Coronary research: More than 2,000 deaths a year from coronary heart disease could be avoided if optimum levels of treatment were given to people at risk of heart attack and heart failure, new research has found.
Using a combination of published data on the use and effectiveness of specific treatments and on mortality from coronary heart disease, researchers from the department of pharmacology and therapeutics in Trinity College Dublin said that increasing treatment uptake could save a further 2,240 lives.
Epidemiologists Dr Kathleen Bennett and Dr Zubair Kabir and their colleagues found that treatment for coronary disease in 2000 prevented approximately 1,800 heart disease deaths in adults aged 25-84 in the Republic.
However, they found that treatment levels using key preventive drugs were less than optimal. Just 33 per cent of patients were taking beta blockers after having a heart attack; 37 per cent had been prescribed statins, a cholesterol- lowering drug; and 64 per cent of eligible patients were found to be taking aspirin.
Beta blockers relieve pressure on the heart, aspirin helps prevent clots and statins reduce cholesterol and help stabilise existing blockages in the coronary arteries. Using a combination of all three drugs has been shown to significantly reduce both death rate and morbidity in patients with pre-existing coronary heart disease.
In addition, the Trinity College researchers found that just 6 per cent of patients suitable for the primary prevention of heart disease using statins were receiving this treatment. Heart failure treatment was also less than optimal, they said.
Acknowledging that 100 per cent treatment uptake was an unrealistic goal, the authors calculated the beneficial effects of treating 80 per cent of eligible patients using figures for the year 2000. Of the 2,240 preventable deaths, the largest reduction (41 per cent) would come from treating more heart failure patients. Some 26 per cent of deaths would be prevented by providing statins to four out of five patients eligible for primary prevention.
"What we can show with our data is that increasing the treatment levels further up to a maximum of 80 per cent, particularly in those with pre-existing coronary heart disease, would have reduced deaths from heart disease by an estimated 2,200 in 2000," Dr Bennett told The Irish Times.
"Many of the treatments, particularly the prescribing of statins for lowering cholesterol, are already starting to approach the target."
Research published last year showed a significant increase in the prescribing of beta blockers and statins to medical card patients with coronary heart disease between 1990 and 2002 in response to the introduction of evidence-based guidelines for doctors.