A five-point plan to reduce heart attack deaths in Australia

February 4, 2013 by Dr. Julie Redfern

Out of the 10,021 Australian who died of a heart attack in 2010, 5305 were experiencing their second such event. Systematic national reforms are needed to reduce the alarming number of people having a second heart attack and ensure the health-care system isn't failing those who survive the first time.

As well as lives lost, deaths from heart attacks result in enormous costs - over $8.4 billion annually. And this figure doesn't account for the time lost at work, or financial, emotional and other family costs.

A failing system

Most repeat heart attacks are preventable but after having their first heart attack many people slip back into old habits. They stop taking medication, don't participate in cardiac rehabilitation programs and don't make or maintain simple such as stopping smoking, being physically active and following a .

Indeed, many people seem to think a heart attack is a one-off - once it happens, it's past - but heart disease is a lifelong problem that needs to be managed properly. And there's no quick fix. There's also a that a stent or bypass is as good as a cure, but that's simply not the case.

Unfortunately, our health-care system is not geared towards the complexity of managing heart disease. Cardiac rehabilitation programs are short, lasting only a few weeks, and are used by less than a third of heart attack survivors.

The risk of dying from a heart attack increases the second time around - 20.7 percent for women and 13.7 percent for men. Given that one in four people who have a heart attack go on to have a second one, it's critical to put an appropriate treatment program into place.

A five-point plan

Reforming how we care for heart attack survivors should be a national priority. Such reform, along with increasing the utilisation of existing schemes, is achievable through the following five-point plan detailed in today's edition of the Medical Journal of Australia.

1. Develop and implement a national approach to secondary prevention that provides a clear and personalised path for all patients including ongoing support for lowering risk and long-term follow up.

2. Bridge the gap between hospital and primary care by implementing a case management approach that's recognised by Medicare. This should provide patients with ongoing support and guidance.

3. Increase awareness and utilisation of existing services by creating a web-based national inventory of prevention services, and potentially a public media campaign. Many health providers and patients are unaware of all relevant services, and the inventory could include a range of programs and schemes including cardiac rehabilitation, Heart Foundation programs, Medicare-rebatable schemes (such as access to allied health and psychology services via chronic disease management plans and home medicines reviews), among others such as Quitline and Aboriginal and Torres Strait Islander services.

4. Develop a system for monitoring and maintaining performance with measures to facilitate clinical practice improvement. These measures should assess service delivery features (access and timeliness, for instance) as well as end health outcomes including hospital re-admissions and coronary heart disease deaths.

5. Implement a National taskforce and a communication strategy involving state and federal government, private health funders, Medicare locals, consumers and health professionals. Such a cohesive and multidisciplinary group is essential to raise the profile of the problem and provide leadership.

Narrowing the evidence-practice gap in secondary prevention for is will save lives and money. Raising it as a national priority, increasing utilisation of existing schemes and developing similar strategies to those effectively implemented for management of other chronic diseases in Australia offer excellent prospects for progress.

Explore further: Taking depression to heart

Related Stories

Taking depression to heart

February 14, 2012
Mental state can play a crucial role in physical health — medical professionals have long known about the connection between anxiety and the immune system, for example. Now researchers at Tel Aviv University have found ...

Depression after heart attack: Threat perception has to be addressed

January 14, 2013
Patients who feel strongly threatened by their heart disease immediately after their heart attack have a higher risk of developing depressive symptoms. The data derived from this study can lead to better heart patient management.

People with schizophrenia more likely to die of heart attack, study finds

October 3, 2012
The risk of death resulting from heart attack is higher in people with schizophrenia than in the general public, according to scientists at the Centre for Addiction and Mental Health (CAMH) and the Institute for Clinical ...

Chronic kidney disease patients could be at similar levels of coronary risk to those who have previously had heart attac

June 18, 2012
Patients suffering from chronic kidney disease could be at as high a risk of coronary heart disease as patients who have previously had a heart attack, according to an article published Online First in the Lancet.

Recommended for you

New discovery could reverse tissue damage caused by heart attacks

July 25, 2017
A new discovery by University of Bristol scientists helps to explain how cells which surround blood vessels, called pericytes, stimulate new blood vessels to grow with the hormone 'leptin' playing a key role. Leptin is produced ...

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.