A NEW analysis of US national health records shows heart disease mortality has fallen by two-thirds since 1970, but deaths from other heart conditions are rapidly climbing. The data reveal important shifts in causes of cardiac death, with fresh challenges ahead for clinicians.
Researchers used data covering adults aged 25 and older from the National Vital Statistics System and CDC between 1970 and 2022. Their findings show that the overall age-adjusted mortality rate for all heart disease declined by 66%, dropping from 761 to 258 deaths per 100,000 people. The proportion of deaths attributed to ischaemic heart disease, once 91% of heart disease cases in 1970, decreased to 53% by 2022. Deaths from acute myocardial infarction fell steeply by 89% (from 354 to 40 per 100,000), and for all ischaemic heart disease by 81% (from 693 to 135 per 100,000). However, age-adjusted mortality for other types of heart conditions grew by 81% over five decades. Marked increases were found in heart failure deaths (up 146%), hypertensive heart disease (up 106%), and arrhythmia fatalities (up 450%).
This turnaround in heart attack and ischaemic heart disease deaths demonstrates the impact of improved prevention, diagnosis, and clinical management. However, the surge in mortality from other cardiac conditions points to significant emerging threats in public health and clinical care. Addressing rising deaths from heart failure, hypertensive heart disease and arrhythmias will require updates to clinical guidelines, more targeted research, and greater awareness among healthcare teams. For clinicians, adapting to these changing trends is essential to improve patient outcomes and respond effectively to new challenges in heart disease management.
Reference
King SJ et al. Heart disease mortality in the United States, 1970 to 2022. Journal of the American Heart Association. 2025;14(13):e038644.
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