University of Western Australia: Study examines reason for decline in death rates after heart attack

The University of Western Australia has collaborated on a new study which examines whether prevention or improved treatment is responsible for a decline in heart attack deaths over the past four decades.

Dr Lee Nedkoff, from the Cardiovascular Research Group at UWA, was co-lead author of the international comparative study of 1.95 million heart attacks in 80.4 million people in four countries published in The Lancet Public Health.

“This is the first study since the WHO’s MONICA study in the 1980s and 1990s to investigate whether improvement in prevention or treatment are driving reductions in death rates from heart attacks on an international comparative scale,” Dr Nedkoff said.

Data from England, New Zealand, Ontario (Canada) and New South Wales (Australia) found there were differences in falling fatality rates depending on country, age and sex.

In the NSW data, treatment improvements contributed to 54 per cent of the reduction in heart attack death rates in men, whereas in women prevention had a bigger effect (60 per cent).

In England, declining heart attack rates were driven by improvements in treatment, while in Ontario and New Zealand, prevention had a much bigger effect on falling rates.

“Our study shows that each country needs to understand its own patterns, to know where to target public health and treatment resources,” Dr Nedkoff said.

Importantly the study found there were limited improvements in prevention of heart attacks in women aged under 55 years. This is in contrast to all other age groups, and men in the same age group, where the rate of heart attacks are falling.

“We now have consistent data that heart attack rates in women are not declining at the same rate as in all other age groups, and in some cases, are increasing,” Dr Nedkoff said.

“While we have very effective treatments now for heart attacks, we need to do more to target younger women, who have historically been considered to have lower cardiovascular risk.”