Heart disease mortality has decreased over the past five decades but there is an increasing burden of mortality from other heart conditions including heart failure, hypertensive heart disease, and arrhythmias, according to a Stanford University study.
A major data analysis has revealed that although heart disease is the leading cause of death around the world, overall heart disease death rates over the past five decades dropped by 66% in Americans aged 25 and older. Additionally, deaths from heart attacks dropped by nearly 90%.
“Over the past 50 years, our understanding of heart disease, what causes it and how we treat it has evolved considerably,” said lead study author Dr Sara King, a second-year internal medicine resident at Stanford University School of Medicine in California.
“There have been great strides made in helping people survive initial acute cardiac events once considered a death sentence,” she added
Unfortunately, reports CNN, deaths from all other types of heart disease, including arrhythmia, heart failure and hypertensive heart disease, increased by 81% in the United States, according to the study published in the Journal of the American Heart Association.
“It’s important to put both sets of numbers into perspective,” said Dr Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, who was not involved with the study.
“These days, the likelihood of dying from a heart attack is relatively low compared with where it’s been, but the likelihood of significant disability from the heart attack is still high,” he observed.
“You might develop heart failure – where the heart is unable to pump enough blood to meet the body’s needs and you’re always short of breath. Or maybe you’re on a number of medications for blood pressure, fluid retention and cholesterol, or you never feel your best.
“It’s one thing to be alive, it’s another to be alive and well.”
Cardiovascular risks escalate
The study analysed government data on deaths from heart disease between 1970 and 2022. In 1970, heart attacks were responsible for 54% of all deaths from heart issues. By 2022 that number had dropped to 29%.
Deaths from atrial fibrillation and other arrhythmias, which happen when electrical impulses to the heart go awry and cause an irregular heartbeat or “flutter” in the chest, were rare in the 1970s. By 2022, the number had risen to 450% – about 4% of all heart disease deaths, the study found.
Deaths from heart failure increased 146% over the same time period, while death due to persistent high blood pressure rose by 106%.
Changes in cardiovascular risk factors are contributing to the rise in certain types of heart disease, the study said. Obesity, type 2 diabetes, high blood pressure, poor food choices and physical inactivity have skyrocketed over the past 50 years.
Obesity prevalence rose from 15% in 1970 to 40% in 2022, the study found. Type 2 diabetes and prediabetes now affects nearly half of all adults in the United States, while high blood pressure increased from 30% in 1978 to nearly 50% in 2022.
Another potential contributor is the ageing Baby Boomer population now reaching a time when they are most likely to develop heart disease.
“All of these risk factors contribute to an ongoing burden of heart disease, especially as related to heart failure, hypertensive heart disease and arrhythmias,” said senior study author Dr Latha Palaniappan, Professor of Cardiovascular Medicine and Associate Dean for Research at Stanford.
“Heart disease hasn’t gone away,” she added. “The focus now must be on helping people age with strong, healthy hearts by preventing events, starting from as early as childhood.”
Study details
Heart Disease Mortality in the United States, 1970 to 2022
Sara King, Tenzin Yeshi Wangdak Yuthok, Adrian Bacong et al.
Published in Journal of the American Heart Association (JAHA) on 25 June 2025
Abstract
Background
Studying trends in mortality is essential to advance understanding of population health. Further evaluation of long‐term heart disease mortality trends and subtypes in the United States is needed to guide public health and clinical interventions.
Methods
This study used the National Vital Statistics System Centres for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research data for adults aged 25 years and older in the United States from 1970 to 2022. Outcomes included absolute number and age‐adjusted mortality of total heart disease, ischemic heart disease, and other heart disease subtypes.
Results
From 1970 to 2022, overall age‐adjusted heart disease mortality decreased by 66% from 1970 to 2022 (from 761 to 258 per 100 000). In 1970, 91% of all heart disease deaths were ischemic, declining to 53% of all heart disease deaths in 2022. From 1970 to 2022, age‐adjusted mortality decreased by 89% for acute myocardial infarction (from 354 to 40 per 100 000) and 81% for all ischemic heart disease (from 693 to 135 per 100 00). In contrast, from 1970 to 2022 age‐adjusted mortality for other heart disease subtypes increased by 81% (from 68 to 123 per 100 000), with the greatest increases in heart failure (146% increase), hypertensive heart disease (106% increase) and arrhythmias (450% increase).
Conclusions
Heart disease mortality has decreased over the past five decades. There is an increasing burden of mortality from other heart conditions including heart failure, hypertensive heart disease, and arrhythmias. Further efforts must be undertaken to address the growing challenge of these other heart conditions.
JAHA article – Heart Disease Mortality in the United States, 1970 to 2022 (Creative Commons Licence)
CNN article – Deaths from heart attacks are way down. Here’s what’s killing us instead (Open access)
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