These prevention efforts appear to have paid off. Over the study period, the heart attack rate declined from 274 to 208 cases per 100,000 people, a decrease of 24%. The percentage of people who died within 30 days of a heart attack also declined by 24%.
Meanwhile, the rates of a severe and often deadly form of heart attack in which a coronary artery is fully blocked—known as an ST-segment elevation heart attack—also decreased, from 133 to just 50 cases per 100,000 people.
“Differences in the patients themselves did not explain what we were finding, so the remaining explanations could be differences in types of care,” says Dr. Go, referring largely to preventive care.
That’s great news for the members of Kaiser Permanente Northern California. What about for the rest of us?
The outlook isn’t nearly as positive in some other regions and populations, says Jeremiah Brown, PhD, an instructor at the Dartmouth Institute for Health Policy and Clinical Practice, in Lebanon, N.H., and the co-author of an article on heart disease trends accompanying Dr. Go’s study.
While heart attack rates were falling among the people in the study, Brown points out, rates of diabetes and obesity continued to climb across the nation as a whole. “We are still facing an epidemic that is causing a gradual-to-rapid increase in heart disease-related deaths,” he says.
And heart disease is not equally distributed across the U.S., Dr. Pearson notes. Southeastern states, and especially the regions lining the Mississippi and Ohio River Valleys—a swath collectively known as “Coronary Valley”—are among the hardest hit, he says.
Though the population in the study isn’t representative of the nation as a whole, the findings do highlight the changes that need to be made to heart disease care, Brown says.
Right now the American health-care system is largely “reactionary,” he says. “We do an excellent job of treating heart attacks and a relatively poor job of prevention.”
If the health-care system can transition from “dealing with problems” to “creating sustainable lifestyle changes in our communities,” Brown adds, “we can prevent the onset of chronic illness in our country beyond that of heart disease alone.”
