Heart Attacks Are No Longer the Top Cause of Heart-Related Deaths—Here’s What Is

Heart attacks have become significantly more survivable in the past 50 years, according to a new study published in the Journal of the American Heart Association. While heart disease is still the leading cause of death in the U.S., the main type of fatal heart condition has shifted.

Heart Attacks in Decline, But Heart Disease Persists

Deaths from acute myocardial infarctions (heart attacks) dropped by 89% between 1970 and 2022. In 1970, heart attacks made up 91% of all heart disease-related deaths. Today, that figure is down to just 53%.

Overall, heart disease fatalities have decreased by 66% since 1970. However, it’s still the number one cause of death in the U.S.—just with a different mix of culprits.

What’s Replacing Heart Attacks?

As treatments for heart attacks have improved, people are surviving them more often. But that survival comes with long-term consequences. Non-fatal heart attacks can leave lasting damage to the heart muscle, increasing the risk of other serious conditions:

  • Heart failure: deaths up 81%
  • Hypertension-related heart disease: deaths up 106%
  • Arrhythmia-related deaths: up a staggering 450%

These conditions now make up 81% of all heart-related deaths.

Why Heart Attacks Are More Survivable

Emergency care and cardiovascular medicine have advanced dramatically over the past five decades. Physicians are now able to stabilize patients quickly and apply life-saving medications, procedures, and devices.

However, surviving a heart attack often means living longer with underlying damage. For example, weakened heart muscle can result in heart failure, which ranges in severity from mild to life-threatening.

Arrhythmias (abnormal heart rhythms) can also develop as a long-term consequence, sometimes leading to sudden cardiac death if left unmanaged.

The Role of Lifestyle and Aging

Longer life expectancy plays a big role in this shift. Surviving a heart attack means a person may live long enough to develop age-related cardiovascular issues like arrhythmias or heart failure.

At the same time, lifestyle risk factors remain high in the U.S., including:

  • Obesity
  • Sedentary habits
  • High blood pressure
  • Poor diet
  • Smoking
  • Diabetes
  • Chronic stress and inflammation

These challenges, combined with barriers to healthcare access and socioeconomic disparities, continue to drive up rates of heart disease subtypes.

Arrhythmia: A Growing Concern

The most dramatic rise has been seen in deaths related to arrhythmia, a condition where the heart beats too fast, too slow, or irregularly. While many arrhythmias are harmless, serious types can interfere with blood flow to major organs and be fatal.

Common types include:

  • Bradycardia: slow heart rate
  • Tachycardia: fast heart rate
  • Ventricular arrhythmias: begin in the heart’s lower chambers
  • Supraventricular arrhythmias: such as atrial fibrillation, begin in the upper chambers

Anyone who notices irregular heartbeats—or feels their heart beating strongly without touching their chest—should talk to a doctor.

This is especially critical for those who have already had a heart attack, as ventricular arrhythmias can be life-threatening.

Preventing the Next Wave of Heart Disease

Survivors of non-fatal heart attacks are often prescribed interventions to reduce further risk. These may include:

  • Statins
  • Implantable defibrillators
  • Cardiac rehab programs
  • Sleep apnea treatment
  • Lifestyle changes and medication combinations like the “foundational four” for heart failure

How to Protect Your Heart

The American Heart Association recommends these eight steps to support heart health at any age:

  1. Eat healthy
  2. Be physically active
  3. Quit tobacco
  4. Get quality sleep
  5. Maintain a healthy weight
  6. Manage cholesterol
  7. Control blood sugar
  8. Regulate blood pressure

The bottom line: We’re winning the battle against heart attack deaths—but the war against heart disease is far from over. Prevention, early detection, and long-term care are now more critical than ever.


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