Between 2011 and 2017, the death rate from heart failure among U.S. adults surged 20.7% and is expected to keep rising. A new study reports that the aging population, along with high rates of obesity and diabetes among adults of all ages, has substantially slowed decades of progress reducing deaths from heart disease. (JAMA Cardiology)
Over the last several decades, falling mortality from all forms of heart disease (HD) has been one of the big success stories of changing lifestyles and improving medical care--not just in the United States but throughout the high-income world. Unlike death rates from major forms of cancer, which have stubbornly resisted improvement, the age-adjusted death rate from HD has dropped dramatically. (See "Trendspotting: 9/9/19.")
Starting around 15 years ago, however, the U.S. HD mortality decline began to decelerate. This bad news was not due to anything wrong happening among the elderly (their HD death rate has continued to fall), but rather among the nonelderly. The HD death rate for midlife adults age 45 to 64 has actually been rising since 2005. (See "Trendspotting: 8/12/19.")
Apparently, the positive effects of less smoking and better medical treatment (statins and anti-hypertension drugs) are now fully reflected in lower death rates, especially among the elderly.
On the other hand, the negative effects of higher rates of obesity, diabetes, high blood pressure, and physical inactivity are beginning to age in with later-born cohorts.
The rising midlife death rate coincides with late-wave Boomers and early-wave Xers hitting their late-50s and early-60s. This alarming rise in cardiovascular mortality among the nonelderly, brought to widespread public attention by the recent deaths of actor Luke Perry (at age 52) and film director John Singleton (at age 51), has attracted ample media coverage.
What's new in the JAMA Cardiology article is the finding that the rise in the age-adjusted HD death rate is being driven by heart failure rather than by coronary heart disease (which often manifests itself in sudden "heart attack" deaths). Heart failure is a chronic condition that develops slowly, is highly correlated with obesity and diabetes, and sometimes afflicts those who have survived heart attacks due to such interventions as heart bypass surgery.
See charts below on age-adjusted death rates by HD type.
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ABOUT NEIL HOWE
Neil Howe is a renowned authority on generations and social change in America. An acclaimed bestselling author and speaker, he is the nation's leading thinker on today's generations—who they are, what motivates them, and how they will shape America's future.
A historian, economist, and demographer, Howe is also a recognized authority on global aging, long-term fiscal policy, and migration. He is a senior associate to the Center for Strategic and International Studies (CSIS) in Washington, D.C., where he helps direct the CSIS Global Aging Initiative.
Howe has written over a dozen books on generations, demographic change, and fiscal policy, many of them with William Strauss. Howe and Strauss' first book, Generations is a history of America told as a sequence of generational biographies. Vice President Al Gore called it "the most stimulating book on American history that I have ever read" and sent a copy to every member of Congress. Newt Gingrich called it "an intellectual tour de force." Of their book, The Fourth Turning, The Boston Globe wrote, "If Howe and Strauss are right, they will take their place among the great American prophets."
Howe and Strauss originally coined the term "Millennial Generation" in 1991, and wrote the pioneering book on this generation, Millennials Rising. His work has been featured frequently in the media, including USA Today, CNN, the New York Times, and CBS' 60 Minutes.
Previously, with Peter G. Peterson, Howe co-authored On Borrowed Time, a pioneering call for budgetary reform and The Graying of the Great Powers with Richard Jackson.
Howe received his B.A. at U.C. Berkeley and later earned graduate degrees in economics and history from Yale University.