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Coronary heart disease is on the decline in the U.S.

REUTERS/Kim Kyung-Hoon
The drop in coronary heart disease "could relate to general trends in lifestyle changes, such as improved diet, increased level of physical activity, or other factors such as prophylactic aspirin use among U.S. adults," said lead author Sung Sug (Sarah) Yoon.

Americans are getting heart-healthier.

The rate of coronary heart disease in the United States among people aged 40 years or older has fallen significantly within the past decade. In 2011-2012, 8 percent of adults in that age group had heart disease compared to 10.3 percent in 2001-2002, according to a new analysis of federal data.

Most of that decline was among people aged 60 and older. Their rate of coronary heart disease fell from 19.5 percent to 14.9 percent, the researchers report.

But other demographic groups also experienced significant declines in coronary heart disease. The rate in women fell from 8.5 percent to 6.2 percent. And the rates dropped among both blacks and whites. In fact, the rate of coronary heart disease among blacks aged 40 and older fell during the past decade at a greater pace than among whites: Blacks experienced a 31 percent decline (to 7.5 percent) between 2001-2002 and 2010-2012 compared to a decline of 22 percent for whites (to 8.2 percent).

Significant declines were also found among adults who did not complete high school (down 31 percent), adults with more than a high school education (down 20 percent) and adults who had health insurance (down 23 percent).

This new study, which was published Wednesday in the American Journal of Preventive Medicine, is based on data collected from more than 21,000 American adults aged 40 years of age or older as part of the ongoing National Health and Nutrition Examination Survey (NHANES).

Country’s leading killer

Bringing down the rates of adults with coronary heart disease — and other forms of heart disease — has been a major U.S. public health effort for decades. 

And for good reason. Each year, about 610,000 Americans die of heart disease, making it the leading cause of death in the U.S., according to the Centers for Disease Control and Prevention.

Here in Minnesota, heart disease is the second-leading cause of death (behind cancer), claiming about 7,500 lives annually, according to the Minnesota Department of Health. 

Coronary heart disease — which occurs when plaques build up in the arteries leading to the heart, reducing blood flow to the heart — includes angina (chest pain), heart attacks and other related conditions. It is the most common type of heart disease in the United States, claiming more than 370,000 American lives each year.

Getting the message

The current study was not designed to determine why coronary heart disease is on the decline, but its authors believe a combination of factors are probably involved.

Most notably, significant numbers of Americans seem to be adopting heart-healthier habits.

The drop in coronary heart disease “could relate to general trends in lifestyle changes, such as improved diet, increased level of physical activity, or other factors such as prophylactic aspirin use among U.S. adults,” said lead author Sung Sug (Sarah) Yoon, a researcher at the National Center for Health Statistics at the time of the study, in a released statement.

She also pointed out the importance of the continuing decline in cigarette smoking. According to government statistics reported elsewhere, the proportion of U.S. adults who smoke dropped from 21 percent in 2005 to 17 percent in 2014.

And although it is not discussed at length in the new study, greater access to health care services through the Affordable Care Act may also be an important factor in why the coronary heart disease rates are down in recent years.

Not-so-positive trends

Still, messages about the importance of adopting a heart-healthy lifestyle are not reaching everyone. For although the trends observed in the new study are mostly positive, some are troubling.

Hispanic Americans experienced no statistically significant decline in their coronary heart disease rates, for example. Nor did people aged 40 to 59.

Furthermore, other than among people who are overweight (but not obese), most of the significant decreasing trends in coronary heart disease observed in this study occurred among people without major risk factors for heart disease.

The study found no change in coronary heart disease rates among people diagnosed with high blood pressure, high cholesterol or diabetes, or among people who are obese or who currently smoke. 

For more information:  You’ll find an abstract of the study on the American Journal of Preventive Medicine’s website, but the full study is, unfortunately, behind a paywall.

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