Heart attack risks lowered mortality rates

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Heart attack study delivers amazing results: the more risk factors a patient has, the more likely they are to survive

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

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

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

The cause of a heart attack is a blood clot in a narrowed part of a coronary artery. The resulting circulatory disorder causes parts of the heart muscle to die. In most cases, the patient expresses severe pain in the arm, chest, or back and suffers from shortness of breath. Because of these symptoms, most patients usually seek medical treatment immediately. In some cases, however, the person experiences only slight pain or other mild symptoms that he does not interpret as a serious illness. If he is not treated promptly, late 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 its chance of surviving the heart attack. Eckart Fleck, Director of Cardiology at the German Heart Center in Berlin, told Spiegel Online as follows: "This is really a surprise. There are only a small group of people without risk factors, but infarcts are obviously more dangerous for them." One can only speculate about the causes of the paradoxical result. For example, factors such as age or body weight were excluded in order to exclude both criteria as the cause. However, the result remained the same.

In The Journal of the American Medical Association (JAMA), the researchers wrote that drugs such as Beta-blockers or cholesterol-lowering drugs that patients had to take due to their risk factors could be responsible for lowering the death rate in these patients than in those who did not have any risk factors. However, some of the researchers point out at the end of the article that they have received funding from pharmaceutical companies.

Another reason for the astonishing result could be that patients who are already burdened by risk factors react faster to physical complaints than previously healthy patients. Eckart Fleck comments on the possible causes as follows: “If a heart keeps getting too little oxygen, as is the case with patients with arteriosclerosis, it can get used to the undersupply in some cases. If, on the other hand, a single vessel of an otherwise heart-healthy person suddenly becomes blocked, the consequences may be more serious. "

Preventive measures against heart attacks The study shows that patients with risk factors survive a heart attack more often than those without risk factors. However, these factors increase the risk of heart attack. A balanced diet and exercise contribute to the prevention of the metabolic syndrome - increased blood lipid levels, diabetes (insulin resistance), obesity and high blood pressure. A team of researchers 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 and thus prevent coronary heart diseases. Mediterranean food includes lots of fruits and vegetables, low-fat dairy products, lean meat in moderation, fish, whole grain cereals and olive oil. The proportion of unsaturated fatty acids in olive oil, for example, is beneficial for the metabolism, reports Demosthenes Panagiotakos in the "Journal of The American College of Cardiology". (ag)

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