Heart Attacks Make Way for New Cardiovascular Diseases: American Heart Association

Risk factors that adversely impact the heart like obesity, diabetes, hypertension, and physical inactivity have been on the rise in the country.

A registered nurse cares for a patient on a stretcher in a hallway of the overloaded Emergency Room at Providence St. Mary Medical Center amid the COVID-19 pandemic in Apple Valley, Calif., on Jan. 5, 2021. Mario Tama/Getty Images

Deaths from heart attacks have declined substantially over the past five decades in the United States while deaths from other types of heart diseases have seen a significant increase, according to a June 25 peer-reviewed study published in the Journal of the American Heart Association.

The age‐adjusted mortality rate for acute myocardial infarction (AMI)—a medical term for heart attack—declined by 89 percent between 1970 and 2022.

In contrast, mortality for other heart disease subtypes increased by 81 percent, with heart failure rising by 146 percent, hypertensive heart disease by 106 percent, and arrhythmia by 450 percent. Arrhythmia refers to a problem in the rhythm or rate of a person’s heartbeat.

“There were also increases in mortality from pulmonary heart disease, nonrheumatic valvular heart disease, cardiomyopathy, and cardiac arrest,” say the researchers in the study.

“These changes in heart disease mortality over the past five decades likely reflect the successes in medical and public health interventions for ischemic heart disease, and in particular, AMI.”

Researchers highlighted several major effective interventions instituted over the past years that have “significantly reduced” mortality from heart attacks.

This includes the establishment and promotion of bystander cardiopulmonary resuscitation, the invention of coronary artery bypass grafting, and the development of medical therapies such as statins and beta blockers.

“However, despite the progress in therapies and guidelines, there has been rising prevalence of several heart disease risk factors such as obesity, diabetes, hypertension, and physical inactivity in the United States,” researchers wrote.

For instance, obesity prevalence rose from 15 to 40 percent between 1970 and 2022, diabetes affected an estimated 50 percent of America’s adult population in 2020, and the prevalence of hypertension was almost 50 percent in 2022, it said.

The mortality for all heart disease deaths, including heart attacks, fell 66 percent between 1970 and 2022, the study said.

Latha Palaniappan, senior author of the study and a professor of medicine at Stanford University School of Medicine, warned in a June 25 statement from the American Heart Association that all these risk factors “contribute to an ongoing burden of heart disease.”

“While heart attack deaths are down by 90 percent since 1970, heart disease hasn’t gone away. Now that people are surviving heart attacks, we are seeing a rise in other forms of heart disease like heart failure,” she said.

“The focus now must be on helping people age with strong, healthy hearts by preventing events, and prevention can start as early as childhood.”

The study analyzed mortality data of all U.S. adults aged 25 years and above from 1970 to 2022, with records accessed from the National Vital Statistics System.

Multiple authors revealed having received funding from various sources including the National Institutes of Health’s National Heart, Lung, and Blood Institute; the American Heart Association; and the Doris Duke Foundation.

Children’s Heart Health, COVID Links

Heart disease was one of the issues cited by the Make America Healthy Again commission in a May 22 report about children’s health. The commission, established by President Donald Trump in February, is chaired by Health Secretary Robert F. Kennedy Jr.

“The health of American children is in crisis,” states the report. “Despite outspending peer nations by more than double per capita on healthcare, the United States ranks last in life expectancy among high-income countries—and suffers higher rates of obesity, heart disease, and diabetes.”

“Today in the U.S. more than 1 in 5 children over 6 years old are obese,” it says, adding that “around 70 percent of youth with obesity already have at least one risk factor for heart disease.”

A Dec. 18 Harvard study suggested that cardiovascular health trajectories among American children begin a steady decline at age 10, around the time they enter middle school. It found 98 percent of children had fallen short of optimal heart health measures.

The decline in children’s cardiovascular health was deemed to be mainly driven by behavior around food, smoking, and exercise rather than biological health factors.

Meanwhile, federal regulators have identified links between heart health issues and COVID-19 vaccines, updating labels of the Pfizer-BioNTech and Moderna COVID-19 vaccines to reflect this risk.

The labels, updated on June 25, state that myocarditis, or inflammation of the heart muscle, and pericarditis, an inflammation of the lining outside the heart, have occurred in people after taking the vaccines, “most commonly in males 12 years through 24 years of age.”

Richard Forshee, acting director of the Food and Drug Administration’s Office of Biostatistics and Pharmacovigilance, said a 2024 study found that some of the myocarditis patients had signs of heart scarring months after getting vaccinated.