Heart Health

I’ve read more than once, usually in books on diet and nutrition, that a century ago heart disease in America was virtually unknown and now, because of our poor lifestyle choices – especially what we eat – heart disease is rampant. Is this true? Or is this an oft-repeated myth? I decided to look at the numbers.

In 1900, the death rate in the US was 1100 per 100,000. Of all the people who died in 1900, one in eight died of heart disease (12.5%). To say that a century ago heart disease in America was virtually unknown is clearly inaccurate.

In 2010, the death rate in the US was 600 per 100,000. Of all the people who died in 2010, one in three died of heart disease (33%). Are we less healthy now than we were then or has something else changed?

In 1900, most people died from pneumonia, influenza, tuberculosis, and gastrointestinal infections. Modern medicine has these diseases largely under control, and that leaves heart disease and cancer as the big killers.

In 1900, doctors couldn’t do much to treat heart disease. Today, doctors have drugs to combat heart failure, emergency rooms are prepared for heart attacks, defibrillators are in every ambulance, stents can open arteries, and coronary bypass surgery is well established. We can transplant hearts and we even have artificial hearts that a person can use while awaiting a transplant. In short, we have an arsenal of treatments that didn’t exist in 1900.

In 1900, people died on average at age 47 – before they were old enough to develop serious heart disease. During the 20th century, the number of Americans under 65 tripled, but due to advances in medicine the number of Americans living to 65 and beyond increased by a factor of 11. In 2010 there were 40.3 million Americans age 65 and older compared to just 3.1 million in 1900.

Death from heart disease occurs mainly in the 65 and older population. In 2010 there were 13 times as many elderly as there were in 1900. In 2010, one would expect 13 times as many deaths from heart disease as in 1900, in the absence of anything to push the number up (such as poor diet and a sedentary lifestyle) or anything to push the number down (such as better treatments for the disease). In 1900, America’s population was 76.2 million and deaths from heart disease numbered 137.4 per 100,000 people, or about 104,700 annually. A statistician in 1900 might have projected that at some time in the future when there were 13 times as many elderly, the number of deaths from heart disease would be 13 times larger, or 1.36 million annually.

In reality, America’s population in 2010 was 309.3 million and deaths from heart disease numbered 192.9 per 100,000 people – just under 600,000 annually. Despite our fast food, sugar addictions, and couch-potato lifestyle choices that would seem to push the number higher, only half as many people (per capita) died of heart disease. Heart disease may – or may not – be more prevalent today, but certainly fewer of us die from the disease.

The truth is that heart disease seems more widespread today because deaths from infectious diseases have been curtailed and because many more people are living long enough to develop the disease.