11,000 UK deaths from poor heart attack care

New research published in the Lancet indicates that thousands of lives could have been saved each year in the UK from heart attacks, but substandard care for victims means that the UK is lagging behind other countries in Europe.

The failure to administer rapid treatment and good quality aftercare has resulted in the loss of at least 11,000 lives in the last seven years, with death rates one third higher than other countries.

The study involved researchers from the UK and Sweden looking at information regarding the care and outcomes of 120,000 heart attack patients across hospitals in Sweden and more than 390,000 in the UK between 2004 and 2010.

Sweden was picked for comparison because its health system is comparable; universally available, receives it’s funding from tax, with no cost at the point of use. Both also have national guidance implemented for heart attack management, although the two countries drastically differ in size with the population in excess of 63 million, whereas Sweden only has a population of between nine and 10 million.

After just 30 days of the occurrence of a heart attack, death rates were discovered to be over a third higher in the UK than Sweden – 10.5% compared with 7.6%.

Over time, the difference in death rates between the two countries decreased, but the UK always had higher mortality, but mortality was always higher in the UK.

Even considering factors like age, sex, the severity of heart attacks, smoking, blood pressure and diabetes, researchers still estimated 11,263 deaths between 2004 and 2010 could have been “delayed or prevented” if patients in the UK had received treatment in the same standard as their Swedish counterparts.

It may also be a concern to learn that the study found patients in Sweden were significantly more like to get quick treatment to help unblock their arteries.

Only 22% of UK patients received balloon angioplasty or stent placements, however a staggering 59% of heart attack patients in Sweden received such treatments.

It gets worse; upon being discharged from hospital, 89% of the Swedish patients were prescribed medications such as beta blockers, with this figure being 11% higher than that in the UK.

Lead author Professor Harry Hemingway, from the National Institute for Cardiovascular Outcomes Research at University College London, said: “Our findings are a cause for concern. The uptake and use of new technologies and effective treatments recommended in guidelines has been far quicker in Sweden. This has contributed to large differences in the management and outcomes of patients.”

NHS England claim that things are improving though, with National Clinical Director for cardiac care, Professor Huon Gray, saying: “The advanced treatment patients now receive in the UK means heart attack death rates have fallen from one in four in the 1970s, to one in 20 now, but we know more needs to be done and we are working hard to further improve survival rates.”

Lack of sleep may be dangerous for the heart

Scientists claim that getting less than seven hours of sleep per night could lead to fatal heart attacks and cardiovascular disease (CVD), and getting enough sleep could just as beneficial as not smoking with regards to heart problems.

The claims come from a study published in the European Journal of Preventive Cardiology. Researchers in the Netherlands analysed the risk of chronic diseases such as heart disease and stroke for over 14,000 men and women in their 20s over a 12-year period.

There were four lifestyle factors that were identified as being ‘positive’ – engaging in exercise, adhering to a healthy diet, only drinking alcohol in moderation, and not smoking. On top of these four key factors, the team of researchers wondered if sleep was also similarly important.

By the end of the study, it was found that the participants who had stuck to all four healthy factors  were actually at a 57% reduced risk of developing cardiovascular disease and had a 67% lower risk of death from events such as suffering a heart attack.

Interestingly, sufficient sleep was found to boost these figures even more. Researchers discovered that with seven or more hours of sleep each night increased the benefit of these  healthy behaviours; now standing at a 65% lower risk of cardiovascular disease  and 83% lower risk of fatal events from occurring.

The researchers state that previous studies have demonstrated a connection between insufficient/poor sleeping habits and cardiovascular disease, however theirs is the first to analyse if sleep – in addition to the other four healthy lifestyle factors – can help to decrease a person’s risk even more.

“If all participants adhered to all five healthy lifestyle factors, 36% of composite cardiovascular disease [heart disease or stroke] and 57% of fatal cardiovascular disease could theoretically be prevented or postponed,” say the researchers, from the National Institute for Public Health and the Environment, Bilthoven, and Wageningen University.

They added: “The public health impact of sufficient sleep duration, in addition to the traditional healthy lifestyle factors, could be substantial,” whilst Lead researcher Dr Monique Verschuren commented: “The importance of sleep should now be mentioned as an additional way to reduce the risk of cardiovascular disease.”

However, before this study causes panic, Doireann Maddock, of the British Heart Foundation, alleviated worries to some extent and says: “This research shows combining a good night’s sleep with other healthy lifestyle choices can reduce your risk of heart disease. But troubled sleepers should not be alarmed – this study doesn’t mean sleepless nights cause heart disease.”

Certain signs of aging could be a predictor for heart disease

A person’s risk of heart disease could be estimated by examining signs of aging such as hair loss or bags around the eyes, claim researchers in from the University of Copenhagen in Denmark. They say such things can be used to determine the true biological age of a person as well as simply a numerical age.

