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Heart Attacks Becoming Less Severe

March 24, 1999

ORLANDO, Fla. (AP) _ Americans’ heart attacks are becoming smaller and less lethal, probably as a result of healthier living habits and better medicines.

Two studies being presented Thursday show a remarkable decline in the severity of heart attacks in recent years. Even though heart attacks remain an exceedingly common and serious problem, the data suggest that people’s chances of surviving them have increased dramatically.

Heart attack deaths have been declining since the 1960s, and the new reports help explain why.

Experts believe that a combination of healthier living habits, better heart medicines and more intense treatment immediately after heart attacks are making them more survivable.

``This is very good and encouraging news,″ said Dr. Melissa Austin of the University of Washington. ``But we have got to be vigilant. We can’t assume everything will continue to get better.″

The latest data, being presented in Orlando at a conference sponsored by the American Heart Association, show that heart attacks became less severe between the late 1980s and the early ’90s. Researchers believe this is the continuation of a trend that probably began after heart attack deaths peaked in the United States in 1963.

In 1996, 477,000 Americans died of coronary heart disease. According to government statistics, there would have been 1.1 million deaths by then if the rate had stayed at its 1960s high.

To help understand the change in heart attack severity, Dr. David C. Goff Jr. of Wake Forest University studied 4,900 heart attack victims over an eight-year period in four communities in Maryland, Minnesota, North Carolina and Mississippi.

One measurement of a heart attack’s severity is the level of creatine kinase, an enzyme released by damaged heart tissue. Goff found that average peak blood levels of this enzyme fell 5 percent per year during the study period. In 1987, levels were at least twice the normal reading in 80 percent of the patients. By 1994, this had fallen to 63 percent.

Goff also found that in 1987, doctors judged three-quarters of the heart attacks to be definite, while the rest were probable. By 1994, the definite heart attacks had fallen to two-thirds.

``It’s really good news that the severity of heart attacks is declining,″ Goff said. ``Less damage is being done, so people will be less likely to become cardiac cripples, unable to live normally because of severe chest pain.″

Dr. Carole Derby of New England Research Institutes in Watertown, Mass., looked at heart attack trends in two southeastern New England towns between 1980 and 1991. While the number of survivable heart attacks went up, heart attack deaths fell in half.

During this time, 6,117 men and women suffered heart attacks. She found that the rate of nonfatal heart attacks increased 37 percent in women and 25 percent in men during this period. But the fatal heart attacks went down 50 percent in women and 47 percent in men.

``People are having less severe heart attacks, and we are getting better at treating them. But the amount of heart attacks is not declining,″ Derby said.

Goff said that quick administration of clot-dissolving drugs has certainly helped reduce the severity of heart attacks. But this could not explain all of the change seen in the late 1980s.

Doctors believe that reducing such risk factors as high blood pressure, smoking and cholesterol also have played a considerable role over the years.

Dr. Donna K. Arnett of the University of Minnesota is reporting results of the Minnesota Heart Study, which followed risk factors in about 6,700 people between 1980 and 1997.

During this time, men’s cholesterol levels dropped from an average of 212 to 203, while women’s declined from 208 to 201. One-third smoked in 1980, compared with one-quarter in 1997.

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