Heart Attacks Consequence of Undetected High Blood Pressure

The area a person lives in could determine the risk of dying from a heart attack, discloses a new study from the University of Leicester.

Medical researchers from the University set out to determine why death rates from coronary heart disease (heart attacks) varied around the country and found that living in a deprived area contributed to your risk.

The study has for the first time established an association at national level between detection of hypertension and death rates from coronary heart disease.

The Leicester team, from the Department of Health Sciences, analysed whether variations in deaths between different parts of the country could be explained by characteristics of primary health care services (such as numbers of doctors, performance against national targets), as well as by characteristics of the population, such as deprivation, lifestyle (such as smoking), or the numbers of people with diabetes

Their findings have been published in the November 10 issue of JAMA.

Lead research and report author Dr. Steve Levene, of the University of Leicester and a city GP, said: "We found that population characteristics were most important, including deprivation; however, 10% of the variation was also explained by how successful primary care services are at detecting people who have high blood pressure (hypertension). People who have hypertension are at greater risk of having heart attacks. No other health service factor that we examined was associated with the variation. Our results were the same for 3 consecutive years, 2006, 2007 & 2008.

"We found that higher proportions of white individuals, higher levels of deprivation, higher levels of diabetes, higher proportions of smokers, and lower levels of detected hypertension were associated with higher levels of coronary heart disease mortality at Primary Care Trust level in our models. Interestingly, when diabetes, age, smoking, obesity and deprivation are taken into account, coronary heart disease death rates are higher in populations with a greater proportion of whites, rather than of non-whites.

"This is important because it suggests ways in which we can reduce deaths from coronary heart disease. Greater detection of hypertension may reduce deaths from heart attacks. However, it is important to recognise the importance of deprivation, obesity and smoking. People need to be aware of the value of having their blood pressure checked, along with other steps to stay healthy including not smoking and controlling their weight. Any policy to reduce coronary heart disease death rates will need to address these problems as well."

Dr Levene said the new study was important since it shows a practical way to reduce deaths from heart attack that can be implemented now at a relatively lower cost. It also suggests that medical practitioners and policy makers need to make better contact with the whole population, rather than just those individuals whose diseases are known about.

Researchers will now make initial plans for a local programme to improve hypertension detection. This could lead to lower deaths in Leicestershire, Northamptonshire and Rutland in the future.

Professor Richard Baker, one of the co-authors and Director of the CLAHRC said: "This would provide an example for other parts of the country, and other countries, on what can be achieved through simple, low cost measures. There is an urgent need for an effective programme, as the city of Leicester has one of the highest death rates from heart attacks in England."



Source: Eurekalert