Rate of heart attacks has been declining, but increase in obesity poses a threat to progress
When World Heart Day takes place Sept. 26, it will celebrate the real progress that is being made in the battle against cardiovascular disease, which claims 17.1 million lives worldwide each year and is the world's leading cause of death.
Created by the World Heart Federation, World Heart Day is focused on spreading the message that at least 80 percent of premature deaths from heart disease and stroke could be avoided if risk factors such as smoking, unhealthy diet, and physical inactivity were controlled. Doing so requires more than medical intervention; it requires taking personal responsibility for eliminating the habits that can lead to cardiovascular disease.
For World Heart Day 2010, the World Heart Federation outlined 10 simple steps that individuals can take to live and work healthier (see sidebar).
The encouraging news is that the rate of heart attacks appears to be declining.
A study in the June 10 issue of the New England Journal of Medicine found a 24 percent decrease in the rate of hospitalization for heart attacks between 1999 and 2008 among enrollees age 30 and older in the Kaiser Permanente Northern California health system. A study in the March 23 issue of Circulation revealed a 23 percent decrease in the rate of hospitalization for heart attacks among Medicare fee-for-service patients between 2002 and 2007.
Researchers with the latter study attributed the decline in heart attacks partly to improvements in the management of cardiovascular risk factors with respect to decreasing prevalence of hypertension, high cholesterol, and smoking.
Dr. James H. Brandt, a trustee of the AVMA Group Health and Life Insurance Trust, said, "These are many of the very risk factors targeted by the prevention benefits GHLIT offers to plan participants."
Most GHLIT health insurance plans cover 100 percent of the cost of an annual adult physical, up to $300, including hypertension, cholesterol, and diabetes screenings. The GHLIT also sponsors the Wellness Center each year at the AVMA Annual Convention, where eligible attendees have access to free screenings that can identify potential cardiovascular problems and monitor chronic conditions that can increase the risk for heart attack or stroke.
Mortality rates for heart attacks also appear to be declining. A study in the Aug. 19, 2009, issue of JAMA, the Journal of the American Medical Association, found that the hospital-specific 30-day risk-standardized mortality rate for Medicare patients who had a heart attack decreased from 18.8 percent in 1995 to 15.8 percent in 2006. Researchers credited the decline partly to widespread use of aspirin, introduction of new medications, and other medical advances.
Despite these decreases in the number of heart attacks and the mortality rates, cardiovascular disease remains the nation's top killer, and much work remains to be done. A study in the Oct. 26, 2009, Archives of Internal Medicine found that the proportion of women ages 35 to 64 who reported a history of heart attack increased from 0.7 percent between 1988 and 1994 to 1 percent between 1999 and 2004.
One factor contributing to heart attacks is the growing prevalence of obesity and its companions, diabetes and metabolic syndrome. Experts warn that unless these and relevant risk factors are brought under control, the progress made against cardiovascular disease will be reversed.
In the June report "F as in Fat: How Obesity Threatens America's Future 2010," the Trust for America's Health and Robert Wood Johnson Foundation noted that 28 states had a statistically significant increase in adult obesity rates when comparing 2006-2008 data with 2007-2009 data. More than two-thirds of states have adult obesity rates above 25 percent, and nearly one-third of children ages 2 to 19 nationwide are obese or overweight.
"As troubling as these trends are, they can be reversed if we all take the time to incorporate even a few of the World Heart Federation's 10 steps for a healthier life. Those actions, coupled with taking advantage of the wellness benefits available through the GHLIT, can have a significant impact on a veterinarian's risk for developing cardiovascular disease or stroke," Dr. Brandt said.
Information on GHLIT's benefits is at www.avmaghlit.org. New York Life Insurance Co. underwrites the GHLIT insurance program. Veterinarians and veterinary students can obtain more information—including plan details, rates, exclusions, limitations, eligibility, and renewal provisions—or find a GHLIT agent by calling the Trust office at (800) 621-6360.