Heart attack deaths drop over past two decades
acc.org
acc.org
However data moves pretty slowly. The article linked above for example cuts off in 2020. Whereas most people only got infected in 2022.
https://www.cedars-sinai.org/newsroom/today-young-people-are...
As those death certificates don't mention measles, rubella, flu, or COVID vaccinations, etc. they don't feature in a pure numerical grouping and summary.
If you feel that vaccination status play a part worthy of notice then you are free to pull the data yourself [1] and cross reference those deaths against vaccination status data.
Very few published studies are the be all to end all, they are each at best parts of a greater picture, what this study does highlight is that AMI's trended downwards for almost a decade and then rose as COVID spread.
Clearly there is more work to be down here - as this study signposts.
e.g. more pre-hospital ecgs so patients go straight to the right hospital?
And with those pre-hospital ecgs, more pre-hospital administration of things like ASA and clopidogrel?
Do you know omega-3 fatty acids promote something called reverse cholesterol transport?
https://pubmed.ncbi.nlm.nih.gov/28984832/
I couldn’t take statins because of the side effects. I went on a fish only, no plant oil diet, and my LDL is now 200 and my HDL for the first time my life rose above 35 to 52. To me, the key was getting the omega-3 level way higher than the omega six level and totally eliminating short chain poly unsaturated fatty acids.
Note that I went on this diet, because I actually know my genetics. I don’t recommend anyone do the same thing without knowing what I know.
Diet works and it’s sad people can’t commit to it. And I’m afraid for a lot of people it won’t be the vegetarian diet that is normally prescribed.
Remember as well cholesterol is not the only contributors her heart disease. Oxidative stress plays a large role in damaging, or oxidizing, the LDL to cause the plaques.
https://www.frontiersin.org/articles/10.3389/fphar.2020.6137....
Oxidative stress can be caused by external forces, but also by the lack in proper nutrients, like zinc and B6 and riboflavin, deficiency in those supplements are all linked to greater incidence of heart disease.
I am in my mid-50s and I’ve had no issues so far.
What do you use as a substitute for vegetable oils in your cooking?
You don’t need oil to cook. Your diet will look a lot different, but you certainly don’t need oil to cook.
It’s instructive to remember that two hundred years ago, palm oil/vegetable oil/canola oil/avocado oil/almond oil/etc didn’t exist, nonstick pans didn’t exist, and somehow people could still cook amazing food.
To say it is "just a fitness fad" is dismissing a ton of good research:
Here's to hoping that with the death of the dollar, the "settled science" practitioners lose their bullhorns.
HDL is an antioxidant and this why HDL rules over all:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607861/#:~:tex....
It sounds like 200 is still trouble. Was it even higher before?
Return short, chain fatty acids into long chain fatty acids by four enzymes FADS1, FADS2, EVOL1, and EVOL2.
https://www.mdpi.com/nutrients/nutrients-06-01993/article_de...
I have polymorphisms in FADS1 and FADS2 that slow down the rate of this pathway. By the way, I have Inuit (SAMI) Heritage.
I will not give medical advice over the internet, but if I were you, I would not want to be messing around with anything short of the standards of care given those odds. Statin therapy is a core part of that standard.
Statin adverse effects do exist, but they are found to be quite rare (1-2% prevalence) when assessed for through well designed placebo-controlled trials. Additionally, there are newer statins with fewer adverse effects you could consider. Assuming you truly have FH and truly are statin intolerant (or remain at elevated LDLs despite maximally tolerated statin therapy), PCSK9 inhibitors can be considered. In the US, you would likely qualify for one if these through a good insurance plan, assuming the above criteria are met.
I’m not screwing around, I know my genetics, and I know how reverse cholesterol transport works. I also know keeping oxidative stress at a minimum is probably more important than the level of cholesterol. I actually moved to a location with extremely low air pollution for that very factor. You can’t look at LDL only to understand the risk of heart disease.
I had very good doctors and if they thought I was at risk, they would be telling me what to do because that’s what they always do. But now they say there’s no need for statins and they’re not concerned about my heart disease risk anymore.
Followingdao@proton.me
There’s no clear/satisfactory answer as to why South Asian patients have so much more heart disease, but the evidence does suggest we should be adopting more aggressive targets of risk parameters for them (A1c, LDL, BP, weight, etc.), and the clinical guidelines likely will reflect this in the future.
Human here, can confirm. No source required.
Diet advices actually have been followed, particularly the demonization of dietary fat and its replacement with sugar, and that may be the cause for the increase in T2D and obesity.
Over the past two decades, the number of gyms and fitness centers saw exponential growth to the point where they became ubiquitous, and some workout programs became widely recognized memes. Working out is now socially acceptable, and in some places social pressure tilted to the targeted against those who do not exercise.
Even though diet/exercise changes may not be widely followed, don't you agree that they have been widely adopted?
