Heart Disease Still Public Health Enemy No. 1

But doctors report progress on treatment

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By
HealthDay Reporter

WEDNESDAY, Jan. 16, 2002 (HealthDayNews) -- Heart disease remains the leading killer of Americans, claiming more lives than cancer, Alzheimer's disease, accidents and AIDS combined.

However, a new report suggests doctors are doing a better job than ever of prescribing recommended drugs and following standard treatments.

Even so, there's room for improvement, contends the report, from the American Heart Association (AHA).

"All in all, we're doing a pretty decent job, but we can do better," says Dr. Eric J. Eichhorn, professor of medicine at the University of Texas Southwestern Medical Center at Dallas.

According to the newly released 2002 Heart & Stroke Statistical Update, an estimated 61.8 million Americans suffer from cardiovascular disease -- conditions including high blood pressure, coronary heart disease, stroke, congenital heart defects and congestive heart failure.

In 1999, the diseases claimed 958,775 lives, more than 40 percent of all deaths in the United States.

When medical expenses and lost productivity are taken into account, the AHA estimates that cardiovascular disease will cost the country $329.2 billion this year, up from $298.2 billion last year.

In a new section, the annual report analyzes how often doctors follow recommendations from the National Committee for Quality Assurance.

"By measuring the quality of care based on these standards, we may be better able to allocate our resources in fighting to reduce disability and death caused by heart disease and stroke," AHA President Dr. David Faxon, says in a statement.

The researchers found that 85 percent of heart attack survivors studied in 1999 were prescribed a beta blocker after they had been discharged from the hospital. That number grew from 62.2 percent in 1996.

Beta blockers help the heart function more efficiently, and experts consider them a necessary part of a strong treatment regimen. The AHA estimates that 4,000 lives could be saved each year if 90 percent of patients were prescribed beta blockers.

Eichhorn cautioned, however, that beta blockers aren't appropriate for every patient, especially those who suffer from asthma or extremely low heart rates.

"There are reasons that you can't give [beta blockers] 100 percent of the time," he says. "But certainly we'd love to see 90 percent" of heart attack survivors take them.

"The higher the better, the more lives you save," he adds.

Part of the problem is that doctors who aren't cardiologists may not be as aware of the new research supporting the use of beta blockers. Only during the last decade have the medications become the "standard of care," he says.

The AHA report also found that only 69 percent of patients hospitalized for heart attack, bypass surgery or angioplasty (an operation to clear arteries) were screened for so-called "bad cholesterol" levels within 60 to 365 days after they had been discharged. That number should be 100 percent because doctors have a number of ways to reduce cholesterol levels, Eichhorn says.

"We can reduce your chances of having a stroke or heart attack," he says.

Perhaps the most disappointing numbers in the AHA report came in its analysis of how often doctors advise smokers to quit. The report found that in 1999, only 65 percent of smokers were advised to kick the habit.

The AHA estimates that if that number grew to 73 percent, as recommended by the National Committee for Quality Assurance, an estimated 2.7 million more smokers would get the message about quitting. An estimated 82,000 smokers would actually quit, the association adds.

What To Do: To learn the warning signs for a heart attack, visit the American Heart Association or HeartInfo.org.

SOURCES: Interview with Eric J. Eichhorn, M.D., professor of medicine, University of Texas Southwestern Medical Center, Dallas; American Heart Association's 2002 Heart & Stroke Statistical Update

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