Population-based prevention credited for 15 year decline in heart attack rates for Kaiser members

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The rates of heart attacks among health plan members of Kaiser Permanente — based in Oakland, Calif. — declined by 23 percent from 2008 to 2014, according to recent study published in the Journal of the American College of Cardiology. The results build on a previous Kaiser study published in 2010 in The New England Journal of Medicine that displayed a 24 percent decline in heart attacks from 1999 to 2008.

For the most recent study, researchers examined heart attack rates by severity, age, gender and diabetes status. Researchers detected a decline across all subgroups, including both high-risk and low-risk patients.

"This persistent reduction in the risk of heart attack is a testament to Kaiser Permanente's ongoing primary and secondary prevention efforts at a community level," said lead author Matthew D. Solomon, MD, PhD, of the Division of Cardiology at Kaiser Permanente Oakland Medical Center. "We have implemented systemwide programs for the management of blood pressure and cholesterol, diabetes, and other chronic illnesses, which has resulted in nation-leading reductions in heart disease among our members."

The primary difference in the two time periods studied is the type of heart attacks making up the bulk of the decline. For the first time period, 1999 to 2008, severe heart attack rates decreased by 62 percent. While the second time period built on that progress with a 10 percent reduction in severe heart attacks — increasing the overall reduction of severe heart attacks from 1999 to 2014 to 72 percent — the occurrence of less severe heart attacks displayed its greatest decline from 2008 to 2014. The rate of less-severe heart attacks peaked in 2004, but underwent a reduction of 33 percent by the end of 2014.

"While the decline in severe heart attacks across our population has been astonishing, we now see consistent declines in all types of heart attacks," Dr. Solomon said. "Reductions in less severe heart attacks, which are nearly four times as common as the severe heart attacks, drove the bulk of the recent decline. But what is most heartening is that these reductions were consistent across every demographic and risk group we examined."

The most recent study identified a total of 29,087 out of 4 million patients who experienced acute myocardial infarction.

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