Study: Rate of Heart Attacks Decreasing

Finally, Americans can get some really good news about our health. A recent report in the New England Journal of Medicine indicates that the incidence of heart attacks is decreasing.

In this study, researchers evaluated the number of heart attacks among the 3 million individuals who utilized the Kaiser Permanente Northern California health system. From 1998 to 2008, approximately 46,000 patients were hospitalized for heart attacks. After an initial increase for the first two years of the study, the number of heart attacks decreased by 25 percent between 2000 and 2008. Researchers also noted an even more dramatic 62 percent decrease in the most deadly form of heart attacks, which is classified on the basis of EKG changes and referred to as ST segment elevation myocardial infarction.

This information is nothing short of incredible. Not only did the incidence of heart attacks decrease, but so too did the mortality rate. This particularly applied to mild heart attacks in which deaths within 30 days of hospitalization decreased from 10 percent to 7 percent. Unfortunately, for those admitted with the more serious ST segment elevation heart attacks, no improvement in risk of deaths was noted.

There are many reasons behind this marked improvement in heart health. In the last decade, physicians have placed a strong emphasis on treating risk factors for heart attacks for patients who have recovered from an attack and those who have never had one. Simultaneously, there has been a major education effort to reduce heart disease, promote heart healthy living and minimize community health risk factors for disease.

In addition to the general trends to promote heart health, between 1999 and 2008, the Kaiser Permanente system began to emphasize prevention and appropriate treatment of risk factors. For example, the percentage of Kaiser patients with hypertension who were treated to achieve target blood pressure increased from 40 percent in 1999 to 80 percent in 2008. The percentage of people who received adequate treatment for elevated cholesterol increased from 67 percent to 76 percent during the same period.

For patients who had heart attacks or coronary artery disease, the percentage receiving the most ideal course of treatment increased from 10 percent to 20 percent to about 35 percent. This includes the use of aspirin or Plavix to reduce the risk of arterial blockage and the use of ACE inhibitors and beta blockers, which have been shown to be highly effective in preventing further heart attacks or heart failure.

Unfortunately, the data also showed that the incidence of heart attacks was still common among older patients, women and blacks. These groups were more likely to have had previous open-heart surgery and to have had multiple chronic illnesses such as diabetes, high blood pressure and markedly elevated cholesterol.

The key to reducing heart attacks is simple and proven: prevention. With compulsive screening for risk factors and treatment when appropriate, we can reduce the incidence of heart attacks and potentially save millions of American lives. Fortunately, screening for risk factors of heart attacks is relatively simple. From age 30 on, measure your blood pressure annually. Measure your cholesterol levels every five years until age 50, and more frequently thereafter. Live a heart-healthy lifestyle that includes exercise, eating right and controlling stress. If you have had a heart attack, make sure that all risk factors are treated and that your physician prescribes aspirin, a beta blocker and ACE inhibitor. (If he doesn't use this course of therapy, ask why.)

Though a heart attack used to be considered a "man's problem," it is rapidly becoming a woman's illness. Women must be carefully screened for risk factors, and education must continue to help all women understand the unique signs of a heart attack.

Currently, risks for heart disease, high blood pressure, elevated cholesterol and diabetes are higher in blacks. Therefore, we must do everything possible to reduce disparities in care and help all Americans live healthier lives.

Finally, and perhaps most importantly, these studies show the benefits of belonging to a health system where care is coordinated and preventive strategies emphasized. To continue to reduce the risk of heart attacks, this kind of health care must be available to everyone.

Dr. David Lipschitz is the author of the books, "Breaking the Rules of Aging" and "Dr. David's First Health Book of More Not Less." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.

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