National Study Suggests Heart Attack Severity May Be Declining

WINSTON-SALEM, N.C. -- The severity of heart attacks in the United States is apparently declining, a Wake Forest University School of Medicine researcher told the American Heart Association today. Possible reasons for the decline include increased preventive measures and better treatment for heart attacks.

David C. Goff Jr., M.D., Ph.D., said results from previous analyses of the long-running Atherosclerosis Risk in Communities (ARIC) study show that both in-hospital and out-of-hospital coronary heart disease mortality decreased between 1987 and 1994, paralleling national and international statistics.

Goff, associate professor of public health sciences (epidemiology) focused his analysis on whether severity of heart attacks was declining.

He told the Heart Association's Conference on Cardiovascular Disease Epidemiology and Prevention in Orlando that analysis of a number of heart attack indicators supports the contention that the average size of the infarct -- the area of heart muscle damaged by the heart attack -- decreased over the study period. The smaller the affected area, the smaller the resulting disability.

"These changes may be due to preventive efforts or to improvements in acute treatments," he said. "Primary prevention efforts, like blood pressure and cholesterol control, may have led to lower severity of heart attacks when heart attacks occur."

The widely reported ARIC cohort study involves about 16,000 randomly selected participants in Forsyth County, N.C., Jackson, Miss., Hagerstown, Md. and suburban Minneapolis, Minn. But a second community surveillance component of ARIC involves complete recording of all heart attacks and coronary heart disease mortality in each ARIC community.

Goff studied records of patients between ages 35 and 74 in the ARIC communities who had definite or probable heart attacks between Jan. 1, 1987, and Dec. 31, 1994. Of the 8,807 cases, he focused on 4

Contact: Robert Conn, Mark Wright or Jim Steele
Wake Forest University Baptist Medical Center

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