CDC: Majority of heart-related deaths in 2016 were preventable

Federal health officials said Thursday that the U.S. is losing ground on its efforts to combat heart disease, finding more than 80% of heart attacks and strokes in middle-aged Americans are preventable.

The Centers for Disease Control and Prevention released new data showing heart disease and strokes were responsible for more than 415,000 deaths and 2.2 million hospitalizations in 2016, racking up more than $32 billion in related healthcare expenses.

The data is the first to show the effects of rising obesity, physical inactivity and diabetes rates, according to Dr. Janet Wright, executive director of the CDC's Million Hearts initiative, a five-year effort started in 2012 to prevent a million cardiovascular events.

"Those three factors interweave to decrease health and eventually we knew they were going to have an impact on event rates," Wright said.

While health providers made progress toward reducing cardiovascular disease over four decades, that has plateaued, according to Wright.

One in thee of all cardiovascular events in 2016 occurred in Amercians between the ages of 35 and 64, accounting for more than 775,000 hospitalizations and 75,000 deaths.

"Middle age can be a ticking time bomb for heart disease because this is when many risks for heart disease begin to take their toll," said Dr. Anne Schuchat, CDC's principal deputy director.

Blacks suffered the highest heart disease risk, accounting for 211 deaths for every 100,000 persons compared to 166 deaths per 100,000 among white individuals. Schuchat said blacks were more likely to have high blood pressure at earlier ages and were less likely to have their blood pressure under control.

Schuchat and Wright agreed that healthcare providers have a pivotal role to play in reducing heart attacks and strokes. They can encourage patients to use more aspirin, properly control their blood pressure and cholesterol and push them to stop smoking.

Clinicians are essential in encouraging patients to make the kind of lifestyle changes that will lower their risk of heart attack or stroke, and more than 80% of those events that occur in middle-age adults are preventable, Schuchat said.

Wright encouraged cliniciants to refer more patients who have suffered a heart attack to undergo cardiac rehabilitation. A previous study found only a third of heart attack patients attend the treatment.

"I had assumed that everybody who had a heart attack or stroke was getting cardiac rehab and was scared into adherence with it," Schuchat said. "I think healthcare providers can really encourage them to keep at it because it is partly the duration of time that you follow up that's very important."

Wright said healthcare providers must make blood pressure and cholesterol control a greater priority. She called on hospitals to employ clinician-led, team-delivered protocols that focus on high blood pressure and cholesterol management to standardize treatment.

"Something as simple as using a standardized treatment protocol either for hypertension or high cholesterol or smoking cessation helps captures everyone who needs a treatment and gets them on that right path," Wright said.

But the healthcare industry doesn't give providers the right incentives to help patients prevent heart disease, according to Dr. Ragavendra Baliga, assistant director of new business development and a professor of internal medicine at The Ohio State University Wexner Medical Center.

"It takes a lot of time to motivate patients and it's not easy to change behavior," Baliga said. "The typical primary care physician does not have a whole lot of time because they're incentivized by insurance companies—it's fee for service."

Care delivery should be redesigned to help patients before they experience heart disease symptoms or suffer a heart attack or stroke, he said.

"This really requires some reconsideration of healthcare delivery systems to provide continuous care to prevent and manage chronic illness," Baliga said.