [heart attacks] happen without warning, the other two major types of coronary heart disease -- chronic ischemic heart disease and atherosclerotic heart disease -- can be diagnosed and treated years before they damage the heart muscles,” Ananth said. Ischemic heart disease is a narrowing of heart arteries that supply blood to the heart muscle. Atherosclerosis develops when plaque builds up inside your arteries.

This study used data from the U.S. National Center for Health Statistics to track all heart disease fatalities in the targeted age range for the three decades.

"The ultimate goal is to help inform standards of care and public health priorities by determining which patients face the highest level of risk for cardiovascular events," Ananth said. “We need to maximize returns from our limited resources by identifying high-risk subsets of patients and targeting intervention to them."

The study findings were published recently in the American Heart Journal.

More information

The U.S. National Institutes of Health has more on coronary heart disease.

SOURCE: Rutgers University-New Brunswick, news release, Aug. 3, 2023