Progress slows in preventing early deaths from heart disease

By American Heart Association News

Dirtydog_Creative/DigitalVision Vectors, Getty Images
(Dirtydog_Creative/DigitalVision Vectors, Getty Images)

The decades-long progress in reducing premature deaths from heart disease in the United States has slowed over the last decade, according to a new county-by-county analysis that found an increase in disparities affecting African American adults and younger populations.

U.S. and Chinese researchers used multiple databases that included information on nearly 1.6 million premature cardiac deaths between 1999 and 2017, among people ages 35 to 74. Though rates declined during the full study period, the pace of decline has slackened significantly since 2010, according to a study published Wednesday in the Journal of the American Heart Association.

"The United States experienced remarkable decline in cardiovascular disease mortality that was coined as one of the major public health accomplishments of the 20th century," lead investigator Dr. Zhi-Jie Zheng said in a news release. He is chair of the department of global health at Peking University in Beijing.

"Increasing numbers of out-of-hospital deaths and fatal heart attacks in younger age groups, coupled with a steady widening of disparity of socioeconomic and health environment factors affecting health care at the county level, appear to be the key drivers of the slowdown," said Zheng, a former lead epidemiologist at the Centers for Disease Control and Prevention in Atlanta and a supervisory medical epidemiologist at the National Heart, Lung, and Blood Institute in Bethesda, Maryland.

Among the study's findings:

– 61% of the nearly 1.6 million premature cardiac deaths from 1999 to 2017 were not in a hospital.

– Out-of-hospital deaths rose from 58.3% in 1999 to 61.5% in 2017.

– Twice as many premature cardiac deaths occurred in men compared to women.

– Premature death rates from heart disease were 3.4 times higher among African Americans than Asians or Pacific Islanders.

The findings are alarming, Zheng said, and warrant more efforts to integrate lifestyle and behavior changes that boost heart health.

"Our findings suggest a need for health care policy changes and programs that can identify high-risk, young populations prone to premature cardiac death and support improved cardiac health," he said.

The disparities were largely linked to demographics and socioeconomic status, according to the study.

Differences in population size, rural living, sex, age, race/ethnicity and foreign-born status accounted for just over a third of out-of-hospital and in-hospital premature cardiac deaths. Disparities in factors such as median household income, unemployment, school enrollment and number of violent crimes per 100,000 population accounted for about 20% of deaths.

The study is among the first to analyze county-level factors related to disparities in premature cardiac death rates.

If you have questions or comments about this story, please email [email protected].

American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association. Statements, conclusions, accuracy and reliability of studies published in American Heart Association scientific journals or presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the American Heart Association’s official guidance, policies or positions.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt from or reprint these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Association’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.