King Sara J, Wangdak Yuthok Tenzin Yeshi, Bacong Adrian M, Khandelwal Abha, Kazi Dhruv S, Mussolino Michael E, Wong Sally S, Martin Seth S, Lewis Eldrin F, Rodriguez Fatima, Palaniappan Latha P
Department of Medicine Stanford University School of Medicine Stanford CA USA.
Division of Cardiovascular Medicine and the Cardiovascular Institute, Center for Academic Medicine Stanford Universitsy School of Medicine Stanford CA USA.
J Am Heart Assoc. 2025 Jul;14(13):e038644. doi: 10.1161/JAHA.124.038644. Epub 2025 Jun 25.
Studying trends in mortality is essential to advance understanding of population health. Further evaluation of long-term heart disease mortality trends and subtypes in the United States is needed to guide public health and clinical interventions.
This study used the National Vital Statistics System Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data for adults aged 25 years and older in the United States from 1970 to 2022. Outcomes included absolute number and age-adjusted mortality of total heart disease, ischemic heart disease, and other heart disease subtypes.
From 1970 to 2022, overall age-adjusted heart disease mortality decreased by 66% from 1970 to 2022 (from 761 to 258 per 100 000). In 1970, 91% of all heart disease deaths were ischemic, declining to 53% of all heart disease deaths in 2022. From 1970 to 2022, age-adjusted mortality decreased by 89% for acute myocardial infarction (from 354 to 40 per 100 000) and 81% for all ischemic heart disease (from 693 to 135 per 100 00). In contrast, from 1970 to 2022 age-adjusted mortality for other heart disease subtypes increased by 81% (from 68 to 123 per 100 000), with the greatest increases in heart failure (146% increase), hypertensive heart disease (106% increase) and arrhythmias (450% increase).
Heart disease mortality has decreased over the past 5 decades. There is an increasing burden of mortality from other heart conditions including heart failure, hypertensive heart disease, and arrhythmias. Further efforts must be undertaken to address the growing challenge of these other heart conditions.
研究死亡率趋势对于深化对人群健康的理解至关重要。需要进一步评估美国长期心脏病死亡率趋势及亚型，以指导公共卫生和临床干预措施。
本研究使用了美国疾病控制与预防中心国家生命统计系统的广泛在线流行病学研究数据，数据涵盖1970年至2022年25岁及以上成年人。结果包括心脏病总数、缺血性心脏病及其他心脏病亚型的绝对数和年龄调整死亡率。
从1970年到2022年，年龄调整后的心脏病总体死亡率下降了66%（从每10万人761例降至258例）。1970年，所有心脏病死亡病例中有91%为缺血性，到2022年降至所有心脏病死亡病例的53%。从1970年到2022年，急性心肌梗死的年龄调整死亡率下降了89%（从每10万人354例降至40例），所有缺血性心脏病的年龄调整死亡率下降了81%（从每10万人693例降至135例）。相比之下，从1970年到2022年，其他心脏病亚型的年龄调整死亡率上升了81%（从每10万人68例升至123例），其中心力衰竭上升幅度最大（上升146%）、高血压性心脏病（上升106%）和心律失常（上升450%）。
在过去50年中，心脏病死亡率有所下降。包括心力衰竭、高血压性心脏病和心律失常在内的其他心脏疾病导致的死亡负担正在增加。必须进一步努力应对这些其他心脏疾病日益严峻的挑战。
