“Modest” increase in hospitalization rates for heart attacks after years of decline

The burden of hospital admission rates due to heart attacks (myocardial infarctions) in England increased between 2012 and 2016, despite decades of low rates, suggests new research published in the Journal of Epidemiology & Community Health.

The researchers also found that after 2010-2011, rates increased in most age groups and young women from 35 to 49 years and even younger men 15- to 34-year-olds were the groups that showed the strongest increases in hospitalization rates for heart attacks in the last five years of the study.

Mortality rates from coronary heart disease and heart attacks have been declining in England and other countries since the 1980s. Despite this, coronary heart disease it remains a major cause of illness and costs the NHS in England over £ 950 million a year.

In other countries, hospital admission rates for heart attacks have also declined since the 1980s, but little is known about these long-term admission rates in England in terms of the age and sex of the patients involved.

Therefore, an international team of researchers led by Dr Lucy Wright of the Nuffield Department of Population Health and Big Data Institute at Oxford University set out to analyze the timing and scale of changes in myocardial infarction hospitalized in England by age and sex in the past. five decades.

They used official data from electronic hospitals for adults aged 15 to 84 between 1968 and 2016 and included 3.5 million hospital admissions for heart attacks in their analysis.

Of this income, about two-thirds (68%) were men. About half (48%) of income in men and 71% in income women they were for people 65 and older.

Hospital admission rates increased in the early years of the study in both men and women, peaked in the mid-1980s (355 per 100,000 population in men, and 127 per 100,000 in women) and decreased by 38, 8% in men and 37.4% in women from 1990 to 2011.

However, as of 2012, there were “modest increases” in revenue for both sexes.

The analysis showed that long-term trends in rates during the study period varied by age and sex, with those aged 70 years or older with the largest and most sustained increases in the early years ( 1968-1985).

Over the following years, rates fell in most age groups until 2010-2011. The exceptions were younger women (35-49 years) and men (15-34 years) who experienced significant increases from the mid-1990s to 2007 (an increase of 2.1% per year until at 4.7% per year).

From 2012, rates increased in total age groups except for the largest, with the sharpest increases in men aged 15 to 34 (7.2% per year) and women aged 40 to 49 (6.9% -7.3% per year).

The authors said a possible explanation for the increase in admissions was that a more sensitive diagnostic test was introduced in English hospitals at the time, which they identified as less serious. color attacks.

However, this is an observational study and, as such, cannot establish the cause. According to the authors, the study had some limitations, such as not being able to identify changes in the hospital admission rates that were due to changes in the behavior and referral practices of patients seeking medical attention.

However, the study used a large data set, which they argued allowed to examine rates in detail according to the sex and age of the hospitalized. heart attack patients over five decades.

They conclude: “Despite substantial decreases in hospital admission rates for myocardial infarction in England since 1990, the annual income burden remains high. Continued monitoring of coronary heart disease trends and strategies is guaranteed. “

The authors added: “Rising hospitalization rates for myocardial infarction in younger women and men are worrying and have implications for clinicians and policymakers. Primary prevention guidelines and public awareness campaigns should continue to include the message that coronary heart disease is not just a disease of men and the elderly. ”