--- title: Heart Disease Is Way Down In the U.S. description: Americans have made their hearts healthier by lowering blood pressure, quitting smoking and taking statins for high cholesterol. canonical: https://time.com/4568036/coronary-heart-disease-diabetes/ author: Mandy Oaklander article:opinion: false article:content_tier: free article:published_time: 2016-11-13T16:00:50.000Z article:modified_time: 2026-02-23T01:47:10.020Z article:section: Health og:title: Heart Disease Is Way Down In the U.S. og:description: Americans have made their hearts healthier by lowering blood pressure, quitting smoking and taking statins for high cholesterol. og:url: https://time.com/4568036/coronary-heart-disease-diabetes/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltd240748d8b1fd465/69887a87524fc08436df6712/time-health-heart-attacks-gender.jpg?branch=production&width=3840&quality=75&auto=webp&crop=16:9 og:image:width: 1200 og:image:height: 675 og:image:alt: Heart Attacks Men and Women og:type: article twitter:card: summary_large_image twitter:title: Heart Disease Is Way Down In the U.S. twitter:description: Americans have made their hearts healthier by lowering blood pressure, quitting smoking and taking statins for high cholesterol. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltd240748d8b1fd465/69887a87524fc08436df6712/time-health-heart-attacks-gender.jpg?branch=production&width=3840&quality=75&auto=webp&crop=16:9 ---  # Heart Disease Is Way Down In the U.S.  by [Mandy Oaklander](https://time.com/author/mandy-oaklander/)  ## Mandy Oaklander Oaklander is a senior editor at TIME. Nov 13, 2016 4:00 PM UTC  1930s 1940s SMILING BLONDE... 1930s 1940s SMILING BLONDE...Photo Illustration by Lauren Margit Jones for TIME/Photo: Getty Images  by [Mandy Oaklander](https://time.com/author/mandy-oaklander/)  ## Mandy Oaklander Oaklander is a senior editor at TIME. Nov 13, 2016 4:00 PM UTC In the last two decades, public health experts have urged Americans to make their hearts healthier. Blood pressure guidelines have been updated, the risks of [smoking](http://time.com/4542672/smoking-cigarettes-cancer-death/?iid=sr-link3) and [diabetes](http://time.com/3687808/this-is-the-number-1-driver-of-diabetes-and-obesity/?iid=sr-link1) have been emphasized, and dramatically more people have taken the cholesterol-lowering drugs called statins. But for all of these steps towards prevention, how big has the payoff been? Researchers posed this question in the [latest issue](http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2016.13614) of the _Journal of the American Medical Association_. To answer it, they used data from five large observational studies and followed thousands of Americans ages 40-79 who didn’t have cardiovascular disease. They matched people up by age, race and sex from the earlier era (1980-1990) and a later one (1996 through 2011). The pairs—14,009 in all—were tracked for up to 12 years to see who developed cardiovascular disease. The researchers then estimated how much of that was due to blood pressure, diabetes, smoking and high cholesterol. They found that over time, the incidence of coronary heart disease—which includes events like heart attack and intense chest pain—dropped about 20%. “That’s a positive message that all the efforts have proven to bear fruit,” says Michael Pencina, professor of biostatistics and informatics at Duke University and one of the authors of the study. When the researchers looked at how much cholesterol, blood pressure and smoking influenced coronary heart disease, they found these risk factors mattered just as much in the later years as much as they had in the earlier era. That each of these risk factors still matters is proof that we can be doing more to address them, Pencina says. “Prevention in the young is one frontier that we need to be exploring more actively.” Even though elevated risk factors in younger adults are known to lead to greater risk later on, most of the guidelines only begin for people at age 40, he says. Diabetes was the lone risk factor that seemed to have a weakened impact on coronary disease over time. Researchers aren’t quite sure why, but Pencina thinks that it may be because we’re better at detecting diabetes now than in the past. “If you had diabetes more than 20 years ago, it was really obvious that you had it—it must have been a really bad case,” he speculates. Now, it’s possible that we’re picking up more people who have the disease, but a milder version of it. “Twenty percent is good, but it’s nowhere near where we could or would like to get,” Pencina says. “There is still a lot of room for improvement.” ```json [{"@context":"https://schema.org","@type":"NewsArticle","@id":"https://time.com/4568036/coronary-heart-disease-diabetes/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/4568036/coronary-heart-disease-diabetes/"},"headline":"Heart Disease Is Way Down In the U.S.","datePublished":"2016-11-13T16:00:50.000Z","dateModified":"2026-02-23T01:47:10.020Z","description":"Coronary heart disease has dropped by about 20%","url":"https://time.com/4568036/coronary-heart-disease-diabetes/","keywords":["Heart Disease","Blood Pressure","heart attack","diabetes","cholesterol","high blood pressure","heart health"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/bltd240748d8b1fd465/69887a87524fc08436df6712/time-health-heart-attacks-gender.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Mandy Oaklander","jobTitle":"Oaklander is a senior editor at TIME.","url":"https://time.com/author/mandy-oaklander/"}],"articleSection":"Health","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/bltd240748d8b1fd465/69887a87524fc08436df6712/time-health-heart-attacks-gender.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"Heart Attacks Men and Women","caption":"Heart Attacks Men and Women","creditText":"Photo Illustration by Lauren Margit Jones for TIME/Photo: Getty Images","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/health/","name":"Health"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/heart-disease/","name":"Heart Disease"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/4568036/coronary-heart-disease-diabetes/","name":"Heart Disease Is Way Down In the U.S."}}]}] ```