Why Is There a Reduction in Heart Attack Deaths in United States?

When heart attack victims are admitted into hospitals, the doctors therein might have different alternatives to treat their patients. For example, they could use angioplasty to clear out clogged arteries, perform heart bypass surgery, or prescribe medications to lower the cholesterol levels, reduce clotting and regulate heart beat. As such, the success rate of treating these patients could vary widely among various hospitals.

According to a study that was published on August 18, 2009 in the Journal of the American Medical Association, there has been a noticeable reduction in heart attack deaths over the period between 1995 and 2006 as a result of clearer United States guidelines on how to treat elderly heart attack patients.

The researchers from the Yale University School of Medicine in Connecticut found a reduction of 3 percent in the number of patients who died within a month of having a heart attack after the introduction of clearer standards on treatments by Medicare.

Medicare is a social insurance program administrated by the United States government to provide health insurance coverage to people who are of 65 years old and above or who meet other special criteria.

In 1990, the American College of Cardiology and the American Heart Association published joint guidelines on which care was suitable and when. 2 years later, Medicare followed the guidelines.

The researchers studied the records of 2.7 million patients discharged from 4,000 hospitals after having heart attack between 1995 and 2006, and found that among Medicare beneficiaries, there was 1 additional patient survive at 30 days for every 33 patients admitted in 2006 compared with 1995.

The 30-day mortality rate decreased from 18.9 percent in 1995 to 16.1 percent in 2006, and in-hospital mortality decreased from 14.6 percent to 10.1 percent,

Meanwhile, they also discovered that a lot less variation in death rates among the hospitals. Such finding might support the argument that healthcare reform efforts should include more standardized guidelines on patients’ care.

The cause of the reduction has yet to be determined with certainty. Nevertheless, the finding of this study might have already reflected one thing: individuals and organizations dedicated to improving health care during the period begin to see some positive and encouraging results.

Back in 1995, 24 percent or more of heart attack patients died within a month after being treated at 39 hospitals.

Is The Number of Young Diabetics Rising in Asia?

Diabetes mellitus, more often referred to as diabetes, is a condition in which the body does not produce enough or properly respond to insulin. Being a hormone produced in the pancreas, insulin has the function of enabling cells to absorb glucose and turning it into energy. When a person has diabetes, the glucose will accumulate in the blood and this will eventually lead to various complications. For instance, diabetes has been identified as a risk factor for heart disease.

There is no doubt that diabetes has turned into a global problem. It is expected that the number of victims will grow from 240 million in 2007 to 380 million in 2025.

In Europe and North America, overweight and obesity have long been thought to lead to Type-2 diabetes. However, a study, published on May 27, 2009 in the Journal of American Medical Association, reported that the number of diabetics is rising in Asia affecting those who are relatively young and less likely to be struggling with obesity, unlike in the West.

Based on the figures from the International Diabetes Federation, more than 60 percent of diabetics will reside in Asia, the fastest growing region in the world. Countries with low- and middle-income will face the hardest hit. The number of diabetics will grow from 40 million to nearly 70 million in India; 39 million to 59 million in China; and 3.8 million to 7.4 million in Bangladesh.

While the trends of diabetes could be influenced from genetic makeup and cultural differences to smoking and degrees of urbanization, the most startling result was still related to body mass and age.

Despite lower obesity rate, the waistlines of Asian population keep expanding as a result of rapid economic development, changing diets and more sedentary lifestyle. Expanding waistline is considered to be harmful to diabetes. This is because fat around the abdomen stores excess energy and releases chemicals that control metabolism and use of insulin.

Although people across Asia generally have lower body mass index (BMI), which is the ratio of weight (kg) divided by the square of height (cm), they can have a similar or even higher chance of developing diabetes, according to the study.

The Number of Diabetics Rises In Europe!

According to IDF (International Diabetes Federation), diabetes affects 246 million people worldwide and the figure is expected to rise to some 380 million by 2025.

People should never treat diabetes lightly because it could lead to fatal consequences. Diabetics might have symptoms such as frequent urination, thirst, unexpected weight loss, extreme hunger, and frequent fatigue. If the blood glucose is too high, they can develop comatose.

If the blood sugar level is not controlled effectively, diabetes can lead to blindness, neuropathy (damage to nerves), and even lower-limb amputations. Patients, who also have hypertension (high blood pressure), can have a higher chance of getting kidney failure. Meanwhile, one should not forget that diabetes has been a known risk factor for cardiovascular and heart disease, too.

A study, published on May 28, 2009 in the British Journal ‘The Lancet’, revealed that incidence of Type-1 diabetes in children aged below 5 in Europe is expected to double and those aged below 15 will increase by 70 percent by 2020 over the 2005 levels.

