Researchers say men and older adults are among those affected most by the slower decline in early cardiovascular death rates. Getty Images
  • A new study reports that the rate of premature cardiovascular deaths is now declining at a slower rate.
  • The report also notes that men, Black Americans, and older adults have been affected the most.
  • There’s also a wide disparity between counties even within the same state.
  • Experts say people should be informed about heart health and practice lifestyles that include good diet, regular exercise, and less stress.

The rate of premature deaths from cardiovascular disease has been falling for decades.

But we’re starting to lose ground.

A new study published in the Journal of the American Heart Association finds that cardiac deaths occurring outside a hospital are declining now at a slower rate.

The researchers also noted considerable county to county disparities.

The analysis involved data on almost 1.6 million premature cardiac deaths in the United States.

Deaths were considered premature if they occurred between the ages of 35 and 74.

The rate declined steadily between 1999 and 2017. However, since 2010, the rate of decline has slowed significantly.

“From the 1960s to 2010s, 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,” said Dr. Zhi-Jie Zheng, a professor and chair of the department of global health at Peking University in China, in a statement.

“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 healthcare at the county level, appear to be the key drivers of the slowdown we have seen since 2010,” continued Zheng.

Key findings and disparities

Overall, premature cardiac deaths decreased from 1999 to 2017.

Other key findings:

  • Deaths occurring outside a hospital increased from 58 percent to 61 percent.
  • The rate for men was double the rate for women.
  • Black Americans had the highest rate. About 90 percent of Black individuals with cardiac arrest had never been told of their risk and 60 percent had not sought care for cardiac symptoms.
  • The rate for adults ages 65–74 was 15 times as high as the rate for adults 35–44.
  • County-by-county rates varied, even among counties in the same state. County disparities have been widening for two decades. Disparities were strongly associated with demographics and socioeconomic status.

Study authors acknowledged several limitations of the research. These include potential errors in cause of death reporting from county health department data.

Dr. Sanjiv Patel is an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.

Patel told Healthline that the 18-year study provides good insight into general issues that are going on and it appears to be a multi-pronged problem.

Younger people, he said, may have an “I’m young, nothing will happen to me” mentality.

“Others may be worried about economics, the feasibility in terms of health insurance, and not being able to get off work. And, depending on the particular culture, some people may try home remedies. When nothing works, they may finally seek care,” explained Patel.

“In certain counties, getting care is a problem. People may live far from a hospital, urgent care center, or doctor’s office. In a small town you may have to go 30 or 40 miles to get help,” he said.

“Those factors definitely play a role in delaying care and increasing mortality risk,” he added.

What individuals can do

Dr. Ragavendra Baliga is a cardiologist and professor of internal medicine at The Ohio State University Wexner Medical Center.

Baliga told Healthline that the key takeaway from the study is that the burden of out-of-hospital premature cardiac deaths appears to be higher in younger age groups.

He recommended a focus on lifestyle.

“This includes exercise, diet to achieve optimal body weight, smoking cessation, sleep hygiene, and controlling blood pressure. And determine LDL cholesterol. Given that statins are now generic, many should benefit from statin therapy,” said Baliga.

Patel also stressed the importance of managing chronic health conditions.

“Even if you take medicine, it doesn’t mean you can forget other things. Don’t be too complacent. Don’t overstress about it, but be vigilant and take care of yourself,” he said.

“Ideally, everybody should have time to rest and exercise. The reality is, the less fortunate have a tougher time in life. The poor may have bad nutrition due to the availability of good food, which we take for granted a lot of times,” said Patel.

He also emphasized the need to manage stress as much as possible.

“People may have financial, emotional, and mental stress. That’s hard to control and depends on where you work and live,” he said.

“Individuals and families should look at their own needs and try to do what they can to improve physical and emotional care. Try to go outside to walk as much as possible, which is important for mental functioning and physical conditioning,” Patel added.

Patel suggested that everyone, young or old, with or without known cardiovascular disease, should have a similar plan of a healthier lifestyle.

He also recommended getting familiar with symptoms of heart attack and stroke.

Symptoms of a heart attack include chest pain and pressure, but can also involve unusual signs such as neck and jaw pain, toothache, nausea and vomiting, and a sudden burning of the stomach.

“Symptoms like that, that don’t resolve quickly, could be a sign of a heart attack. Don’t procrastinate. Get emergency care, but don’t drive yourself. Call 911. It’s the reason it’s there,” said Patel.

Know in advance what you’ll do in an emergency situation.

“If you need help, how will you get it? Where will you go? Have a plan in place so you’re not stuck at the last minute,” continued Patel.

The bigger picture

Study authors said that improving socioeconomic conditions of disadvantaged populations could help improve health outcomes.

“This requires a system level funding from [the National Institutes of Health] and other foundations for research to identify factors that explain disparities in premature cardiac death,” said Baliga.

Patel believes it’s a societal issue.

“It’s across the country, but every place has different issues and different types of problems. Proximity of care is a problem and access to hospitals affects all medical care. It can’t be solved overnight,” said Patel.

Our partners: