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U.S. Reaps Rewards for Reducing Heart Risk

Study finds simple measures sharply reduced deaths of all kinds

TUESDAY, Oct. 2, 2001 (HealthDayNews) -- Doctors spoke, we listened, and the rate of death from heart disease has gone down.

A study appearing in the October issue of the Journal of the American College of Cardiology revealed that, as a nation, Americans have curtailed smoking, reduced cholesterol levels and controlled blood pressure -- and the effects were well worth the efforts.

"Many Americans have made the recommended diet and lifestyle changes, and they have heeded the call in regard to controlling blood pressure, and the results are reflected in both the death rate from cardiovascular disease as well as overall mortality for all causes," says study author Dr. Lee Goldman, chairman of the Department of Medicine at the University of California at San Francisco.

In the 1980s, says Goldman, deaths from heart disease were reduced by 430,000, while all-cause mortality declined by 740,000. And the really good news is yet to come, he adds.

"In some instances, the positive results are not seen right away. It can take time; so as time goes on, these numbers are likely to get even better," says Goldman.

Indeed, future projections based on study analysis show that if we continue to stay on a healthy course, simple lifestyle changes could save a total of 3.6 million deaths from heart disease and reduce overall mortality another 1.2 million by the year 2015.

Among those especially pleased with study results is Dr. Lynn Smaha, the past president of the American Heart Association.

"Studies like this are important because they help people to see that the health recommendations we are making really do work -- not only clinically, but in real life -- and that by making the extra effort, each of us can make a significant difference in our health," says Smaha, who is also the executive vice president of the Guthrie Clinic in Sayre, Pa.

What makes the efforts particularly worthwhile is that, from an economic standpoint, living longer is also cost-effective. In many instances, strategies and treatments necessary to save lives are so cost prohibitive that potentially lifesaving public health recommendations are often tabled.

The new research, however, found that the tools necessary to put these particular health recommendations into place -- including not only public awareness health campaigns but also medications and dietary changes -- are relatively cheap, saving lives without overspending our health care dollars. By 2015, the study says, these changes will cost only $5,400 per year-of-life saved.

"This was an impressive aspect of this study -- it was able to show that cost per person was far below the benchmark of what is considered average spending , and yet good results were achieved," says Smaha.

The study analyzed data from a 10-year period, from 1981 through 1990. The goal was to validate both the impact and the cost-effectiveness of public health strategies to reduce the risk of death from heart disease -- specifically, stop-smoking programs and controlling cholesterol and blood pressure levels.

To make the assessments, researchers relied on computer data extracted from what scientists call the Coronary Heart Disease (CHD) Policy Model, a program that simulates factors involved in heart disease, in this instance in Americans between the ages of 35 and 84.

A series of mathematical calculations then allowed the researchers to analyze changes in blood pressure and cholesterol levels, as well as smoking habits, in Americans over those 10 years. Based on this information, they were also able to project continued activity through 2015.

"We also took into account monies spent on everything from public awareness campaigns to medications that were necessary to control risk factors, and then compared what was spent to what was accomplished," says Goldman.

Most Americans practiced what their doctors preached, and their risk of heart disease went down.

In terms of specific strategies, cholesterol was most often controlled by dietary changes, which researchers say brought about a modest yet significant impact on cardiovascular disease and was considered highly cost-effective. Controlling blood pressure often required the use of medications. Although some of those drugs were expensive, Goldman says they still met the criteria for cost-effectiveness.

Quitting smoking had perhaps the most dramatic effect on our national health profile. It affected "more than just death from heart disease, so it really had an impact," adds Goldman.

Although both Goldman and Smaha say Americans deserve a pat on the back for progress thus far, they also agree that we must continue to strive for greater results if we are to control heart disease.

"I hope that all Americans see that these strategies do work, and they should keep doing them," says Smaha. Hopefully, he adds, those who are "sitting on the fence, deciding whether or not to quit smoking or modify their diet will do so when they realize that the evidence is in. These efforts are being rewarded."

What To Do

If you are one of millions of Americans "still sitting on that fence" and considering making some of the lifestyle changes we now know work, the following links can help.

To learn more about cutting cholesterol in your diet, check the advice of the American Heart Association. The association also has some heart-healthy recipes to reduce cholesterol.

For information on lowering blood pressure, including the latest on diet, exercise and medication, try the National Heart, Lung and Blood Institute or

To find strategies to help you quit smoking, turn to the American Lung Association. Also, the Department of Health and Human Services has a consumer guide to medications that can help.

SOURCES: Interviews with Lee Goldman, M.D., M.P.H., chairman, Department of Medicine, University of California, San Francisco; Lynn Smaha, M.D., Ph.D., executive vice president, Guthrie Clinic, Sayre, Pa., and past president, American Heart Association; October 2001 Journal of the American College of Cardiology
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