The United States saw a significant decline in the overall rate of heart attack-related deaths over the past 20 years, and the gap in the rate of heart attack deaths between white people and Black people narrowed by nearly half.
“It's good news,” said study lead author Dr. Muchi Ditah Chobufo, a cardiology fellow at West Virginia University's School of Medicine.
"People should know that even if we're not there yet, we're making progress in the right direction. I think the reasons are multifactorial, spanning all the way from health-promoting and prevention activities through treatment during and after a heart attack,” he said in a news release from the American College of Cardiology.
For the study, researchers analyzed data from the U.S. Centers for Disease Control and Prevention from 1999 to 2020.
Age-adjusted rates of heart attack fell by an average of over 4% per year across all racial groups over the two decades.
In 1999, there were about 87 deaths from heart attack per 100,000 people. By 2020, there were 38 deaths per 100,000 people.
Black Americans still had the highest death rates from heart attack, with 104 deaths per 100,000 people in 1999 and 46 deaths per 100,000 in 2020. Death rates from heart attack were lowest among Asians and Pacific Islanders.
It's difficult to determine whether the decline is due to fewer heart attacks or better survival rates because of new diagnostic strategies and treatment options, according to the study authors.
One example of this is that hospitals now frequently test for troponin in the blood when a heart attack is suspected. This can help clinicians diagnose a heart attack sooner, leading to earlier and more sensitive heart attack detection.
The authors also noted that Americans have become more aware of the need to reduce heart risk factors, including quitting smoking and managing cholesterol.
And doctors better understand the signs of a heart attack. Hospitals are equipped with mechanical support devices to assist with heart attack treatment. New medications, such as potent antiplatelets, have become available. These may have improved survival rates and reduced the likelihood of a second heart attack.
The authors also noted the racial disparity differences in these past two decades. The difference in rates of heart attack were about 17 deaths per 100,000 between Black people and white people in 1999. That dropped to eight per 100,000 by 2020.
"That's a big closure of the gap," Chobufo said. “I didn't think the disparities were going to drop this far this fast.”
Researchers noted a slight uptick in 2020, an exception to an overall steady decline in heart attack-related deaths. This is likely related to the COVID-19 pandemic but will require more study.
About 80% of premature heart attacks and strokes could be prevented with a heart-healthy lifestyle. That means eating a healthy diet, exercising and avoiding tobacco.
More than 800,000 people have a heart attack in the United States each year, according to the CDC. Common signs include shortness of breath and pain or discomfort in the chest, jaw, neck, back, arm or shoulder. Some people may feel weak, lightheaded or faint. Anyone experiencing this should call 911 and get to an emergency room.
The study findings will be presented March 5 at a meeting of the American College of Cardiology and the World Heart Federation, in New Orleans. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.
The U.S. Centers for Disease Control and Prevention has more on heart attacks.
SOURCE: American College of Cardiology, news release, Feb. 23, 2023