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Senior Citizen Health & Medicine
Lifestyle Changes, Medical Advances Share Credit for
Decline in Heart Deaths
Decrease would be greater had it not been for
increases in obesity and diabetes
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Deaths 1980 and 2003 |
|
|
Heart Disease |
All Causes |
Heart % |
|
2003 |
563,390 |
1,804,373 |
31.2 |
|
1980 |
595,406 |
1,341,848 |
44.4 |
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Centers for Disease Control - Nov.
2006 |
June 7, 2007 Although heart disease is still the
biggest killer in America, the rate of deaths from heart disease have
steadily declined for over 50 years. In 2003, the age-adjusted death
rate for heart disease, the leading cause of death, was 60% lower than
the rate in 1950. A new study says that approximately half the recent
fall in coronary heart disease deaths in the U.S. is due to positive
life style changes and a further half to medical therapies. Most other
recent studies have given most of the credit to advances in medicine.
A report from the Centers for Disease Control
issued late last year, which did recognized the changes in lifestyle,
said, "Factors contributing to the decline in heart disease and stroke
mortality include better control of risk factors, improved access to
early detection, and better treatment and care, including new drugs and
expanded uses for existing drugs."
Heart disease is the number one cause of death in
America, but just because it kills so many senior citizens. Those 65 and
older are the only age group where it is the number one cause of death.
The new research by epidemiologists at the
University of Liverpool and the Heart of Mersey found that a decrease in
smoking, cholesterol, blood pressure and physical inactivity contributed
to the fall in deaths from coronary heart disease, yet this decrease
could have been substantially more had it not been for the increases in
obesity and diabetes cases.
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Approximately 47% of the decrease was attributed to
treatments, including:
● secondary preventive therapies after myocardial
infarction or revascularization (11%),
● initial treatments for acute myocardial infarction or unstable
angina (10%),
● treatments for heart failure (9%),
● revascularization for chronic angina (5%), and
● other therapies (12%).
Approximately 44% was attributed to changes in risk
factors, including:
● reductions in total cholesterol (24%),
● systolic blood pressure (20%),
● smoking prevalence (12%), and
● physical inactivity (5%),
● although these reductions were partially offset by increases in
the body-mass index and the prevalence of diabetes, which accounted for
an increased number of deaths (8% and 10%, respectively).
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Coronary heart disease (CHD) death rates in the
U.S. almost halved between 1980 and 2000. To understand how this fall
occurred scientists combined information on medical treatments with
national changes in the levels of major risk factors, such as smoking
and high cholesterol. The UK has seen similar falls in heart disease,
but this fall is mainly attributed to healthier diets rather than
medication.
From 1980 to 2000, the US death rates for CHD fell
from 543 to 267 per 100,000 population among men and from 263 to 134 per
100,000 population among women. Overall there were 341, 745 fewer CHD
deaths in 2000 than in 1980.
The team found that this decrease was attributed to
reductions in risk factors such as total cholesterol, systolic blood
pressure, smoking and physical inactivity. However, they found that this
reduction could have been 15% more had it not been for an increase in
obesity and diabetes. Approximately half the fall in CHD deaths was also
attributed to medical treatments, including medications for heart
failure and emergency treatments for heart attacks and angina.
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What CDC
Says About Decline in Mortality Rates |
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July 2007 - The latest statistics from the Centers for Disease
Control, which were released late last year, show deaths attributed to
heart disease continue to decline.
In 2003, a total of 2.4 million
deaths were reported in the United States. The overall age-adjusted
death rate was 42% lower in 2003 than in 1950.
The reduction in overall
mortality during the last half of the 20th century was driven mostly by
declines in mortality for such leading causes of death as heart disease,
stroke, and unintentional injuries.
In 2003, the age-adjusted death rate for heart
disease, the leading cause of death, was 60% lower than the rate in
1950. Preliminary data shows it declined 16% between 2000 and 2004,
continuing the long-term downward trend
The age-adjusted death rate for stroke, the third
leading cause of death, declined 70% since 1950.
Heart disease and stroke mortality are associated
with risk factors such as high cholesterol, high blood pressure,
smoking, and dietary factors.
Other important factors include socioeconomic
status, obesity, and physical inactivity.
Factors contributing to the decline in heart
disease and stroke mortality include better control of risk factors,
improved access to early detection, and better treatment and care,
including new drugs and expanded uses for existing drugs.
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Professor Simon Capewell, from the University of
Liverpools Division of Public Health and Trustee at CHD prevention
charity, Heart of Mersey, said: Using a sophisticated computer model
called IMPACT we were able to combine and analyse data on the uptake and
effectiveness of specific cardiac treatments and changes in risk factors
among adults aged 25 to 84 years in the US. Data included results from
trials, official statistics and national surveys.
"We found that CHD death rates halved, and 47% of
the fall was attributed to medical treatments and approximately 44% to
changes in risk factors. Prevalence of smoking, for example had fallen
by 12%. Decreases in physical inactivity however, were offset by
increases in body mass index and diabetes.
Robin Ireland, Chief Executive at Heart of Mersey,
added: We have recently seen similar falls in heart disease here in the
UK. These changes mainly reflect healthier diets, not tablets. However
the increase in obesity and diabetes are a wakeup call. They reflect the
increasing consumption of large helpings of junk food. We need
legislation to encourage food manufacturers and supermarkets to provide
healthier food options.
The research is published in the New England
Journal of Medicine.
Editors Notes:
The University of Liverpool is one of the UK's
leading research institutions. It attracts collaborative and contract
research commissions from a wide range of national and international
organisations valued at more than £100 million annually.
Heart of Mersey is a coronary heart disease charity
primarily funded by Greater Merseysides primary care trusts and local
authorities. It aims, through advocacy, campaigns, information and
research, to co-ordinate a strategic approach to preventing high rates
of heart disease and associated inequalities in Greater Merseyside
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