The researchers say that if you have three to four signs of aging such as a receding hairline, baldness (particularly around the crown), earlobe crease or yellow fatty deposits around the eyelid, then you could have a 57% increased risk of a heart attack and a 39% increased risk of heart disease.
They further state that deposits of cholesterol beneath the skin named ‘xanthelasmata’ are one of the biggest signs that can predict the risk for both a heart attack and heart disease. These deposits usually appear as slightly yellow or skin-coloured lumps on the hands or ankles, and are an early sign of familial hypercholesterolaemia (FH).

If you are unfamiliar with this term, it is a genetic defect that affects roughly 1 in every 500 of the population and causes them immediately from birth to be lacking in low-density lipoprotein (LDL) receptors, which get rid of cholesterol from our blood. Because these people have high cholesterol from the moment they are born, they are at great risk from vascular diseases and hardening of the arteries, much earlier than normal. For anybody unfortunately who has FH, usually the most effective treatment is through statin therapy (e.g. Lipitor or Crestor). These medications decrease the production of LDL cholesterol by the liver, which in turn decreases LDL cholesterol blood levels by around 50%. There are around 120,000 sufferers in the UK and only 15% actually know they have the condition. Medical Specialists would advise everybody to visit their doctor who is able to perform a simple cholesterol check. If your cholesterol is abnormally high then they can suggest ways to best manage this, such as through statin medication.

For the recent study analysing heart risks, the Danish researchers looked at 10,885 people over 40 years of age. It was noted that 7,537 had fronto-parietal baldness - where the hairline is receding at the temples. Furthermore, 3,938 were suffering with crown top baldness. In addition, they also found that 3,405 had earlobe creases and 678 people had fatty deposits around their eyes.

A follow-up period was then carried out, spanning an incredible 35 years. The researchers, led by Professor Anne Tybjaerg-Hansen, found that 3,401 people had developed heart disease and 1,708 had suffered from a heart attack.

In the study – presented at the American Heart Association’s Scientific Sessions 2012 – researchers explained how the quantity of greying hair, presence of wrinkles, the type and severity of baldness, and presence of earlobe crease and eyelid deposits were linked to a possible increased risk of heart problems.

Professor Tybjaerg-Hansen, said: “Checking these visible aging signs should be a routine part of every doctor’s physical examination. The visible signs of aging reflect physiologic or biological age, not chronological age, and are independent of chronological age.”

Statins may almost halve the risk of developing liver cancer

Cholesterol-busting statins such as Crestor (Rosuvastatin) and Lipitor (Atorvastatin) are currently prescribed to nearly a tenth (7 million) of the population in the United Kingdom, working their magic by raising good/protective cholesterol (HDL) and lowering bad cholesterol (LDL) and triglycerides. The higher your cholesterol level, the higher the chance of you suffering from a stroke or heart disease and thus increasing the overall risk of having a heart attack due to your arteries being clogged up with the fat-like substance known as cholesterol.

Health experts are continuously exploring the potential of statins though and already in the calendar year it has been found they could be beneficial for asthma sufferers, have been linked to a reduction in stroke occurrences and evidence suggest that even the healthier ones among us may reap rewards from taking them.

Amazingly, yet another study has emerged that shows their mind-boggling potential. This time, it is experts from the University of Milan who have decided to spend time to analyse the health boost that statins can bring-about, and they claim that a daily dose of cholesterol-busters can slash the risk of developing fatal liver cancer.

Researchers at the University collated information from a number of past studies that had focused on both statins and liver tumours. This kind of review of data is referred to as a ‘meta-analysis’ and is generally thought to be more accurate than other methods of analysis as it is collecting together results from a large number of studies in order to reach a more definitive conclusion on a particular medications effectiveness; in this case it is statins.

Their analysis looked at findings from five previous studies and uncovered that by taking statins on a regular basis, that person’s risk of developing a tumour was dramatically cut by an incredible 42% when compared against those who were not taking any form of statin medication.
This may now reinforce the argument of many health experts who have been calling for all people over the age of 50 to be prescribed statins to help stop a wide range of chronic and potentially fatal conditions, even if they are in the ‘low-risk’ category.

It is still not certain specifically how the statins work at offering a barrier against the formation of a liver tumour, and more work may need to be done in the future. In their report, published in the European Journal of Cancer Prevention, the Italian researchers commented: “Liver cancer is the third leading cause of cancer mortality and its rates have recently been increasing in central and northern Europe. This analysis suggests a favourable effect of statins on the disease.”

After seeing the report, Dr Safia Danovi, Cancer Research UK’s senior science information officer, gave his opinions and said: “This is interesting work but it doesn’t mean that cancer patients should start reaching for cholesterol-lowering drugs. Scientists, including our own, are asking whether statins could be used to treat cancer but we’re still a long way from a clear answer.”