Based on diagnosed cases between 1989 and 203, the researchers warned that the trend will be highest in the former Communist countries of Eastern Europe. The dramatic increase could be attributed to genes as well as the modern lifestyle habits.

In general, there are 2 types of diabetes, namely Type-1 and Type-2 diabetes. Type-1 diabetes generally begins during childhood and early adolescence. The immune system destroys cells in the pancreas that make insulin, and this does cause the glucose level in the blood to rise dangerously. Insulin is the hormone, which breaks down glucose into other forms of energy.

A mix of genetic vulnerability and environmental factors, such as increases in weight and height, less exposure to early infections in childhood and delivery by caesarean, might cause such disorder, according to health experts.

On the other hand, Type-2 diabetes occurs when there is insufficient insulin or cells become insensitive to the insulin that is produced. It is closely linked to chronic obesity, resulting from sedentary lifestyles and the consumption of sugary and fatty foods. The number of Type-2 diabetics is far more than Type-1 diabetics.

How Can Recession Obesity Affect The American Children?

In 2008, a study published in the Journal of the American Medical Association (JAMA), reported that nearly 32 percent of American children were overweight and 16 percent were obese.

Meanwhile, between 1980 and 1999, the obesity rate had tripled and this no doubt had created an epidemic. Poor diet that is heavy on fat and sugar with little consumption of fruits and fresh vegetables, and lack of exercise were blamed to be responsible for such phenomenon.

Obese children not only have a higher chance of becoming obese adults but are also at a higher risk of developing heart disease, high cholesterol and Type-2 diabetes.

Now, there is another possible force, which in the opinion of researchers, will help increase the obesity rate. Researchers from Duke University argued that the prevailing economic downturn would probably put American children at risk of ‘recession obesity’.

‘Recession obesity’ is a term for unhealthy side effects of people who lose their jobs and health insurance, then drop their gym memberships, delay medical treatment, and eat cheaper but less healthy meals. As fast food is cheap and filling, its consumption is on the rise during the economic downturn. The researchers fear that parents would substitute for their children fast food, high carbohydrate and high sugar-content food for healthy food. This would surely cause an uptick in the rate of overweight children and adolescents.

After analyzing dozens of indicators, the researchers compiled the 2009 Child Well-Being Index. The index tracks how American children are faring socially, emotionally, in terms of education and health. It aims to assess how American children are faring today, comparing their current situation with the past. They also project what these children might face in the future. This year’s index includes a special report on the impact of the current recession on the American children.

Is Endoscope Really Harmful For Heart-Bypass Patients?

During heart bypass surgery or what is also known as coronary artery bypass surgery, heart surgeons have to remove a blood vessel from the heart disease patient’s chest or leg and attach one end to the aorta and the other end to the coronary artery below the point where it is clogged. By doing so, the blood can then flow through the new vessel to the heart muscle the way it should. Aorta refers to the large artery coming out of the heart.

Data showed that the leg veins of about 70 percent of the bypass patients are being removed by endoscopes. The main reason is that it produces much less scarring and infection to the leg than the traditional method known as ‘open harvesting’, a technique that remove vein by directly cutting along a stretch of the leg.

Endoscopes have widely been used for various procedures and were utilized for vein harvesting for 13 years. Endoscopes are little cameras, which can be inserted, sometimes with surgical instruments, via a small incision in the skin.

Meant to be less invasive and gentler, the endoscopic technique of removing leg veins appeared to damage the veins and lead to heart attack, and in fact, it would cause patients 52 percent more likely to die within 3 years.

The study of 3,000 patients by researchers from Duke University Medical Centre in Durham, North Carolina reported on July 15, 2009 in the New England Journal of Medicine that veins removed by the endoscopic technique were significantly more likely to become clogged within a year or so.

Measurements at the end of 12 months and 18 months showed that 47 percent of the patients had at least 1 of their bypass grafts fail, while only 38 percent for those using older method of removing veins. Most patients had 2 or 3 grafts.

At the end of 3 years after the heart surgery, patients whose leg vein was removed using endoscopes had 38 percent higher risk of death or non-fatal heart attack. For death rate alone, the risk was 52 percent higher: 128 of the 1,753 patients with endoscopic technique died, as compared with only 71 died of the 1,247 patients who had open harvesting.

As stipulated in the report, though ‘open harvesting’ is no doubt more invasive and associated with more wound complications, it might be less traumatic to the vein and could result in a better conduit. After listening to the pros and cons of both techniques, most patients still prefer to adopt endoscopic technique, as patients rather choose the short-term benefits over the possible the long-term risks.