Significantly fewer people die from acute myocardial infarction: ‘We are pushing the age up’ | Healthy

While in 1990 17,302 people died from an acute myocardial infarction, this is now around 4,900 per year. The total number of deaths in the Netherlands actually increased during that period. In particular, significantly fewer elderly people now die from heart attacks.

Care for heart patients has greatly improved, cardiologists explain. Because patients get to a hospital quickly, they also receive the right care quickly. “We are doing better than larger countries, where the distance to the hospital is greater,” says Rudolf de Boer, chairman of the Dutch Association for Cardiology.

If the ambulance determines that a patient with acute chest pain has an infarction, he or she will be on the operating table within ninety minutes on average, says Pim van der Harst, head of the cardiology department at UMC Utrecht. “They have relatively little damage.” And the less damage, the better the quality of life after the infarction.

Better treatments have also been introduced. Cardiologists achieve good results, especially with angioplasty – where a balloon opens the blocked artery and a stent can then be placed. In addition, people receive a better cocktail of medications to lower their cholesterol or blood pressure and reduce the risk of clot formation.

Although the number of deaths has decreased drastically, it is always better to prevent a stroke. Because those people are heart patients, cardiologists warn. After such an infarction, they have to take medication for the rest of their lives. They also more often have heart failure, such as disturbed pump function or too little oxygen in a heart chamber. “The prognosis after such a heart attack is just as bad as with some forms of cancer,” says Fabrice Martens, cardiologist at the Amsterdam UMC and professor of preventive cardiology.

This is also reflected in the figures. The number of people over 70 who still die from heart failure is growing. In 1995 the number of deaths was around 5200, last year it was just over 8000.

Although the number of deaths from heart attacks has decreased drastically, cardiologists have seen a cautious increase in recent years from 4718 to 4979. This is partly because there are simply many elderly people. “It remains a disease that occurs in many people. We push survival forward. But to some extent it is inevitable that more people will die from a heart attack at an older age,” says De Boer.

But the risk of an acute heart attack also increases because more people are overweight, have diabetes, high cholesterol or high blood pressure. According to Martens, patients sometimes think too easily about an angioplasty procedure. “We send patients home as quickly as possible after such a procedure. Such a patient thinks: that wasn’t too bad. And it continues in the same way.” If there are no genetic factors involved, it is important to ensure that there is no excess weight and that the blood pressure and cholesterol are good. Martens: “Otherwise we will have to wait for the next infarction.”

Figures in the United States already show this. The number of heart attacks there has skyrocketed in recent years, says cardiologist Van der Harst. “If you compare the trend of obesity, the lines are almost identical. People have probably started exercising less and eating unhealthier.” The number of overweight people is also growing in the Netherlands. “I hope we don’t go the American way, but being overweight and not getting enough exercise is really a big risk.”

The cardiologist himself tries to emphasize this to the patients he helps. Van der Harst: “When they are on the treatment table, I give them a smoking ban and immediately emphasize that, for example, they are never allowed to smoke again. During an infarction, people are most sensitive to changing their behavior. It would of course be nice if we could maintain that low number of deaths.”

In this video, immunologist Xanthe van Dierendonck (Wageningen University) explains why you get sick more quickly if you are overweight:

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