I’ve seen it a lot: A sports jock at 20-25, gets a manager job and becomes quite unhealthy at 40, much more in US than in, say, France, where gyms arrived much later and there hasn’t been a culture of muscle size in high school/uni until very recently.
Gyms aren't that popular, most people going to gyms aren't doing enough
I was a certified trainer under NASM years ago. It was fairly intensive, but largely nonsense.
This is a huge bummer.
If one wants to get in shape they almost need to make fitness a hobby.
"In shape" is the normal state of a human being. If you want to get in shape you just need to disconnect from the high calorie food supply and eat normal, plus do a bit of walking.
For some reason we have come to believe that everyone is born fat and only lose weight through costly and time consuming interventions.
For that you probably need at least 3h of decent training per week. After you add changing, showers, etc, it's a commitment of 5-6h a week. Quite a hobby. I certainly consider it a hobby.
I think you are not getting the point - being fit was the default since humans mutated from our predecessors, till very very recently. I mean I can't believe I have to explain this to anybody, especially here.
Also, you have incorrect world view on what it means 'being fit' that may be very effectively hindering your motivation to get better. Its definitely not about looks, if somebody is selling it as such they are doing a great disservice. Some people have genes that make their bodies look very different from ripped bodybuilders with 4% body fat, yet if they are very fit can achieve pretty amazing things.
Don't look for external validation, if you are happy in your own body (which being fit brings pretty much guaranteed, some mental disorders notwithstanding) then its all good and you can focus on other amazing things in life, while being happier, living better and longer and so on. Everything is connected.
Whilst it is possible to lose weight by eating a similar diet and increasing exercise you just end up someone who is fitter but still eating what will almost certainly be a poor diet.
Most people are overweight because they have a poor or terrible diet, not because they don't do enough exercise. (Although to be fit or healthy you need to tackle both.)
(Again this is a generalisation. There are many reasons why people are overweight. I am, and I'm changing my diet and the amount of exercise I do to sort this out.)
Genetics matter, we’re not all the same. These generalizations are OK but they won’t mean they will work for you.
30 years ago, so many guys had a bench and cheap weights in their basement that they barely used. Now that group just has a gym membership they barely use. Women had home VHS aerobic workouts they barely did instead of a gym membership they barely use. It has really just reflected the change in gym membership prices. My first gym was $75 a month adjusted for inflation and it was nothing special. The nice Golds Gym that was the alternative was $100 a month adjusted for inflation. It is just easier now to pay $15 a month and not use the gym.
I can't imagine we have a more fit population now. Maybe there is 10% more very fit people in the tail but the median is most likely much less fit.
What I notice most is going for an hour walk at sunset on a beautiful spring night in a nice suburban neighborhood, there is absolutely no one outside. Everyone is inside sitting. When I see a kid they are usually riding a motorized scooter to zoom between places to sit.
You also have to factor in that old people now grew up with so much more physical activity than young people now. I can't imagine the knock on effects of what all this sitting by young people will have once they are old.
When was working out socially unacceptable?
A lot of GPs I’ve talked to are negative on them as they are expensive and they seem to have the mindset “you should just eat better”. But we know that dietary interventions fail like 97% of the time because long term adherence is almost impossible.
1: 112 call to an ambulance
2: Ambulance arrives, takes an ECG and gives aspirin and GTN
3: Paramedics drive to the emergency department
4: ER doctor identifies the patient is having a heart attack, and pages cardio
5: Cardio decide the patient needs a stent and they bring them to an OR to have it fitted.
In each of these steps, the patient could go into cardiac arrest and likely will not survive.
Today it looks more like this:
1: 112 call happens, the call taker follows a protocol that asks the caller to administer aspirin if appropriate while the ambulance is on the way
2: Ambulance arrives, takes an ECG, identifies a heart attack and transmits the ECG to a cardiologist, all while treating the patient
3: Cardiologist thinks the patient would benefit from a stent, so the paramedic begins transporting the patient and administers whatever pre-operation drugs the cardiologist wants (this would normally happen at step 5 in the previous example)
4: Patient is brought direct to the OR (or PPCI as they're specifically called here) where the cardiac team are waiting around the table for the patient
It's so efficient. I'm not up to date with the latest research on this but just the time savings alone must have saved so many lives. Treatment starts far sooner and all unnecessary steps are removed.
source: https://www.reuters.com/article/us-health-diet-trans-fat-idU...
A heart attack doesn't always look like a crushing pain in your chest. (It can - don't ignore it if that happens!) Sometimes it looks like "I used to be able to do that two weeks ago, and now I can't".
I play ultimate frisbee. At one point, I noticed that I was getting winded more easily, and taking longer to recover. Now, that happens as you get older, but it happens over the course of decades. When it happens in a month, that's not just aging.
So I went to a cardiologist, and they had me do a stress echo test. They did an ultrasound of my heart while resting, then put me on a treadmill and ran me until I dropped, then did another ultrasound. They said that there was "abnormal motion of my heart wall under stress". Translation: when the load got high enough, parts of the heart muscle weren't getting enough oxygen (blood) to keep up.
