Illustration of a heart

The good news: Fewer people these days are saying they’ve suffered a heart attack. The bad news: Those who have had heart attacks may not be changing lifestyle habits that could result in another one.

The percentage of U.S. adults who reported that they had heart attacks dropped to 3.9 percent in 2014, down from 4.5 percent in 2008, according to a new Gallup-Healthways poll released Wednesday and first reported by American Heart Association News.

The information gathered in the survey was all self-reported and not validated by medical records or other clinical means bringing with it the potential for lack of accurate recall or inaccurate representation by the participant. The survey is not longitudinal, meaning it does not follow the same people over time

The poll found that those who reported themselves as heart attack survivors were more likely to have unhealthy lifestyle behaviors than those who said they had never had a heart attack. For example, those who had a history of heart attack were less likely to exercise than poll respondents who reported no history of heart attack. They also were more likely to smoke, be obese and have a history of high blood pressure.

While patients cannot change certain heart disease factors such as age, gender and family history, research has shown that making specific lifestyle improvements can reduce the risk for cardiac disease. Even slight changes – like incorporating physical exercise or eating more servings of fruits and vegetables – can decrease the risk of a heart attack.

“Nationwide efforts to improve cardiovascular health are making an impact,” said American Health Association President Mark Creager, M.D., director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center.

“However, there is much more to do to reduce the burden of heart disease. Let’s make sure that people have access to nutritious foods, safe places to exercise, and help to stop smoking,” Creager said. “I also encourage people to see their health care provider so they can be checked for high blood pressure, high cholesterol or diabetes and treated effectively, since each of these contribute to the risk of heart disease.”

heart attack map

The Gallup-Healthways poll also found that the incidence of heart attack went up as the age group of those surveyed increased. The highest rate of those who had experienced a heart attack occurred in those 65 and older.

An inverse relationship surfaced, however, between the rate of heart attacks and the income level of survivors. In other words, the more income levels rose, the fewer heart attacks reported among respondents. For example, individuals with household incomes of less than $24,000 were more than three times as likely to have experienced a heart attack as someone who had an annual household income of $120,000 or more.

All findings were collected as part of the Gallup-Healthways Well-Being Index survey, which polled 265,369 adults 18 and older, in all 50 states and the District of Columbia, from Jan. 2, 2014, through June 30, 2015. The survey reported two margins of error: For the total sample of adults, it was plus/minus 0.24 percentage points; among the sample who reported a heart attack, it was plus/minus 1.08 percentage points.

Each sample included a 50 percent split among respondents on landlines and cell phones and are conducted in English and Spanish.

Potential biases exist as a function of which respondents were reachable by phone and were willing to participate in the survey, although all phone numbers are taken through a multiple call design to ensure that hard to reach respondents are given the best possible opportunity to participate.

Additionally, all data are weighted according to Census statistics to ensure that underrepresented and overrepresented demographic groups are proportionalized in the data to reflect their actual occurrence in the population.