In a surprising shift, heart attacks are no longer the deadliest threat to Americans’ hearts. Over the past five decades, heart attack-related deaths have dropped by nearly 90% in the U.S., a dramatic decline that highlights the success of medical advances and public health efforts. But at the same time, deaths from chronic heart conditions have been steadily rising — and are now taking center stage.
“We’ve made some really great progress in reducing deaths from heart attacks,” says Sara King, a researcher at Stanford University. “But now we’re seeing a new trend.”
King and her team analyzed data from the CDC’s WONDER database, which tracks all recorded deaths in the U.S. between 1970 and 2022. Their findings reveal a major transformation in heart disease trends.
Back in 1970, heart disease was responsible for 41% of all deaths in the U.S. Fast forward to 2022, and that number had dropped to 24%. A large part of that decline is due to the sharp drop in heart attack fatalities — once the top killer, now greatly reduced thanks to better treatments like stents, bypass surgeries, cholesterol-lowering drugs, and public health initiatives such as anti-smoking campaigns and CPR training.
“We’ve come a long way in treating heart attacks,” King says. “It’s a success story for modern medicine.”
But there’s a catch.
Even though fewer people are dying from heart attacks, heart disease remains the number one cause of death in the U.S. — just not in the way it used to be. Instead of sudden, acute events like heart attacks, it’s now chronic heart conditions doing most of the damage. Deaths from issues like heart failure, arrhythmias, and hypertensive heart disease have surged by 146%, 106%, and a staggering 450% respectively since 1970.
So, what’s driving the rise?
“A lot of these chronic conditions are tied to aging,” King explains. “People are surviving heart attacks and living longer, which gives more time for long-term heart issues to develop.”
Still, the data isn’t perfectly clear-cut. Many people who die from chronic conditions like heart failure may have originally had a heart attack — meaning their underlying cause of death might still be linked to artery blockages. “It’s not always black and white,” King adds. “Heart disease is complex, and so is tracking its causes.”
Despite that nuance, one thing is certain: the face of heart disease is changing. With heart attacks becoming less fatal and chronic conditions on the rise, the future of cardiology may lie not just in emergency response, but in helping people age with healthier hearts.
“The next frontier,” King says, “is finding better ways to age well and manage heart health over time.”