Heart attack risks lowered death rate

Heart attack study provides amazing results: The more risk factors a patient has, the higher the likelihood that he will survive

11/18/2011

A new US study by scientists at the Center for Cardiocascular Prevention in Lakeland, Florida, has shown amazing results: Heart attack patients have a greater chance of surviving the more risk factors they have. Risk factors include diabetes, high blood pressure, elevated blood lipid levels, smoking and family history. Researchers can only speculate about the reasons.

More than 540,000 heart attacks were examined
The researchers around John Canto evaluated data from the US National Register of Heart Attacks (NRMI) from 542,008 patients in the study. These were first-heart infarctions, which occurred from 1994 to 2006. Of these, 50,788 died in clinics. The factors studied included the onset of diabetes, hypertension and elevated blood lipid levels, as well as smoking and family history. The researchers found that 85.6% of patients had at least one risk factor. Only 14.4% of those affected had no risk factors.

The mean age of the patients, with all five risk factors, was almost 57 years. Patients without a risk factor were on average about 72 years old when they suffered the heart attack. 14.9% of the risk factor-free patients died of infarction while only one in ten did not survive with a risk factor. The death rate was 7.9% for two risk factors, 5.3% for three risk factors, 4.2% for four risk factors and only 3.6% for five risk factors.

The cause of the onset of a heart attack is a blood clot in a narrowed part of the coronary artery. The resulting circulatory disturbance kills parts of the heart muscle. In most cases, the patient expresses severe pain in the arm, chest or back and suffers from respiratory distress. As a result of these symptoms, most patients usually seek immediate medical attention. In some cases, however, the person feels only a slight pain or other mild symptoms that he does not interpret as a serious condition. If not treated promptly, delayed therapy is often unsuccessful.

Paradoxical result
The more risk factors a patient has, such as the metabolic syndrome - factors that increase the risk of having a heart attack - the greater is its chance of surviving the heart attack. Eckart Fleck, Director of Cardiology at the German Heart Center in Berlin, told Spiegel Online: "This is really a surprise: there is only a small group of people without risk factors, but infarcts are obviously more dangerous for them." About the causes of the paradoxical result can only be speculated. For example, factors such as age or body weight were excluded to exclude both criteria as causes. The result remained the same.

in the „The Journal of the American Medical Association“ (JAMA), the researchers wrote that possibly medications, e.g. Beta-blockers or cholesterol-lowering agents, which patients had to take because of their risk factors, could be responsible for the lower mortality rate in these patients than in patients who had no risk factors. However, some researchers point out at the end of the article that they have been financially supported by pharmaceutical companies.

Another reason for the amazing result could be that patients who are already preoccupied with risk factors respond faster to physical discomfort than previously healthy patients. Eckart Fleck comments on the possible causes as follows: „If a heart repeatedly receives too little oxygen, as is the case with patients with arteriosclerosis, it can become partially used to the shortage. On the other hand, if a single vessel of an otherwise heart-healthy person suddenly clogs up, the consequences may be more severe. "

Preventive measures against heart attacks
The study indicates that patients with risk factors more often survive a heart attack than those without risk factors. However, these factors increase the risk of having a heart attack. Preventing the metabolic syndrome - elevated blood lipid levels, diabetes (insulin resistance), obesity and high blood pressure - contributes to a balanced diet and exercise. A research team led by Demosthenes Panagiotakos from Harokopio University in Athens found out in a comprehensive meta-study that Mediterranean diets have a particularly positive effect on the metabolic syndrome, preventing coronary heart disease. Mediterranean food includes lots of fruits and vegetables, low-fat dairy products, lean meats, fish, whole grain cereals and olive oil. For example, the proportion of unsaturated fatty acids in olive oil is beneficial for metabolism, Demosthenes Panagiotakos reports „Journal of The American College of Cardiology“. (Ag)

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