Are Heart Attacks Still a Death Sentence?

As I approached my 47th birthday, I found myself in Manhattan, gearing up for a coronary artery calcium scan (CAC), a high-tech way to assess heart health. This CT scan reveals calcium build-up in the arteries, a bad sign indicating plaque accumulation and an increased risk of heart conditions.

My Results: A Mixed Bag

Hours after the scan, my phone buzzed with my CAC score: 7, a low but concerning figure indicating I had some calcified plaque. This translates to a 2.1% risk of a major cardiovascular event over the next decade — not exactly comforting. With these results, I joined the ranks of millions of Americans taking statins to combat ‘bad’ cholesterol.

Why Heart Attacks Are Less Deadly Today

While heart attacks were once a near-certain death sentence, especially for older adults, survival rates have dramatically improved. In the late 60s, a man over 65 hospitalized for a heart attack had only a 60% chance of survival. Fast forward to today: if that same man goes to the hospital, he has a staggering 90% chance of walking out alive.

A 90% Drop in Death Rates?

Recent studies from the Journal of the American Heart Association show a nearly 90% drop in heart attack-related deaths since 1970. Heart disease has decreased as a cause of adult deaths from 41% to 24%. This incredible progress represents countless lives saved, and it's critical to understand what made this turnaround possible.

Public Health Campaigns and Medical Innovations

The seeds of this transformation were planted decades ago. The Surgeon General’s 1964 report on smoking initiated a public health campaign that effectively cut the smoking rate from 40% in 1970 to just 14% in 2019. This crucial shift significantly lowered the risk of heart disease.

Additionally, the rise of statins in the 1980s revolutionized how we manage cholesterol. These medications are linked to nearly 2 million lives saved globally every year.

Furthermore, the spread of CPR training and portable defibrillators — which became common in the late 1960s — drastically improved survival rates during critical moments.

The Ongoing Battle Against Heart Disease

Despite the progress, heart disease still claims around 700,000 lives in the US annually, accounting for 1 in 5 deaths. The success in treating acute cases means that many people now live longer, only to face other chronic conditions like heart failure and pulmonary issues.

Emerging treatments like GLP-1 inhibitors, such as Ozempic, show promise in further reducing heart disease risks. Some studies suggest these drugs can lower the incidents of heart attacks and strokes by 20% in at-risk populations.

Advancing Screening Opportunities

Importantly, advanced screenings like the CAC tests I received could benefit more than 30 million Americans, even though less than 1.5 million underwent them in 2017. Just as with cancer, early detection plays a vital role in heart health.

It’s an astonishing achievement to witness a 90% reduction in heart attack deaths over the past five decades. Yet, the ultimate goal remains: preventing individuals from reaching the brink of cardiac emergencies in the first place.