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The benefits were seen in both sexes, which suggests women are now getting medical care equal to men, the study authors noted.
"We used to think men had a higher cardiovascular risk than women," said senior researcher Eileen Crimmins, a professor of gerontology. "But now we see everybody has gotten better. Cardiovascular risk has improved and that's a big plus."
In general, "both men and women are equally treated, and treatment has gotten more effective," Crimmins said.
The findings may help explain why the life expectancy gap between the sexes has narrowed, she added.
For the study, the research team analyzed national data on adults aged 40 and over from 1990 to 2010. The heart risk factors studied included blood pressure, body mass index (BMI), cholesterol, triglycerides and blood sugar.
Heart specialists welcomed the report.
"The narrowing gap of gender disparities for the treatment of heart disease is a promising sign of improvement in overall health care," said Dr. Rachel Bond, associate director of women's heart health at Lenox Hill Hospital in New York City.
This suggests heart health programs for women have worked, said Bond, who was not involved with the study.
"I take these findings as a validation of those programs, but continued efforts need to be made," Bond said.
"The next target population should be those of younger ages and focused around prevention," she added.
Dr. Byron Lee is a cardiologist and electrophysiologist at the University of California, San Francisco.
"In addition to the risk factor reduction reported in this study, we have also seen a significant decrease in actual heart attacks and strokes over the same time frame," said Lee, who also wasn't involved in the study.
Many factors likely have contributed to the decline in heart attacks and strokes, he said.
However, "I mainly credit our aggressive approach to lowering cholesterol with medicines like statin drugs," Lee added.
According to the study, the average number of cardiovascular risk factors decreased among both men and women. The biggest improvement was seen among people in their 60s, Crimmins said.
However, men experienced steady improvement over the whole 20 years, while improvements for women came later, between 2000 and 2010.
Hearts risks among women aged 40 to 60 actually increased between 1990 and 2000, but fell off by 2010, the findings showed.
Both sexes benefited from cholesterol medications, the researchers reported. The percentage of men whose cholesterol levels were under control rose from about 63 percent to over 96 percent. Among women, controlled cholesterol levels rose from 65 percent to 88 percent.
Although these overall gains continued through 2015, Crimmins predicted that future progress may be less striking.
"We have reached a place where we are not going to be able to make much more improvement because we're already pretty good at controlling cholesterol and [high blood pressure]," Crimmins said.
Also, Crimmins said increased prevalence of the abnormal heart rhythm called atrial fibrillation and rising obesity could end up offsetting these important gains.
The report was published online recently in the journal Aging Clinical and Experimental Research.
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SOURCES: Eileen Crimmins, Ph.D., professor, gerontology, University of Southern California, Los Angeles; Rachel Bond, M.D., associate director, women's heart health, Lenox Hill Hospital, New York City; Byron Lee, M.D., professor, medicine, director, electrophysiology laboratories and clinics, University of California, San Francisco; March 22, 2018, Aging Clinical and Experimental Research, online