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Experts say there are lifestyle changes you can make to lower your risk of heart disease. Getty Images
  • Researchers say deaths from coronary heart disease have not declined significantly in the United States since 2011.
  • They say part of the reason is that increases in obesity, high blood pressure, and diabetes have offset reductions in smoking rates and cholesterol levels.
  • Experts say there are lifestyle habits you can adopt to lower your risk of heart disease, including reducing insulin resistance and inflammation.

Heart disease is the leading cause of death in the United States, with 659,000 people dying from the condition every year.

Coronary heart disease is the most common type of heart disease. It accounts for more than half of the annual deaths.

Progress was made on the disease for a while.

However, over the past decade, deaths from coronary heart disease stopped declining, according to an analysis published Jan. 19 that looked at data from the Behavioral Risk Factor Surveillance System between 2011 and 2018.

In 2013, a study noted the decline of coronary heart disease in parts of the industrialized world.

“The decline of coronary heart disease mortality in the United States and Western Europe is one of the great accomplishments of modern public health and medicine,” study authors wrote.

Researchers credited efforts to understand the disease as one of the main reasons for the decline. Educating the public about the risks also helped.

However, the change in coronary heart disease between 2011 and 2018 has been insignificant, according to the new analysis.

Participants answered two questions in this latest survey:

  • Has a doctor, nurse, or other health professional told you that you have angina or coronary heart disease?
  • Has a doctor, nurse, or other health professional told you that you had a heart attack?

Researchers evaluated the survey data by age, sex, race and ethnicity, education, household income, and health insurance coverage.

After excluding people with a history of coronary heart disease and those who had missing demographic information, the researchers still had information on more than 3.5 million adults.

Overall, the rate of coronary heart disease dropped from 6.2 percent to 6 percent during that time period, a decrease that was considered insignificant.

Some notable findings included:

  • Utah had the most significant decline in coronary heart disease.
  • Other areas with a reduction included Washington, D.C., California, and Nebraska.
  • There were substantial increases in coronary heart disease in Oregon and West Virginia.
  • Adults over age 65 and those with a college education showed a small but statistically significant decrease.
  • Adults between ages 18 and 44 also had a small but statistically significant increase.

Nationwide, deaths from cardiovascular disease (not just coronary heart disease) declined between the 1970s and 2016, according to a 2021 study published in BMC Public Health.

Researchers for this study noted that obesity and diabetes increased over this time frame. They said that if these risk factors were better mitigated, the decreases would have been more significant.

What stopped the downward trend?

“Although considerable advances have been made for treating heart disease, the insignificant decline in the prevalence of heart disease over the past decade is most likely due to little success in preventing heart disease, particularly with regards to factors such as obesity, physical inactivity, poor diet, hypertension, and diabetes,” Dr. Ragavendra Baliga, FAAC, a cardiologist and professor of internal medicine at The Ohio State University Wexner Medical Center, told Healthline.

A 2020 study in Maine might help us better understand.

This study showed that deaths from heart disease in that state increased from 2011 to 2015.

The researchers noted that between 1999 and 2017:

  • obesity increased from 19 percent to 29 percent
  • hypertension rose from 26 percent to 34 percent
  • diabetes increased from 5 percent to 10 percent

During this time, some risk factors such as smoking and cholesterol levels did decrease.

Researchers offered some theories to explain:

  • The increase of some risk factors negated the positive effects of the decrease of other risk factors.
  • There could be limitations to prevention programs.
  • Prevention programs did not reach specific populations within the state.

Researchers also noted that modern medical advances may be causing part of the increase.

New treatments are helping people survive acute coronary episodes such as a heart attack, but these people are eventually dying of heart failure.

Health programs might also be more successful at responding to acute events but less at rehabilitation and follow-up programs.

To prevent heart disease, “individuals should focus on the American Heart Association’s Life’s Simple 7,” said Baliga. “This includes stopping smoking, increasing physical activity, losing weight, improving your diet, managing blood pressure, lowering blood sugar, and controlling cholesterol.”

“Meaningful reductions in heart disease come by pinpointing and addressing the factors that cause coronary heart disease,” said Dr. William Davis, a cardiologist in Wisconsin, chief medical officer at Realize Therapeutics, and the author of “Super Gut.”

Davis told Healthline that positive lifestyle choices can include:

  • reducing or eliminating triggers for low-density lipoprotein, which carry cholesterol to the cells
  • reducing triglycerides
  • reversing insulin resistance by eliminating foods that raise blood sugar and insulin
  • reversing inflammation

Experts say continuation of care helps you build your heart strength and remain healthy.

You can work with your doctor and healthcare team to find lifestyle changes that help your heart stay healthy.

In you have heart disease, your medical team will come up with a treatment plan, which could include a combination of lifestyle changes, medicine, and surgery.