Wednesday, November 29, 2023

Pleasing development – fewer deaths due to heart attacks etc.

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Cardiovascular diseases are still the number one cause of death. But the death rate has been falling for years, which shows that our lives have become healthier.

Over 30 percent for women and even over 40 percent for men: this is how much the so-called death rate from cardiovascular diseases fell from 2010 to 2019. An astonishing development, but one that fits into a larger picture: “Mortality from cardiovascular diseases has been falling for 40 years, that is a very consistent trend,” says Milo Puhan, director of the Institute for Epidemiology, Biostatistics and Prevention the University of Zurich.

We live healthier lives

In the 1970s, diseases of the heart and blood vessels were still feared bugbears: there were years in which over 40 percent of Swiss succumbed to such diseases – heart attacks, strokes, heart failure.

Air quality has improved greatly, people are moving more and eating healthier.

In 2020, the share of cardiovascular diseases among the causes of death was just under 27 percent. What is the reason for the sharp decline? It’s an interplay of many factors, says Milo Puhan. The most important thing: life has become healthier. “The air quality has improved significantly, people are moving more and eating healthier.”

Passive smoking has also decreased massively. Many people in this country also have cholesterol levels and high blood pressure better under control, thanks to family doctor checks and better medication.

Significant advances in cardiac medicine

In addition, cardiac medicine as a whole has made significant progress in recent years. According to epidemiologist Milo Puhan, it contributed around a third to reducing cardiovascular mortality.

In the last ten years, two new classes of substances have been introduced for the treatment of heart failure, both of which are surprisingly effective.

Lorenz Räber is professor of cardiology at the Inselspital Bern. He says the advances in cardiac medicine are based on several pillars, such as medication. “In the last ten years, two new classes of substances have been introduced for the treatment of heart failure, both of which are surprisingly effective.” Thanks to them, the heart function can now be improved even in those patients who were previously difficult to treat.

Technical achievements

There are also technical developments such as pacemakers and the internal defibrillator, and some surgical methods have also been improved.

“A defective aortic valve no longer needs to be operated on with an open heart using a heart-lung machine; today the procedure is carried out gently and minimally invasively using a catheter,” says Lorenz Räber. Studies have shown that high-risk patients in particular die less often after this procedure.

Biggest advances in heart attacks

The greatest progress has been made in the treatment of heart attacks: the provision of so-called stents, which keep the narrowed blood vessels open, better techniques for operating, the close Swiss supply network with cardiac catheter laboratories, all of this has led to “that today it no longer means that “You die if you have a heart attack at the age of 60,” says cardiologist Räber.

However, even the best heart medicine cannot prevent people from dying. Despite all the progress, cardiovascular diseases remain the number one cause of death.

Heart attack: greater risk in women

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Compared to men, women are more likely to die from a heart attack. The reasons are differences in age and comorbidities, which also make risk assessment in women more difficult. Using artificial intelligence, researchers at the University of Zurich have now developed a new risk assessment that is intended to improve personalized care for women with heart attacks.

In their study, which was published in The Lancet, researchers from Switzerland and the United Kingdom analyzed data from 420,781 patients from all over Europe with the most common type of heart attack. “The study shows, among other things, that established risk models that guide current patient management are less accurate in women,” says Florian Wenzl from the Center for Molecular Medicine at the University of Zurich. Therefore, female patients tend to be undertreated.

With the help of machine learning and data sets from Europe, the researchers have now developed a new type of risk score. This is able to take “gender-specific differences in the risk profile into account and improve the prediction of mortality in women and men,” says Markus Wenzl.

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