Still top cause of death, the types of heart disease people are dying from is changing – www.heart.org

Report on Trends in Heart Disease Mortality and Implications for Sustainable Development Goals (SDGs)

Overview

Recent research published in the Journal of the American Heart Association highlights significant changes in heart disease mortality in the United States over the past 52 years. The study analyzed data from the U.S. Centers for Disease Control and Prevention (CDC) covering adults aged 25 and older from 1970 to 2022. This report emphasizes the relevance of these findings to the Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being.

Key Findings

1. Overall heart disease death rates have decreased by 66% since 1970.
2. Deaths from heart attacks have declined by nearly 90%.
3. The pattern of heart disease mortality has shifted, with increased deaths from heart failure, arrhythmias, and hypertensive heart disease.
4. Heart disease accounted for nearly one-third (31%) of all deaths during the study period, decreasing from 41% of total deaths in 1970 to 24% in 2022.
5. Deaths from arrhythmias increased by 450%, heart failure deaths rose by 146%, and hypertensive heart disease deaths increased by 106%.

Advancements Contributing to Mortality Reduction

• Public health measures including smoke-free policies, promotion of physical activity, and improved blood pressure and cholesterol management.
• Medical innovations such as coronary artery bypass grafting, coronary care units, coronary angiography, balloon angioplasty, and coronary stenting.
• Development of medical therapies including thrombolytics, aspirin, beta blockers, renal-angiotensin-aldosterone system inhibitors, statins, and advanced lipid-lowering agents.
• Implementation of bystander CPR and automated external defibrillators for cardiac arrest outside hospital settings.
• Establishment of systems for early recognition and rapid treatment of acute cardiac events.

Underlying Factors and Emerging Challenges

• Rising prevalence of cardiovascular disease (CVD) risk factors such as obesity (from 15% to 40%), Type 2 diabetes (affecting nearly half of U.S. adults), hypertension (increasing from 30% to nearly 50%), and physical inactivity.
• An aging population contributing to increased incidence of chronic heart conditions.
• Shift in mortality from acute ischemic heart disease to chronic conditions like heart failure and arrhythmias.

Implications for Sustainable Development Goals (SDGs)

The findings have direct implications for several SDGs, particularly:

• SDG 3: Good Health and Well-being – The reduction in heart disease mortality aligns with targets to reduce premature mortality from non-communicable diseases (NCDs) by one-third by 2030. Continued efforts in prevention, early diagnosis, and treatment are essential to sustain progress.
• SDG 10: Reduced Inequalities – The study highlights the need for future research on disparities in heart disease mortality by age, sex, race, ethnicity, and region to ensure equitable health outcomes.
• SDG 11: Sustainable Cities and Communities – Public health policies improving community environments, such as smoke-free zones and promotion of physical activity, contribute to healthier living spaces.
• SDG 17: Partnerships for the Goals – Collaboration between medical research institutions, public health organizations, and policy makers, exemplified by the American Heart Association’s initiatives, is critical to advancing cardiovascular health.

Recommendations for Future Action

1. Enhance prevention strategies focusing on early-life interventions to reduce risk factors such as obesity, hypertension, and diabetes.
2. Expand multidisciplinary care models to manage chronic heart conditions and support healthy aging.
3. Prioritize research addressing demographic disparities in heart disease mortality to tailor interventions effectively.
4. Promote widespread adoption of the American Heart Association’s Life’s Essential 8™ health measures:
   • Eat better
   • Be more active
   • Quit tobacco
   • Get healthy sleep
   • Manage weight
   • Control cholesterol
   • Manage blood sugar
   • Manage blood pressure
5. Continue investment in scientific research and public health policies to reduce cardiovascular disease burden.

Study Limitations

• Potential variations in heart disease mortality trends by demographic factors were not analyzed.
• Changes in International Classification of Diseases (ICD) coding over time may affect consistency in cause-of-death classification.
• The complexity of underlying causes in heart disease subtypes may lead to underestimation or oversimplification of ischemic heart disease burden.

Conclusion

While significant progress has been made in reducing deaths from heart attacks, the evolving landscape of heart disease mortality presents new challenges. Addressing chronic heart conditions through prevention, early intervention, and equitable healthcare aligns with the Sustainable Development Goals and is essential for improving population health and well-being.

About the American Heart Association

The American Heart Association (AHA) is dedicated to improving cardiovascular health and reducing the burden of heart disease and stroke. With over 35 million volunteers globally, the AHA funds research, advocates for public health policies, and provides resources to support healthier lives. Their efforts contribute directly to achieving SDG 3 and related goals.

For more information, visit heart.org.

1. Sustainable Development Goals (SDGs) Addressed or Connected to the Issues Highlighted in the Article

1. SDG 3: Good Health and Well-being
   • The article focuses primarily on heart disease, its mortality rates, prevention, treatment advances, and public health measures, all of which align with SDG 3’s aim to ensure healthy lives and promote well-being for all ages.
2. SDG 2: Zero Hunger
   • Implied through the emphasis on healthy eating as part of the American Heart Association’s Life’s Essential 8 components, which contributes to cardiovascular health.
3. SDG 11: Sustainable Cities and Communities
   • Smoke-free policies and community health initiatives mentioned in the article relate to creating healthier living environments.
4. SDG 4: Quality Education
   • Public awareness and education on heart disease prevention, CPR, and healthy lifestyle behaviors are implied in the article.

2. Specific Targets Under Those SDGs Identified Based on the Article’s Content

1. SDG 3: Good Health and Well-being
   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
   • Target 3.b: Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries.
2. SDG 2: Zero Hunger
   • Target 2.2: By 2030, end all forms of malnutrition, including achieving targets on stunted and wasted children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons.
3. SDG 11: Sustainable Cities and Communities
   • Target 11.6: By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management.
4. SDG 4: Quality Education
   • Target 4.7: By 2030, ensure that all learners acquire knowledge and skills needed to promote sustainable development, including health education and awareness.

3. Indicators Mentioned or Implied in the Article to Measure Progress Towards the Identified Targets

1. Heart Disease Mortality Rates
   • Age-adjusted death rates from heart disease, heart attacks, heart failure, arrhythmias, and hypertensive heart disease are used as key indicators to measure progress in reducing premature mortality (related to SDG 3.4).
2. Prevalence of Risk Factors
   • Prevalence rates of obesity, Type 2 diabetes, hypertension, and physical inactivity are mentioned as indicators of cardiovascular disease risk factors and overall population health.
3. Access and Use of Medical Interventions
   • Implementation and usage rates of bystander CPR, automated external defibrillators, coronary artery bypass grafting, coronary angiography, balloon angioplasty, coronary stenting, and medication therapies (e.g., statins, beta blockers) imply indicators of healthcare access and quality (related to SDG 3.8).
4. Public Health Policies and Behavioral Measures
   • Adoption of smoke-free policies, physical activity levels, and adherence to the American Heart Association’s Life’s Essential 8 health behaviors serve as indicators of health promotion and disease prevention efforts.
5. Life Expectancy
   • Increase in life expectancy from 70.9 years to 77.5 years is an indicator of overall health improvements in the population.

4. Table: SDGs, Targets and Indicators

Source: newsroom.heart.org