Fewer heart attacks are lethal, study finds
DANIEL Q. HANEY
Americans’ heart attacks are becoming smaller and less lethal, probably as a result of healthier living habits and better medicines.
Two studies being presented today show a remarkable decline in the severity of heart attacks in recent years. Even though heart attacks remain an exceedingly common and serious problem, the data suggests that people’s chances of surviving them have increased dramatically.
Heart attack deaths have been declining since the 1960s, and the new reports help explain why. Experts believe that a combination of healthier living habits, better heart medicines and more intense treatment immediately after heart attacks is making them more survivable. “This is very good and encouraging news,” said Melissa Austin of the University of Washington. “But we have got to be vigilant. We can’t assume everything will continue to get better.” The latest data, being presented in Orlando at a conference sponsored by the American Heart Association, shows that heart attacks became less severe between the late 1980s and the early 1990s. Researchers believe this is the continuation of a trend that probably began after heart attack deaths peaked in the United States in 1963. In 1996, 477,000 Americans died of coronary heart disease. According to government statistics, there would have been 1.1 million deaths by then if the rate had stayed at its 1960s high. To help understand the change in heart attack severity, David C. Goff Jr. of Wake Forest University studied 4,900 heart attack victims over eight years in four communities in Maryland, Minnesota, North Carolina and Mississippi. One measurement of a heart attack’s severity is the level of creatine kinase, an enzyme released by damaged heart tissue. Goff found that average peak blood levels of this enzyme fell 5% per year during the study period. In 1987, levels were at least twice the normal reading in 80% of the patients. By 1994, this had fallen to 63%. Goff also found that in 1987, doctors judged three-quarters of the heart attacks to be definite, while the rest were probable. By 1994, the definite heart attacks had fallen to two-thirds. “It’s really good news that the severity of heart attacks is declining,” Goff said. “Less damage is being done, so people will be less likely to become cardiac cripples, unable to live normally because of severe chest pain.” Carole Derby of New England Research Institutes in Watertown, Mass., looked at heart attack trends in two southeastern New England towns between 1980 and 1991. The number of survivable heart attacks went up, while heart attack deaths fell by half. During this time, 6,117 men and women suffered heart attacks. She found that the rate of non-fatal heart attacks increased 37% in women and 25% in men during this period. But the fatal heart attacks went down 50% in women and 47% in men. “People are having less severe heart attacks, and we are getting better at treating them. But the amount of heart attacks is not declining,” Derby said.
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