Coloured coronarography scan showing a narrowing (stenosis) in the left coronary artery.

Narrowing of a coronary artery (upper left) is a step toward a heart attack. Deaths from cardiovascular disease are no longer declining as quickly as in previous decades. Credit: Zephyr/SPL

Epidemiology

Where heart disease is making a comeback

Death rates from cardiovascular disease were falling in many wealthy nations but are now plateauing.

Since the 1970s, death rates from cardiovascular disease have declined substantially in many high-income nations, but that trend is slowing.

Alan Lopez and Tim Adair at the University of Melbourne in Australia analysed World Health Organization data for 23 high-income countries from 2000 onwards. With a few exceptions, each nation’s mortality from cardiovascular disease (CVD) — such as strokes and heart attacks — declined fastest before 2010, then began to level off, and reached its slowest pace of change in the most recent year measured.

Countries recorded average declines in CVD mortality of 3.2% per year after 2010, compared with roughly 4% per year over the preceding decade. The levelling out of CVD death rates was especially evident in people aged 35–74. In the latest figures for this age group, CVD mortality actually rose among women in Canada and people of both sexes in the United States.

Possible explanations for the stagnation include rising levels of obesity, the authors say.