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MI rates falling

Study
Results
Comment

We expend considerable effort in trying to reduce heart attacks. Interventions include exhortation to better lifestyle (smoking cessation, exercise, weight control, and healthy diet) and drugs (including cholesterol reduction and blood pressure control). Feedback is important, particularly knowing that the totality of our efforts is having some beneficial result. An examination of hospital admission rates for myocardial infarction from the whole of Holland [1] is encouraging.


Study

Patients admitted to hospital for first myocardial infarction in 1995 and in 2000 were identified through a national hospital discharge register, and this was linked to a national population register. Admissions were used if they were unique, were first admissions, and were residents in Holland. Incidence rates were calculated using the number of people in the population as the denominator.


Results

The final cohorts included 21,500 admissions for myocardial infarction in 1995, and 19,000 in 2000. The mean age for women was 72 years and for men 67 years. Figures 1 and 2 show the incidence rates by age for women and men respectively. At almost all ages the incidence was lower in 2000 than it was in 1995. In women the overall incidence fell from 106 to 91 per 100,000, a 14% fall. In men the overall incidence fell from 221 to 190 per 100,000, again a 14% fall. The age-standardised incidence fell by 17% for women and 19% for men.



Figure 1: Incidence of hospital admission for first myocardial infarction in women







Figure 2: Incidence of hospital admission for first myocardial infarction in men






Comment

Studies have been showing reductions in myocardial infarction rates in western countries for some years, from the mid-1970s in the USA (Bandolier 119), though it is unusual to see the decrease computed for a whole county. Since 2000, interventions to reduce heart disease have increased, with a much greater awareness of the major impact of healthy lifestyles, reducing smoking rates generally, and much more use of drug intervention, for instance to reduce levels of cholesterol. It is interesting to speculate how much more is likely to be achieved when more recent studies report.

Reference:

  1. HL Koek et al. Decline in incidence of hospitalisation for acute myocardial infarction in the Netherlands from 1995 to 2000. Heart 2006 92: 162-165.

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