The death rate from heart attacks in England halved in the eight years between 2002 and 2010, new data show.
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Overall, just over half of the decline is attributed to a fall in event rate and just less than half to a decline in case fatality, so advances in both primary prevention and secondary prevention appear to have contributed.
The latest data come from a study conducted by researchers led by Kate Smolina (Unit of Health-Care Epidemiology, Oxford), who used national hospital and mortality data to identify 840,175 patients who had suffered a myocardial infarction (MI) during the eight year period.
The standardised mortality rate from MI decreased in men from 78.7 to 39.2 (38.6 to 39.9) per 100,000 population and in women from 37.3 to 17.7. A declining mortality rate was seen in all age groups and for both sexes. The greatest rates of decline occurred in men and women aged 65-74 and the lowest in those aged 30-54 and 85 and older.
The authors suggest that the rising rates of obesity and diabetes may be potential contributing factors to a levelling of event rate in younger people. “These findings support previous reports of a flattening and a possible reversal in coronary heart disease mortality rates in young adults… and reinforce the importance of monitoring and managing risk factors in this population,” they write (BMJ 2012;344:d8059).