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New federal data show that the rate of deaths due to heart disease continues a decades-long decline, although more Americans still die of heart disease than any other cause. Age-adjusted death rates for heart disease fell from 520.4 deaths per 100,000 Americans in 1969 to 169.1 in 2013. Stroke deaths dropped from 156.8 per 100,000 Americans to 36.

A report on the nation’s leading killers released Wednesday said 614,348 Americans died from heart disease in 2014. The Centers for Disease Control and Prevention releases the data yearly outlining the total number of deaths. The top five killers in 2014 were heart disease, cancer, chronic lower respiratory diseases, accidental injuries and stroke.

The death rate for heart disease declined 1.6 percent, from 169.8 in 2013 to 167 in 2014. Death rates are adjusted for age and calculated as the number of people who die for every 100,000 people in the U.S. population.

“We are encouraged about the gains we’ve made against heart disease over the years,” said ·¬ÇÑÊÓƵ President Mark Creager, M.D., director of the Heart and Vascular Center at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

“More people are avoiding heart events at younger ages and more people are surviving them and living longer,” he said.

Age-adjusted statistics allow death rates to more accurately reflect the burden of a disease across an entire population, Creager said.

They also allow analysis of trends over time and comparisons of death rates from different causes without the influence of age. For example, heart disease generally affects older people, so without age adjustments, the rate of deaths from heart disease could drop immediately after a baby boom or rise with a swelling older population.

Over the past century, heart disease has accounted for more deaths than any other major cause of death in the U.S., according to the CDC’s National Center for Health Statistics. Since 1910, it has been the worst killer every year but three. The Spanish influenza pandemic helped make flu and pneumonia the worst from 1918 to 1920.

Despite ranking at No. 1 every year since 1921, heart disease death rates have continued a steady fall in recent decades. From 1969 to 2013, there were 68 percent fewer deaths from heart disease and 77 percent fewer deaths from stroke, according to a recent analysis published in the Journal of the American Medical Association.

The new CDC data show that stroke retained its No. 5 ranking for the second year, after falling from No. 4 in 2012 to No. 5 in 2013. The death rate from stroke remained steady between 2013 and 2014, with about 36 deaths per 100,000 Americans.

“The decline in stroke has been remarkable in the last 15 years and we hope it will continue to drive further down,” said Wayne D. Rosamond, Ph.D., professor of epidemiology at the University of North Carolina in Chapel Hill and chair of an AHA committee that monitors such progress.

Yet for both stroke and heart disease, no single breakthrough can be credited for the progress made, he said. Rather, it has been the cumulative effect of better prevention, diagnosis and treatment. Some of those efforts have included:

• fewer people smoking and being exposed to secondhand smoke;
• better emergency response to heart disease;
• improved heart medications and procedures;
• scientific research advances;
• legislation to build healthier environments; and
• increased public awareness about healthy living.

Despite the falling death rates, the number of people suffering from cardiovascular diseases is rising. Risk factors such as obesity, high blood pressure and unhealthy diets remain high, experts say.

In the U.S., 82.6 million people are living with cardiovascular diseases, including the after-effects of heart attacks and strokes. Globally, heart disease and stroke remain the leading causes of death, with deaths projected to rise.

“We cheer the progress that we’ve made, but recognize we have much more to accomplish,” Creager said. “We must intensify our efforts in prevention and treatment in order to see heart disease fall to No. 2, and then No. 3 and No. 4 and ultimately fall off the charts.”