Myocardial infarction mortality, risk factors, and prevention strategies in the United States

Myocardial Infarction

According to the Centers for Disease Control and Prevention (CDC, 2006), each year approximately 1.2 million Americans suffer from myocardial infarction (heart attack) each year. 40% of these people who a have heart attack will die from it. This equates to a person having a heart attack every 34 seconds, and a person dying from a heart attack every minute. Heart disease is the leading cause of death in the United States, causing over 26% of the deaths in 2006 (CDC, 2010). Additionally, heart disease is the leading cause of death for both women and men, and for most racial/ethnic groups, including African-American, Native Americans, Hispanics, and whites. For Asian-Americans, heart disease was the second leading cause of death after cancer (CDC, 2010). The CDC also estimates that in 2010, heart disease cost the United States $316.4 billion in health care services, medications, and lost productivity.

Myocardial Infarction (heart attack) occurs when the blood supply to the heart is cut off. This happens as a result of blockage (usually from a blood clot) in one or more of the coronary arteries, which supply blood to the heart. These arteries become thicker and harder from a buildup of fat, cholesterol and other substances, called plaque. If this plaque breaks open it may form a clot in the artery and block blood flow to the heart. This causes the heart attack. Cells in the heart muscle that the artery supplies do not receive enough oxygen and begin to die. The longer the artery is blocked, the greater the damage to the heart (American Heart Association, 2007; CDC, 2006). Signs of a heart attack include chest discomfort that feels like uncomfortable pressure, squeezing, fullness, or pain; discomfort in other areas of the upper body such as the arms, the back, neck, jaw, or stomach; shortness of breath; or other symptoms such as breaking out in a cold sweat, nausea, or light-headedness. In order to diagnose a heart attack, a doctor will review the patient's medical history, give a physical examination, use an electrocardiogram (ECG or EKG) to discover any abnormalities caused by damage to the heart, and sometimes use a blood test to detect abnormal levels of certain enzymes in the bloodstream.

The American Heart Association outlines several risk factors for the development of heart disease. Some of these risk factors, such as age, gender, and heredity, are not modifiable. However, many of the risk factors may be ameliorated with lifestyle changes or medication. Exposure to tobacco smoke, whether as a smoker or through exposure to secondhand smoke, increases one's risk of developing heart disease. Those who smoke a pack of cigarettes a day are twice as likely as nonsmokers to have a heart attack. Another risk factor contributing to heart disease is high blood cholesterol. Therefore the American Heart Association recommends maintaining the following cholesterol levels: total cholesterol below 200; LDL (bad) cholesterol below 160 for those at low risk for heart disease, 130 for those at intermediate risk, and 100 for those at high risk; HDL (good) cholesterol above 40 for men and 50 for women, and; triglycerides below 150. The third risk factor is high blood pressure. High blood pressure increases the heart's workload and causes the muscles to thicken and stiffen. High blood pressure may be treated by maintaining a healthy diet, exercise, and through medication. Diabetes is another risk factor even if blood sugar is under control. According the American Heart Association, at least 65% of people with diabetes die from heart or blood vessel disease.