If you are like most people over age 50, having a heart attack is probably one of your major health concerns— and understandably so. Amid headline-grabbing advances in virtually every field of medicine, heart attacks remain the leading cause of death among Americans.

Heart Attack Incidence in the U.S.

Each year, about 785,000 people in the United States have a heart attack for the first time and another 470,000 have a repeat attack. In about one fifth of cases, the heart attack will be fatal.

But there is some good news despite these sobering statistics. The death rate from and the severity of heart attacks has been declining steadily for many years, in large part because people are receiving better medical care. For instance, there have been significant improvements in identifying the risk factors associated with heart attacks, and doctors can choose from a variety of medications to help control high blood pressure, high cholesterol levels, and diabetes. There is also a greater focus on improving lifestyle, with changes like losing weight, exercising regularly, stopping smoking, and eating a low-saturated-fat, low-cholesterol diet.

Overall, the approach has become one of prevention, involving a combination of lifestyle measures, medication, and, sometimes, revascularization procedures like angioplasty or bypass surgery.

Who Has Heart Attacks?

You might think that having a heart attack is only a concern for men or the very old. But heart attacks strike both men and women, young and old. Even so, some people are more vulnerable to heart attacks than are others.

Some of this vulnerability is beyond your control. For example, you have a greater chance of a heart attack as you grow older. More than half of the people who have heart attacks—and four out of five who die of them—are over age 65.

Your gender also affects heart attack risk. More men than women have heart attacks each year, and men suffer heart attacks at a younger age than women. But after menopause, a woman's risk begins to climb substantially. In fact, heart attacks—not breast cancer—are the number one killer of women age 65 and older in the United States.

Family history plays a role, too. If one or more of your close family members (a parent or sibling) has had a heart attack, particularly at a young age, you have a greater likelihood of having a heart attack, too, and having one at a relatively young age as well.

But many of the risk factors for a heart attack—such as smoking, high cholesterol levels, high blood pressure, and obesity—are controllable. The vast majority of people who have a heart attack have at least one of these modifiable risk factors. Fortunately, you can dramatically lower your likelihood of a heart attack (as well as a stroke) by avoiding, controlling, or eliminating these risk factors.

Primary Prevention of Heart Attack is Important

People who have not had a heart attack, but who may have one or more risk factors, should take steps to protect their heart health. Tens of millions of Americans fall into this category.

Some people think that heart attacks are an inevitable part of growing older. But there's nothing inevitable about them. In fact, heart attacks are highly preventable. Regardless of your gender or age, you can dramatically reduce your chances of having a heart attack by incorporating the information in these pages into your everyday life. Yet too many men and women are not taking the steps that could help protect them.

According to the latest statistics from the American Heart Association, more than 102 million Americans have a total cholesterol level of 200 mg/dL or higher—a level that increases their risk of a heart attack. But less than half of those who need to lower their cholesterol are taking cholesterol-lowering medications. In addition, many stop using these drugs within six months. Yet research shows that cholesterol-lowering medications called statins are beneficial for a much wider range of people than previously believed, including those over age 70, women, people with elevated C-reactive protein (CRP), and anyone with vascular disease (disease of the blood vessels) or diabetes, regardless of whether or not they have high cholesterol levels.

The story is similar for high blood pressure (hypertension). Approximately 20% of the nearly 74 million Americans who have this health problem are not aware that they have the condition, and around half do not have their blood pressure under control.

Millions of Americans are also overweight, sedentary, or both. All of these individuals have an increased chance of having a heart attack, yet many of them are not taking the potentially lifesaving preventive measures that are known to reduce their risk. Learn more, and work with your doctor to develop a customized plan for heart attack prevention.

Publication Review By: Roger S. Blumenthal, M.D. and Simeon Margolis, M.D., Ph.D.

Published: 08 Mar 2011

Last Modified: 15 Jan 2015