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Deaths from stroke and heart disease are down

Published 2:43 pm, Wednesday, August 20, 2014

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  • Steve Horowitz MD, the interim director of cardiology at Stamford Hospital, poses at Tully Health Center in Stamford, Conn., on Wednesday, Aug. 20, 2014. A recent study shows heart disease is on the decline. Photo: Jason Rearick / Stamford Advocate
    Steve Horowitz MD, the interim director of cardiology at Stamford Hospital, poses at Tully Health Center in Stamford, Conn., on Wednesday, Aug. 20, 2014. A recent study shows heart disease is on the decline. Photo: Jason Rearick

 

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At a glance
Here are a few key facts about a Yale University School of Medicine study showing that hospitalizations and deaths from heart attack and stroke are on the decline.
Study examined data on more than 34 million Medicare patients 65 and older.
Between 1999 and 2011, the rate of hospitalization for heart attack dropped by 38 percent.
During that time, rate of hospitalization for unstable angina fell 83.8 percent; hospitalization for heart failure fell 30.5 percent and ischemic stroke hospitalization fell by 33.6 percent.
The research also showed that the risk of dying within a year of being hospitalized for unstable angina dropped 21 percent and the risk of dying from a heart attack fell 23 percent. The risk of death from both heart failure and stroke declined by 13 percent.
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Hospitalizations and deaths from stroke and heart disease dropped significantly in the past decade -- more so than for any other condition.

That's according to a new study from the Yale School of Medicine, which examined data on more than 34 million fee-for-service Medicare patients 65 and older. Researchers found that, between 1999 and 2011, the rate of hospitalization for heart attack dropped by 38 percent and the rate of hospitalization for ischemic stroke fell 33.6 percent.

The risk of dying within a year of being hospitalized for a heart attack fell 23 percent, and the risk of death from stroke a year after hospitalization fell 13 percent.

The study's lead author Dr. Harlan Krumholz said, given such factors as increased public awareness of heart attack and stroke risks and better hospital care, it's not surprising that outcomes of these illness are improving.

"What we were surprised at was the speed and the magnitude of this progress," said Krumholz, director of the Center of Outcomes Research and Evaluation at Yale-New Haven Hospital. "That it changed so much and this fast was kind of stunning."

Dr. Stuart Zarich, cardiology chief at Bridgeport Hospital, said the Yale research echoes trends he's noticed for years. He said rates of heart procedures, such as angioplasty and bypass surgery, have been on the decline for a while, so a reduction in hospitalizations and deaths makes sense. "The major reason (for these improvements) is the prevalence of really good evidence-based medicine that's reducing the risk of heart attacks," he said.

In addition to the falling rates for heart attack and stroke hospitalization, Yale researchers also found that hospitalizations for unstable angina -- a sudden chest discomfort that can lead to heart attack -- fell by 83.8 percent and the rate of hospitalizations for heart failure dropped by 30.5 percent. One-year survival rates from these illnesses also improved, by 21 percent for unstable angina and 13 percent for heart failure.

Krumholz said researchers looked at hospitalization and death rates for a variety of other illnesses, including pneumonia, kidney injuries and urinary tract infections. They found that rates for all these conditions either stayed flat or improved slightly during the decade studied. Heart disease and stroke were the only ones to show significant improvement.

That's likely because so many changes have been made in treatment of these illnesses over the past decade, Krumholz said.

For instance, he said, heart attack patients are more likely to be treated within 90 minutes of arriving at the hospital -- which improves survival rates -- than they were 10 years ago.

Also, the general public is more aware of how lifestyle choices, such as eating properly and exercising regularly, can help lower the risk of heart disease and stroke. Krumholz also cited improvements in identifying and treating high blood pressure -- a risk factor in many illnesses -- and a decline in smoking for the drop in hospitalizations and deaths.

"We still have progress to make, but it sure feels good" to have come this far," Krumholz said.

Other medical experts in the region echoed his thoughts, including Mark Warshofsky, Danbury Hospital chief of cardiology. "I think it's great news," Warshofsky said. "Obviously, we have made a concerted effort (in this area)." He also mentioned a decline in smoking and other advances as possible reasons for the improvement.

But Warshofsky pointed out that the Yale study only looked at an older population, and said it would be meaningful to examine heart attack and stroke trends in younger people as well.

"We need to make sure that these efforts are effective across all age groups," he said.

At Greenwich Hospital, neurologist Dr. Frederick Nahm said the Yale results confirm what he's suspected for a while about stroke hospitalization rates.

He said he's known for a while that some indicators for heart disease have improved, and he was waiting to hear about similar progress in stroke statistics.

"Stroke is very much like cardiovascular disease," he said. "A lot of the risk factors are the same."

acuda@ctpost.com; 203-330-6290; twitter.com/AmandaCuda; http://blog.ctnews.com/whatthehealth/