Heart attacks have become significantly more survivable over the past five decades and are no longer the leading cause of heart disease-related deaths in the United States, according to a new study published on June 25 in the Journal of the American Heart Association.
The study reveals that fatalities from acute myocardial infarctions — commonly known as heart attacks — have declined by an impressive 89% between 1970 and 2022. This improvement is largely attributed to advances in medical treatment, early detection, public health efforts, and better lifestyle management.
In 1970, ischemic heart disease, which includes heart attacks, accounted for 91% of all cardiovascular-related deaths. By 2022, that figure had dropped to 53%. While overall heart disease mortality has declined by 66% during the same period, it still remains the leading cause of death in the United States.
Read More: Trying Exercise Snacks for 2 Weeks: Results & Insights
Shifting Trends in Cardiovascular Mortality
As fewer people are dying from heart attacks, the landscape of heart-related deaths has shifted. The majority of current cardiovascular fatalities are now due to other heart disease subtypes. As of 2022, 81% of heart disease deaths in the U.S. stem from conditions other than myocardial infarction. These include:
- Heart Failure: Deaths have increased by 81%
- Hypertension-Related Heart Disease: Fatalities have risen by 106%
- Arrhythmias (Irregular Heartbeats): Deaths have surged by a staggering 450%
This shift highlights the growing burden of chronic cardiovascular conditions that often receive less public attention than heart attacks.
Public Health Implications
While the dramatic reduction in heart attack mortality represents a major public health success, the rise in other cardiovascular conditions underscores the need for continued vigilance, prevention, and targeted interventions. Addressing risk factors such as high blood pressure, obesity, diabetes, and physical inactivity remains essential to curbing the overall impact of heart disease on American lives.
Heart Attack Deaths Decline, But Long-Term Heart Conditions Are on the Rise
While heart attack mortality rates have dropped significantly in recent decades, experts say the number of heart attacks themselves has not necessarily decreased. Instead, more Americans are surviving these events—only to face long-term heart complications down the line.
Jayne Morgan, MD, a cardiologist and vice president of medical affairs at Hello Heart, told Healthline that the latest findings don’t suggest fewer heart attacks are happening, but rather that they are no longer the primary cause of cardiovascular death. (Dr. Morgan was not involved in the new report.)
“I did not note a decline in myocardial infarctions themselves, but rather a decline in heart attacks being the primary cause of death,” Morgan explained. “As Americans, we are not that great at prevention. Our strength has been in the science and application of medicine.”
She added that the real takeaway is how much more survivable heart attacks have become today compared to 55 years ago, thanks to advancements in emergency care, medications, interventional procedures, and medical technology.
Surviving the Heart Attack, Living With the Consequences
Although more patients now survive heart attacks, the event often marks the beginning of ongoing cardiovascular challenges.
“Non-fatal heart attacks are often the trigger for long-term heart conditions like heart failure and arrhythmias,” Morgan noted.
Dr. Cheng-Han Chen, a board-certified interventional cardiologist, echoed this, explaining that the heart muscle damage caused by a heart attack can have lasting effects. (Chen was also not involved in the study.)
“Patients who otherwise would have passed from their heart attack are now surviving, and then living longer dealing with the consequences,” said Chen.
The severity and duration of a heart attack influence how much damage is done to the heart muscle. That damage can lead to a weakening of the heart, eventually resulting in heart failure—a condition where the heart doesn’t pump as effectively as it once did.
However, Chen clarified that heart failure does not mean the heart has stopped working completely.
“Heart failure is a spectrum,” he explained. “It could be very mild, or it could be very severe—and everything in between.”
With proper medical management, many individuals can live relatively normal lives even with mild heart failure. Medications, lifestyle changes, and routine monitoring help control symptoms and prevent complications.
Aging and the New Face of Heart Disease
As more people survive heart attacks and live longer, other age-related heart conditions have become more prevalent. These include heart failure, hypertension-related heart disease, and arrhythmias—all of which are more likely to occur as people age.
Survival, in many cases, brings a new set of long-term health challenges.
“Living longer increases the odds of eventually developing these conditions,” Chen said.
While the drop in heart attack mortality represents a triumph of modern medicine, the increasing burden of chronic heart disease underscores the need for a dual focus: effective emergency care and robust prevention strategies to reduce the overall incidence of cardiovascular disease.
Lifestyle Plays a Major Role in Heart Health, Experts Say
Despite advancements in cardiovascular medicine, lifestyle choices continue to be a major contributor to heart disease in the United States. Dr. Jayne Morgan, a cardiologist and vice president of medical affairs for Hello Heart, told Healthline that the typical American lifestyle puts many people at high risk for heart failure, hypertension, and arrhythmias.
