April 8, 2007
About the Series
They are the leading causes of illness and death in the United States today — heart disease, cancer, stroke, chronic obstructive pulmonary disease, diabetes and Alzheimer’s disease, in that order. And they have a lot in common.
They are expensive — together, they account for 25 percent of the nation’s annual health care expenditures, said Jonathan Skinner, a health economist at Dartmouth College.
They come in clusters — accumulations of plaque in arteries lead to heart attacks but also can lead to strokes and predispose to Alzheimer’s disease. Diabetes can lead to heart disease, stroke and even cancer. Smoking can lead to chronic obstructive pulmonary disease as well as cancer and heart disease, which in turn predisposes to Alzheimer’s.
And the outlook for them is improving — people are getting the diseases later in life, and death rates are falling.
Yet, in many instances, patients are undertreated or treated inappropriately. In some cases, science has not offered answers, but in others, the medical system has been unable to turn proven remedies into everyday care.
Today, The New York Times examines the No. 1 killer, heart disease.
A million Americans have heart attacks each year and half a million die. A great deal is known about how to prevent heart attacks, how to save lives and prevent disability. But opportunities are squandered out of complacency, denial and because of the way heart care is paid for. Among the current findings:
¶Only a small fraction of the nation’s acute care hospitals offer a treatment, angioplasty, that can open blocked arteries. Yet many other hospitals are reluctant to divert patients there because heart attack patients are so lucrative.
¶If patients get proper treatment within an hour of when their attack began, most, if not all, of the heart damage can be prevented. Only 10 percent get to a hospital that soon.
¶Half the people who need to be treated to prevent heart attacks are not treated and half who are treated are treated inadequately. Patients go home with the wrong drugs or the wrong doses or misimpressions about the importance of taking their medications.
Copyright 2007 The New York Times Company
Today's Article is entitled Lessons of Heart Disease, Learned and Ignored