Community commitment to preventive care credited with California slashing heart attack rate

"If every American got the same level of care, we would avoid 200,000 heart attacks and stroke deaths in this country every year," said Dr. Robert Pearl, executive director and CEO of the Permanente Medical Group, regarding a miraculous drop in the number of heart attacks suffered by the organization's Northern California patients over a 10-year period during which providers focused heavily on reducing the community's risk.

The study, published in today's issue of the New England Journal of Medicine, showed that the heart attack rate among Kaiser patients fell 24 percent between 1999 and 2000, increased briefly from 1999 to 2000 and declined every year after that. The most serious form of heart attacks--ST-segment elevation heart attacks--fell 62 percent.

During this time span, more Kaiser patients lowered their blood pressure and cholesterol levels, and quit smoking, while more at-risk patients began using beta-blockers and aspirin.

"Researchers keep trying to find more ways to treat heart attacks, but we need to focus just as much attention on things that we know work now, and doing those things on a large scale: adopting healthier lifestyles, stopping smoking, taking medications," said Dr. Alan Go, an author of the study and director of the Comprehensive Clinical Research Unit at the Kaiser Permanente Division of Research in Oakland.

Though better understanding of risk factors had led to dropping heart attack rates nationwide for the past 20 years, the Kaiser study is one of the largest and most diverse in terms of age, race and sex. And the sharp drop in the more serious ST-segment elevation heart attacks came as a pleasant surprise to much of the medical community.

"That was really good news, because it suggests that the prevention things we're doing are really working, especially in terms of these events that really kill people," Dr. Michael Crawford, chief of clinical cardiology at UCSF Medical Center, told the San Francisco Chronicle. "It's hard for people to see on a personal level what preventative therapies are doing for them. By looking at the population, this really demonstrates that we're actually making headway."

To learn more:
- read this HealthDay article via U.S. News & World Report
- see this piece in the San Francisco Chronicle
- view the abstract in the New England Journal of Medicine