“Obesity, hypertension, sedentary lifestyles, processed and palatable fast food, decreased physical movement, smoking, cholesterol, diabetes, as well as societal stressors leading to chronic inflammation — all contribute significantly to heart disease,” Morgan explained.
Socioeconomic and Gender-Specific Risk Factors
Dr. Morgan also emphasized that socioeconomic factors further complicate the prevention and management of heart disease. In many cases, these barriers make it difficult for individuals to adopt heart-healthy habits or access timely medical care.
Additionally, she highlighted gender-specific concerns, particularly for women.
“Pregnancy complications such as hypertension of pregnancy, preeclampsia, and gestational diabetes increase a woman’s lifetime risk of heart disease,” she noted. “These are still primary drivers of maternal mortality outcomes in the U.S.”
Despite these challenges, the overall decline in heart-related deaths suggests some progress has been made, particularly in prevention and treatment strategies.
Arrhythmia-Related Deaths on the Rise
One of the most alarming findings in the recent report is the sharp increase in deaths caused by arrhythmias — disorders where the heart beats too fast, too slow, or irregularly. While many arrhythmias are benign, others can interfere with the heart’s ability to pump blood effectively, potentially damaging vital organs such as the brain, lungs, or heart itself.
The Four Main Types of Arrhythmias Include:
- Bradycardia: abnormally slow heart rate
- Tachycardia: abnormally fast heart rate
- Ventricular Arrhythmia: originates in the lower chambers of the heart
- Supraventricular Arrhythmia: starts in the upper chambers (e.g., atrial fibrillation)
Because arrhythmias can sometimes be silent but dangerous, Morgan advises getting regular medical checkups that include heart evaluations.
“If you can feel your heartbeat without placing a hand on your chest, that could be a warning sign,” she said, urging individuals to seek medical attention.
Heart attack survivors, in particular, are at increased risk of life-threatening arrhythmias. Ventricular arrhythmias — irregular rhythms originating in the heart’s lower chambers — can be especially fatal if not managed properly.
Managing Arrhythmia Risk After a Heart Attack
To reduce the risk of arrhythmias following a myocardial infarction, Morgan recommends a combination of medications and interventions:
- Foundational Four Drug Combo for managing Heart Failure with Reduced Ejection Fraction (HFrEF)
- Statins to manage cholesterol
- Cardiac rehabilitation programs
- Implantable defibrillators to prevent sudden cardiac arrest
- Sleep apnea screening and treatment
- Comprehensive lifestyle modifications
These measures can significantly improve outcomes and reduce mortality among heart attack survivors.
AHA’s ‘Essential Eight’ for Heart Health
The American Heart Association (AHA) recommends the following eight lifestyle pillars to support long-term cardiovascular wellness:
- Eat a heart-healthy diet
- Be physically active
- Quit tobacco use
- Get adequate, quality sleep
- Maintain a healthy weight
- Control cholesterol levels
- Manage blood sugar
- Keep blood pressure within a healthy range
These guidelines apply to both adults and children, with dedicated resources available through the AHA’s Essential Eight platform.
Frequently Asked Questions
Are heart attacks becoming less common in the U.S.?
No, the frequency of heart attacks has not significantly declined. However, advancements in medical care have made them far more survivable than in past decades.
If heart attacks are no longer the top cause of death, what is?
While heart disease overall remains the leading cause of death, heart attacks specifically (myocardial infarctions) have declined in fatality. Other cardiovascular conditions like heart failure, arrhythmias, and hypertension-related heart disease now account for a larger share of heart-related deaths.
Why are more people surviving heart attacks today?
Improved emergency care, modern medications, quicker response times, and medical technology such as stents and defibrillators have drastically increased survival rates.
What are the long-term effects of surviving a heart attack?
Many survivors develop chronic heart conditions such as heart failure or arrhythmias due to damage to the heart muscle.
Are heart-related deaths still a major health concern?
Yes. Although heart attack deaths have declined, cardiovascular diseases remain the number one cause of death in the U.S., shifting from acute events to chronic conditions.
What factors are driving the increase in other heart-related deaths?
An aging population, obesity, sedentary lifestyles, high blood pressure, and diabetes are key contributors to the rise in deaths from conditions like heart failure and arrhythmias.
Conclusion
The decline in heart attack fatalities marks a significant achievement in cardiovascular medicine, reflecting decades of progress in emergency response, diagnostics, and treatment. However, the shift in heart-related mortality—from acute heart attacks to chronic conditions like heart failure, hypertension-related disease, and arrhythmias—signals a new challenge. As Americans live longer and survive initial cardiac events, managing the long-term consequences of heart disease becomes increasingly important.