Heart disease still America's top killer, although the death rate has declined

Heart disease remains the top cause of death in the United States, but progress is being made and more lives are being saved, a new report finds.

There were 931,578 heart-related deaths in 2021, an increase of less than 3,000 from the year before, the report from the American Heart Association (AHA) showed. But overall, death rates from heart disease have declined 60% since the 1950s, AHA experts noted.

"When the American Heart Association was founded 100 years ago, heart disease was considered a death sentence. Little was known about what caused it and even less about how to care for people living with and dying from it," said Dr. Joseph Wu, volunteer president of the American Heart Association.

"The knowledge we continue to gain through research and data such as that reported in this statistical update is helping make significant inroads," Wu, director of the Stanford Cardiovascular Institute, added in an AHA news release. "Although too many people still die each year, many are living longer, more productive lives while managing their cardiovascular disease and risk factors."

Heart disease has been America's top killer since before the founding of the AHA, researchers noted in the report published Jan. 24 in the journal Circulation.

However, the number of people who die from their heart attack each year has dropped from 1 in 2 in the 1950s to 1 in 8.5 now, thanks to improved diagnosis and treatment options for the medical emergency.

Progress also has been made against stroke, which was the third-leading cause of death in 1938 but now is the fifth-leading cause, the report noted—thanks to better treatments and aggressive preventive measures.

Cigarette smoking has also fallen dramatically. More than 40% of adults smoked in the mid-1960s, but only 11% smoke today.

"Identifying trends like this is a key reason why we compile the American Heart Association's statistical update, which has been released annually since 1927," said Dr. Seth Martin, chair of the AHA report committee and a cardiologist at Johns Hopkins School of Medicine, in Baltimore.

Although progress is being made, it's a rocky road, the report noted. Heart disease remains a major threat to the health of Americans. For example, nearly half of the U.S. population—about 49%—have some type of heart disease, including clogged arteries, heart failure, stroke and, most notably, high blood pressure. Nearly 47% of American adults have high blood pressure, but 38% of those with the condition are unaware they have it, the report found.

During the past decade, the age-adjusted death rate from high blood pressure increased 66% while the actual number of deaths rose 91%.

"High blood pressure is a leading risk factor for heart disease and stroke, and yet with proper treatment and management it can be controlled and your risk for cardiovascular disease can be greatly reduced," Wu said.

Heart-related deaths in the report include deaths from coronary heart disease (40%), stroke (18%), other heart diseases combined (17%), high blood pressure (13%), heart failure (9%) and diseases of the arteries (3%).

Despite the overall downward trend, the age-adjusted death rate from heart disease increased in 2021 to 233.3 deaths per 100,000, up 4% from 224.4 per 100,000 the year before, the report noted.

The previous year, 2020, also experienced a rate increase of 4.6% from the year before—the first increase in age-adjusted death rates seen in many years, the report said.

"While the long-term impact of the pandemic is yet to be seen, we're cautiously optimistic that the trends from this year's update indicate a slowdown in the striking effects we initially saw," Martin said.

Other key stats from the new report include:

• There are 1,905 deaths from heart disease each day in the United States, and 2,552 daily deaths from all heart-related causes combined
• On average, someone dies of heart disease every 34 seconds
• There's a heart attack every 40 seconds, with 605,000 new heart attacks and 200,000 recurrent attacks annually
• About 170,000 of those heart attacks are silent, without significant symptoms
• Each year, 795,000 people suffer a stroke—610,000 first strokes and 185,000 recurring strokes
• Someone dies of a stroke every 3 minutes, 14 seconds, on average, and stroke accounts for one in every 21 U.S. deaths
• Sudden cardiac arrest caused 20,114 U.S. deaths in 2021, about 55 a day

"I cannot stress enough how important it is for people to fully recognize just how much cardiovascular diseases, including heart disease and stroke, impact each of us as individuals and communities," Wu said. "If you don't have heart disease yourself, chances are you know someone who does, perhaps a family member or other loved one."

2024 HealthDay. All rights reserved.