But possibly not for the reasons that many people on social media think of:
“Incredible progress has been made to reduce deaths from heart attacks over the last 50 years,” says King. This includes new therapies such as heart stents, coronary artery bypass surgery and cholesterol-lowering medications. Public health measures, such as bystander CPR training and efforts to lower smoking rates, have also probably helped, says King.
Heart attacks are no longer the leading cause of death in the US | New Scientist
WHAT CHANGED?
I asked AI about the controllable risk factors for heart disease, which I summarize here.
The incidence of heart disease has fallen since the 1980s. Many people, especially on social media, and often the media too, promote “eating right” or exercise as the cause for this drop. But this is not the case.
Here is what AI says, based on the available literature it has access to (this is my summary of the paragraphs of information).
Reduction in heart disease since the 1980s
- up to 30% decrease was due to reduction in smoking (40% of adults in 1970, down to 12% today)
- up to 25% decrease was due to statins
- up to 25% was due to blood pressure management
- up to 6-19% was due to banning transfats
- up to 10-15% due to dietary factors (except they note this might be offset by people consuming more sugar, higher prevalence of diabetes, and more obesity)
Not shown on the list are exercise or the impacts of diabetes diagnosis and/or treatment.
Consequently, diet might not have that much to do with heart disease, although with the other factors substantially decreased, diet could play a larger role now.
Yet perusing social media, I find a “social media consensus” that eating right and exercise prevents all heart disease. Unfortunately, while it likely offers benefits, uncontrollable factors such as genetics and randomness may overshadow controllable factors. This is why we see marathon runners who did everything right and followed all the dietary guidelines have died of heart attacks. Do a search for “runner dies heart attack” – it’s an astounding number.
In May of 2025, a doctor, runner, expert on nutrition – died while hiking in the Grand Canyon. A year ago, in the winter, another doctor, ultamarathon runner, lifelong vegetarian, died of a heart attack while cross country skiing near Medford, OR. I have a personal friend, one of the fittest people I know, ate “perfectly” – and went into cardiac arrest at work, and again, in the hospital ER. He’s doing well 20 years later. You do not need to look very hard to see this is going on.
Of course, we should still strive to be fit and healthy and “eat right” (a term that has varied considerably over the decades and, surprisingly, is now almost the opposite of what we were told in the 1980s and 1990s). And being fit may have some benefits if one does have a heart attack.
Survivability is now 50% higher due especially to angioplasty, stents, new medications, and fast medevac transport to cath labs – when time of treatment is critical.
Summary
Heart attacks are now a lower cause of mortality due to a reduction in smoking, the use of statins to reduce LDL levels, the use of blood pressure medication, and the banning of transfats. Dietary changes have not resulted in a large change relative to the other changes.
Heart attacks are also now more survivable given fast access to a cath lab to remove blockages with angioplasty and stents.
Again, outside of smoking and diabetes, controllable factors like diet may play a role but not a large one.
