Deaths from heart attacks halved in last decade
The factors behind the decrease in heart attack mortality differed by age, sex and geographic area. The greatest declines in heart attack event rate and mortality were seen among middle-aged individuals, whereas the smallest declines were seen for the younger and older age groups in both men and women. Rising rates of obesity and diabetes may help explain the lack of improvement in the occurrence of heart attacks among the youngest age group.
The authors say that further research is required to gain a clearer understanding of the specific elements of prevention and treatment that have contributed to the fall in death rates.
In an accompanying editorial, Hugh Tunstall-Pedoe from the Institute of Cardiovascular Research at the University of Dundee argues that death rates from heart attacks have only fallen in “rich nations” whereas they continue to rise in many others. He suggests that more data is needed from the other countries to reach a conclusion, but that resources to obtain data are scarce.
All that exercise, dieting, quitting smoking, new drugs, and new technologies have taken their toll. Without them 127,000 more people in the U.S. would have died from heart disease between 1980 and 1990, according to researchers at the School of Public Health.
From 1960 to 1980, decreases in deaths were due mainly to lowering cholesterol and blood pressure and to stopping smoking. With those changes firmly in place, improvement in caring for those who have already experienced a heart attack has been the main force in driving down the death rates from 1980 to 1990.
“If nothing had changed with regard to reducing risk factors for heart disease, improving survival after a heart attack, and preventing subsequent attacks, we predict that there would have been 127,000 more deaths,” declares Milton Weinstein, Kaiser Professor of Health Policy and Management.
About 700,000 people still are hospitalized with heart attacks, and about 500,000 die from coronary heart disease each year in the U.S. That toll costs the nation an estimated $80 billion each year, or about 15 percent of the health-care budget.
A full report of this research appears in yesterday’s issue of the Journal of the American Medical Association. In addition to those from Harvard, the authors include researchers from the University of California, San Francisco; Dartmouth-Hitchcock Medical Center in New Hampshire; and the University of Cincinnati.
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By William J. Cromie
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Provided by British Medical Journal