Nevertheless, you can check it out yourself, right now. As of February 22, 1997, the document was on the site of the American Heart Association. It is THAT document which is reproduced next below. But, as of December 14, 1997, the document was not available.
However, 10 days later, that document was no longer posted on the web site of the American Heart Association. It can still be found, however, on the site of the American Medical Association, since this data was originally published in the Journal of the American Medical Association.
Below, first, is the document as promoted by the American Heart Association.
Then, there is, at the bottom of this page, an excerpt of the same data taken from the American Medical Association.
Finally, here is a click to the abstract of the actual article in that Journal.
The American Medical Association requires that you register to visit most of their pages. I recommend that you click HERE to register, and then you can click on the next link, below, for the document quoted above.
Here is the extract as it originally appeared in the Journal Of The American Medical Association:
Treatment and Prevention Reducing Coronary Deaths in U.S.
Coronary heart disease prevalence on the rise
CHICAGO--Despite constant messages that diet and exercise can help to prevent coronary
heart disease (CHD), advancements in the management of those who have already developed
CHD are credited with most of the striking decline in coronary mortality from 1980 to
1990, according to an article in this week's issue of The Journal of the American Medical
Association (JAMA).
Maria G.M. Hunink, M.D., Ph.D., from the University of Groningen, the Netherlands; Milton
C. Weinstein, Ph.D., from the Harvard School of Public Health, Boston, Mass., and
colleagues used a computer technique to determine why the number of deaths from CHD
dropped from 1980 to 1990. Data were obtain from a literature review, U.S. statistics,
health surveys, and ongoing clinical trials.
The researchers found that actual coronary mortality in 1990 was 34 percent lower (127,000
deaths) than would be predicted if certain variables remained the same as in 1980.
They write: "Our analysis suggests that only about one-fourth of the decline in CHD
mortality between 1980 and 1990 was owing to primary prevention [such as lower blood
pressure, lower cholesterol levels, losing weight or quitting smoking] ... Most of the
decline [72 percent] was explained by improvement in the management of patients with
diagnosed CHD through risk factor reduction [secondary prevention] and improvements in
treatment."
Improvements in treatment include thrombolysis and primary coronary angioplasty for
patients suffering from acute myocardial infarction (MI, or heart attack), and
lipid-lowering drugs for patients with high cholesterol, according to the researchers.
The researchers found that improvements in low-density lipoprotein (the bad cholesterol)
and high-density lipoprotein (the good cholesterol), whether through diet or medication,
explained one-third of the decline in CHD mortality.
They write: "The potential impact of medications appears to be substantial especially
in patients with diagnosed CHD. The results from the current study indirectly support the
notion demonstrated in other studies that treating hyperlipidemia (high cholesterol) in
patients with diagnosed CHD is probably more cost-effective than primary prevention of
hyperlipidemia."
CHD Prevalence on the Rise
While the number of deaths from CHD decreased from 1980 to 1990, the researchers found the
prevalence of CHD actually increased for men and women of all ages.
They write: "[This] implies a future increase in the financial burden associated with
CHD and the possibility that age-adjusted CHD death rates may start to rise again as the
enlarging pool of prevalent CHD cases remains at risk for CHD death."
CHD is the leading cause of morbidity and mortality in the United States. Information
cited in the study says that about 700,000 patients are hospitalized each year with a
diagnosis of acute MI. About 400,000 people die from CHD each year in the U.S., accounting
for about one-third of all deaths.
CHD costs the U.S. about $80 billion dollars each year, or about 15 percent of the annual
U.S. health care budget.
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