Published in the journal Circulation, the study was led by Yale School of Medicine researcher Harlan Krumholz, M.D., director of the Center of Outcomes Research and Evaluation at Yale-New Haven Hospital, and national American Heart Association volunteer. Krumholz said the drop was mainly due to a steady increase in the use of evidence-based treatments and medications, as well as a growing emphasis on heart-healthy lifestyles and behaviors.
Krumholz and colleagues examined data on nearly 34 million Medicare Fee-For-Service patients from 1999 to 2011 for trends in hospitalization, dying within a month of being admitted, being admitted again within a month, and dying during the following year. The team also factored in age, sex, race, other illnesses, and geography.
By the end of 2011, hospitalization rates among all races and areas dropped 38% for heart attack; 83.8% for unstable angina, sudden chest pain often leading to heart attack; 30.5% for heart failure; and 33.6% for ischemic stroke.
The team found that risks of dying for people hospitalized within a year decreased about 21% for unstable angina, 23% for heart attacks, and 13% for heart failure and stroke.
Improved lifestyle, quality of care, and prevention strategies contributed to the decrease, said Krumholz. He and the team also noted improvements in identifying and treating high blood pressure, a rapid rise in the use of statins, marked declines in smoking, and more timely and appropriate treatment for heart attack patients as contributing to the declines in deaths and hospitalizations.
"It is clear that the efforts of the American Heart Association, the American College of Cardiology, and others are helping people avoid premature death and disability," said Krumholz, who is also the Harold H. Hines, Jr. Professor of Medicine (cardiology) and professor of investigative medicine and of public health (health policy) at Yale. "I look forward to seeing how we can produce the same or greater progress in the next decade. We also need to help others around the world to see the path to progress in the places that are seeing great growth in heart disease and stroke."
Other authors on the study include Sharon Lise T. Normand and Yun Wang
Citation: Circulation: doi: 10.1161/CIRCULATIONAHA.113.
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