Lifestyle changes help reduce heart deaths

Healthier eating habits and a decline in smoking has contributed significantly to the drop in heart disease related deaths. A recent study shows that heart disease deaths have fallen by roughly one-half in many industrialised countries sine 1980. Researchers from the University in Izmir, Turkey were not sure whether primary or secondary prevention is more important. Primary prevention refers to the prevention of heart disease in healthy people, while secondary prevention means reducing potentially fatal complications like heart attack in people with diseased heart arteries. The researching team found that primary prevention was responsible for about half of the steep decline in heart disease deaths in England and Wales since 1981, with diet changes and a reduction in smoking getting most of the credit. Primary prevention was four times more effective at preventing deaths as compared with treatment of existing heart disease. Primary prevention works not only because it targets people who are generally healthy, it also encourages smoking cessation and lifestyle changes to cut cholesterol and blood pressure before they rise too high. Medications are also part of preventing heart disease, but they are prescribed only after cholesterol and blood pressure reach high levels. The investigating team used a statistical model that synthesised data on more than 35 million adults in England and Wales. The data came from various sources, including official statistics, national surveys and clinical trials. The researchers found that heart disease deaths fell by 54 percent between 1981 and 2000. The single largest factor was the concurrent 35 percent decline in smoking prevalence. They estimate that this trend prevented nearly 30,000 deaths from heart disease mostly among people who had no known heart problems at the time they quit. There were also more modest dips in adults' cholesterol levels and blood pressure, which resulted in a reduction in heart disease related deaths. For people without existing heart disease, the biggest factor seems to be changes in diet including a higher intake of fruits, fibre and unsaturated fats, and a declining consumption of saturated fats and salt. More than 45,000 deaths were prevented by reductions in smoking, cholesterol and blood pressure and 81 percent of these were among people without recognized heart disease. Thus the findings suggest that lifestyle changes can save more lives, but a stronger focus on primary prevention of heart disease is needed.