Heart attacks are no longer the most common cause of heart-related death in the United States.
This shift is not because heart attacks are happening less often, but rather because they are now more survivable than they were in the past.
Emergency care, modern medications, and early interventions have greatly improved survival rates for myocardial infarctions over the last five decades.
Despite this progress, heart disease remains the leading cause of death in the U.S., responsible for over 695,000 deaths in 2021 alone.
The change lies in what’s now driving those deaths.
Today, conditions like heart failure, hypertension-related disease, and arrhythmias account for a growing share of cardiovascular fatalities.
Heart failure deaths have risen by over 80% since 1999.
Hypertension-related deaths are up more than 100%, and deaths tied to arrhythmias have increased by over 400%.
This trend is partly because people are living longer after surviving heart attacks.
When the heart muscle is damaged during an event, that damage can linger and later lead to complications like heart failure or irregular heart rhythms.
Interventional cardiologist Dr. Cheng-Han Chen notes that the severity and duration of a heart attack often determine how much heart muscle function is lost — which can eventually reduce the heart’s ability to pump effectively .
What’s more, these follow-up conditions often go unnoticed in early stages.
Heart failure, for example, may begin with only mild symptoms and be easily managed with medication, but can progress if not addressed.
At the same time, lifestyle factors continue to play a significant role in the rise of other heart disease subtypes.
Many Americans still face risk factors like poor diet, inactivity, obesity, smoking, and chronic stress — all of which contribute to chronic inflammation and elevate the risk of heart complications.
According to the CDC, nearly half of U.S. adults have hypertension, and only about one in four has it under control.
Socioeconomic factors further complicate the picture.
Access to care, education, and resources — as well as maternal health issues like gestational diabetes and pregnancy-related hypertension — can raise lifetime cardiovascular risk, especially for women.
Even with all this in mind, the decline in heart attack deaths does signal that progress is being made.
Preventive cardiology, statin therapy, cardiac rehabilitation, and even newer interventions like implantable defibrillators and sleep apnea management are helping patients live longer, healthier lives after cardiac events.
However, this shift means that long-term management is more critical than ever.
Arrhythmias, particularly ventricular types, can become life-threatening if not properly monitored and treated.
That’s why annual checkups that include a heart-health screening are important — especially for those with a history of cardiac events.
If you’ve ever felt your heart flutter or beat irregularly without touching your chest, consider speaking with your healthcare provider.
With the right tools and awareness, many of the complications emerging now can be managed before they become fatal.
Heart disease is evolving.
Our approach to understanding and preventing it must evolve too.