So they scheduled me for a catheterization (I forget whether that's the right term). They ran a catheter in my right wrist, threaded it through my arteries to the arteries that feed the heart, and went looking around. They found an artery that was blocked 90% and one that was blocked 80%, and they put stents in them. They found another that was blocked 60%, which is called the "widow maker", and they didn't put a stent there, because it was only 60% blocked. I found this kind of weird at the time, but after thinking about it, I suspect that if they put a stent there, then they can't later come back and put a stent at any point downstream of it, so the options would be to either do nothing or cut my chest open, and they'd rather leave their options open and monitor.
They put me on a heavy statin dose. (I'd been on statins for decades, but the cardiologist looked at my previous dose and said "that's like a placebo". There's doses that a GP thinks are useful, and there's doses that a cardiologist thinks are useful, and those are quite different.)
I get to have a stress echo every three years for the rest of my life. But I can still be as active as I was, with no restrictions or caution needed.
TL;DR: Watch out for an abrupt decline in your ability to sustain physical exertion. In order to see it, you need to regularly be physically active. If you do see it, take action now - don't wait for the crushing chest pain.
There are some side effects from statins - liver damage is the main one I remember. So far, I haven't experienced any, so I can't really speak about how bad or how common they are.
This can be mean TWO things. Not just ONE as the line suggests.
Pretty sure it means that while all groups decreased in deaths from heart attacks, the highest risk groups (white and black Americans) saw a larger decrease in deaths than the groups that had lower risk of death (Hispanic and Asian Americans). Therefore the gaps between racial groups' deaths are lower than they were at the start.
Hydrogenated margerine was just heading out the door 20 years ago. The cohort who lived off it probably had their heart attacks by now.
(I don't think "i can't believe its not butter" caused the heart attacks, I just point out there's been wider societal changes than just smoking: Exercise is trendy again, and TV has got crap so people do less couch time than they used to)
I'm sure the real science here is good. If they say it's smoking, and they ran the numbers, I'd believe them.
You know, it says "smoking" in a sentence which says "and other factors" to me. The truly interesting thing is the variance in survival rates between POC and white America has reduced. Thats really good. Because survival is about improved treatment and detection. It may mean a POC harming bias in social/medical services and access to quality healthcare has improved, or that their income levels have aligned more with mainstream america and so the health improvement is about lifestyle lift.
Is it a last 20 year development? I remember people going to the gym in the '90s. Step aerobics anyone?
If you were gym old in the 90s, and lived on tater tots smothered in lard, chain smoked and drank sprite out of a bucket, you were the cohort who did die over the next 30 years.
Mr Kurtz, he dead. (Marlon Brando wouldn't have known a Gym after the waterfront)
I dont know, but today we do see quite a few men of prime heart attack age in their 50s who are absolutely Jeff Bezos jacked.
Increased fitness and decreased smoking in most groups seems to explain the results.
Do they do less couch time? I’d have guessed that streaming/on-demand services and mobile phone usage at home have well more than made up for what traditional TV has lost.
This is not true at all. Sedentary time increased to all time highs to 12hrs/day and 3/4 of population is obese.
An economist minded colleague said if you want to reduce end of life costs in healthcare then encourage smokers over 45 to puff more not less and remove the problem faster.
Currently, the top 5 causes of death in the US are, in descending order, heart disease, cancer, COVID, accident, and stroke. If you could wave a magic wand and make it so that nobody ever died of heart disease anymore, those people would still die eventually of something else. So, curing 100% of all heart disease would actually cause more people to die of cancer, COVID, accident, stroke, etc.
A lot of people dont want their idols to be associated “with drugs” but thats just childish at this point
https://nida.nih.gov/research-topics/trends-statistics/overd....
This data comes from a book by Chris Knobbe, MD studying consumption of different fats. It is supposed to be released this month not sure if it has yet. Blaming saturated fats has basically been a complete lie IMO.
Now those same types of people sit in F-150s and use laptops to control heavy machinery.
Fitness is worse, but risk for a single catastrophic event is less.
He also practically changed no bad habits after the heart attack. We have got better when the heart attack happens and better at keeping people alive who want to eat pizza and drink beer all the time.
It's just a thought, I don't have any data to support this. Not sure if anyone has any insight.
The classifications are not mutually exclusive. You can have one without the other, or both together. Given that most cardiac arrests are caused by MCI I’d expect the rates of deaths due to cardiac arrest declining as well.
And I think this is the crime of the medical system. It’s not healthcare, it’s sickcare.
Public healthcare is non-profit and directly incentivized by a healthy population.
Is this true? Because to my American eyes it has always seemed true.
The obesity epidemic seems like a good case study. Private health care looks to prescription drugs to fix it (subscription model) whereas public conceivably would push community awareness campaigns promoting exercise/diet (no profit stream).
And I know I’m in the early stages of ankylosing spondylitis yet since I don’t have any bone deformation yet they just don’t care about my pain.