Death rates from premature heart disease plateau in 2011 after years of decline

Clinician talking to adult female patient in a medical setting about health

Have preventable deaths from heart disease in the U.S. declined over the past two decades?

A study published in the
British Medical Journalfunded by the National Heart, Lung, and Blood Institute, finds the answer depends on the type of heart disease and varies within the population.

Researchers analyzed 12.9 million death certificates in the U.S. between 1999-2018. They found coronary heart disease deaths, which are attributed to a narrowing of the arteries surrounding the heart, decreased since 1999, while deaths from heart failure, when the heart can’t pump enough blood throughout the body, and high blood pressure, which can cause a heart attack or stroke, increased after 2011. Changes among less-common heart disease types, including arrhythmia, a heart-rhythm disorder, pulmonary, or heart valve disease, were minimal. 

The researchers conclude 3.5 million years of life were lost in 2018, which they calculated by analyzing modifiable heart disease risk factors. Black men had the highest rates for coronary heart disease, heart failure, and hypertension. Since 2011, white women and men had the fastest rise in deaths related to high blood pressure. Compared to white women and men, black men and women had higher premature death rates from elevated blood pressure and heart failure.

The authors conclude a “comprehensive multilevel, multi-stakeholder approach focused on prevention of modifiable risk factors, adherence to evidence based secondary prevention strategies, and targeting of disproportionally burdened groups is urgently needed to curb worrisome trends in deaths from heart disease in the U.S.”

Targeted prevention strategies, such as increased awareness about smoking, and secondary interventions, including the introduction of statins, a cholesterol-lowering drug, supported the steady decline of premature death rates from coronary heart disease between 1950-2000.

Current recommendations include targeted programs that increase access to health screenings, reduce rates of obesity, diabetes, and high blood pressure, with a focus on diet quality and physical activity, and address health inequalities.