Improvement in Heart Attack Incidence and Outcomes Over the Past Twenty Years

The story of the past few decades has been a steady reduction in the incidence and mortality of the major age-related diseases that dominated old age in the last century. This has been a strange triumph, in the sense that it was achieved using very inefficient strategies for medical research and development, coupled with an aggressive push towards prevention through lifestyle choice. At no point were the causes of aging deliberately targeted; instead medical efforts focused on tinkering with the downstream consequences of the late disease state. That this combination nonetheless achieved the results that it did is a testament to the dedication of researchers and clinicians. Imagine how much could be achieved given a better research and development strategy, one capable of producing rejuvenation via repair of the causes of aging.

Heart attack prevention and outcomes have dramatically improved for American adults in the past two decades. Compared to the mid-1990s, Americans today are less likely to have heart attacks and also less likely to die from them. Tracking more than four million Medicare patients between 1995 and 2014, this is the largest and most comprehensive study of heart attacks in the United States to date. Its two key findings are that hospitalizations for heart attacks have declined by 38%, and the 30-day mortality rate for heart attacks is at an all-time low of 12%, down by more than a third since 1995.

The researchers believe these gains are no accident. The last 20 years have been marked by national efforts to prevent heart attacks and improve care for those who suffer them. The Centers for Medicare and Medicaid Services, the American College of Cardiology, and the American Heart Association - along with other organizations and "legions of researchers and clinicians and public health experts" - have focused on reducing risk by promoting healthy lifestyles, addressing risk factors, and improving the quality of care.

While the study tallies the impressive overall gains, it also sheds light on the health outcome disparities in America on a county by county basis. "Priority health areas," which were previously identified as lagging areas, saw little or no change in their 30-day mortality rates following heart attack in the past two decades - indicating that they should receive particular attention in future healthcare improvement activities. "We are now at historic lows in the rates of heart attacks and deaths associated with heart attacks. However, this is no time to be complacent. We document extraordinary gains - but the effort is far from finished. The goal is to one day relegate heart attacks to the history of medicine."



Its great progress, a 38% decline in hospitalizations for heart attacks from 1995 to 2014. Talking just in linear terms that is ~2% a year decline. I will have to read through the study, I am assuming they adjusted for age.

Ultimately with the circulatory system we want to restore a persons heart and arteries to a youthful state of function. Even if that person has sustained a lot of damage throughout their life.

Posted by: aa3 at March 18th, 2019 7:02 AM

Statins made a big difference and with the novel psck9 inhibitors you can even see plaque regression. The question is should you take pcsk9 inhibitors even if you are not at risk (defined by the medical establishment), when it comes to ldl lower seems better. My doc refuses, I probably wait till the big studies for the anti-sens and RNAi pcsk9 inhibitors come out, you have to inject them less frequently and they work even better.

Posted by: Tom at March 18th, 2019 1:07 PM

I like the way Mr. Reason quietly but clearly points out that Medical Science today is still mostly not focusing on the FUNDAMENTALS when it comes to scientific research to preserve human health.

Posted by: Zan at March 23rd, 2019 1:38 PM
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