U.S. heart attack mortality reached a two-decade low in 2014

Heart-healthy changes to diet and exercise along with a national focus on improving treatment and recovery from heart attacks appears to be making a difference.

Fewer older adults are having heart attacks, and fewer of those who do die as a result, according to an analysis of more than 4.3 million U.S. Medicare patients that spanned two decades up to 2014.

The percentage of patients who died within 30 days of a heart attack dropped to 12.4 percent in 2014, from 20 percent in 1995, researchers report online March 15 in JAMA Network Open. Declines were seen across sex, race and age in this group of patients, who are 65 and older.

The number of these older adults hospitalized for a heart attack also declined over the two decades, from 914 per 100,000 per year to 566 per 100,000 — an indication that fewer older adults are having heart attacks.

The average age for a first heart attack was 78.2 in 2014, more than a year older than in 1995 when it was 76.9. Patients generally trimmed a couple of days from their stay in the hospital after a heart attack in 2014 compared to 1995. And fewer patients returned to the hospital within a year due to another heart attack.

“Most of the basic effective therapies we have in prevention and treatment were available 20 years ago, but were being inconsistently applied,” says coauthor and cardiologist Harlan Krumholz of Yale School of Medicine. “There were massive opportunities to improve their use.”

The 20-year period studied was a time of intense activity focused on prevention strategies and the immediate care of people hospitalized with a heart attack, he says. “As a result, improvements in lifestyle and treatments achieved dramatic results.”