Estimated read time: 3-4 minutes
This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.
U.S. deaths from heart disease have dropped by half over the last quarter-century, but not everyone is benefiting equally, a new study shows.
A new Mayo Clinic study finds men doing better than women and people in hospitals doing better than those who are treated at home, according to a study of one Minnesota county.
"The main message is that the face of cardiovascular death is changing," says Dr. Veronique Roger, a professor of medicine and epidemiology at the Mayo Clinic College of Medicine in Rochester, Minn. "There is a shift from inpatient location to out-of-hospital deaths, and the overall decline hasn't been experienced in the same way by women as by men."
Her team reported the results in the May 9 issue of Circulation.
The results come from analysis of the 6,378 cardiovascular deaths that occurred in Olmsted County -- where the Mayo Clinic is situated -- between 1979 and 2003. The analysis showed that while the death rate for men fell by 3.3 percent annually, the annual decrease for women dropped by only 2.5 percent per year.
As an epidemiologist, Roger says she had "no direct explanation for the data." It might reflect a lowered awareness among women about cardiovascular disease, Roger says, something that the American Heart Association has been trying to change with a program called "Go Red for Women." The study doesn't capture the possible influence of that effort because it was done in the years before the program began, Roger says.
The difference in in-hospital and out-of-hospital death rates can be partially explained by "the enormous advances in the care of patients with heart attacks, (and) very effective treatments to improve outcome" once people are hospitalized, she says.
There have been fewer advances in emergency treatment for out-of-hospital events, such as the use of defibrillators to start hearts beating again, Roger says.
Dr. Gerald Fletcher, a preventive cardiologist at the Mayo Clinic's Florida branch in Jacksonville, agrees that the smaller rate of decline for out-of-hospital deaths has several possible explanations.
One reason is that "we are not doing enough in the field," says Fletcher, who is also a spokesman for the American Heart Association. "We need more portable defibrillators in public places and more people trained in the use of those devices."
Another explanation is that too many people are not aware of the warning signs of a heart attack, so they don't get to the hospital in time. But the realities of health care costs might also have something to do with the issue, Fletcher says.
Patients are being discharged from hospitals more quickly these days, to keep costs down, he says. "They're out of the hospital when something happens," and that could make a life or death difference, the AHA expert says.
Some other findings of the study are less controversial. For example, the decline in death rates was dependent on age. The annual rate of decline was 3.9 percent for people under 75, 3.4 percent for ages 75 to 84, and 1.5 percent for those 85 and older.
And there was a shift in the kind of conditions causing death.
Fewer people are dying of coronary conditions such as heart attacks and more are dying of other cardiovascular conditions such as high blood pressure and stroke.
The purpose of the study was not to determine why such changes are occurring but to show the changes in detail, Roger says. "The purpose was to raise questions for the next study to answer," she says.
(The HealthDay Web site is at http://www.HealthDay.com.)
c.2006 HealthDay News
