Not relying purely on preventive measures is being considered a better strategy for heart patients
CONTRARY to the conventional wisdom
that prevention is better than cure, here
is a case where cure certainly outweighs
the benefits of preventive measures.
According to a study done at the
Department of Harvard School of
Public Health, Boston, us, 70 per cent of
the overall decline in deaths in heart
patients was attributed to the use of
clot-dissolving drugs like streptokinase
and tissue plasminogen activator and
surgical procedures like angioplasty and
bypass surgery. Dietary changes in the
general population aimed at preventing
heart disease accounted for only 25 per
cent of drop in deaths between 1980 and
1990 (journal of American Medical
Association, Vol 277, No 7).
The Harward analysis shows that
medical and surgical treatments have
been more important in the real drop of
heart-disease deaths in recent years than
wide spread changes in other means of
prevention, at least in the US. The
researchers employed a computer simulation state transition model of
heart diseases for people in the US
between ages 35 and 84 years.
Maria Hunick, who led the research
group, said that she was quite surprised
at the outcome of the study that medical
treatment had a larger impact than
prevention on the incidence of heart
disease. This finding is significant as
coronary heart disease is still a leading
cause of death in India as well as most of
the developed world.
However, the study does not suggest
that preventive measures like cutting
down or stopping smoking and watching diet carefully to avoid fat-rich foods do not contribute to the positive health
of the population. They are still important. This study only shows that treating people with heart disease has a greater effect.
Which is why Hunick specially
cautions against slackening measures,
particularly public health education that
would help even in a small measure the
overall number of people developing heart disease. However, this study did
not correlate the decline in deaths from treatment with the money spent in the groups who took preventive precautions in terms of life style change
and those who did not bother. Some, measures left out included exercise,
taking of aspirin and oestrogen, well known preventive steps against heart disease. According to Hunick, they account for only a minuscule portion of decline in deaths.
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