Three quarters of deaths from heart disease and stroke aren’t preventable

Austin sent me a news story, “One in four deaths from heart disease and stroke in the US is preventable“:

More than 200 000 of the 800 000 deaths from heart disease and stroke in the United States each year are preventable, the US Centers for Disease Control and Prevention (CDC) has said in a report.

The CDC’s director, Tom Frieden, said in a telephone press briefing, “These findings are really striking because we’re talking about hundreds of thousands of deaths that don’t have to happen when they happen.”

The report looked at deaths from heart disease and stroke in Americans under age 75 that could have been prevented by lifestyle changes, medical care, or public health measures.

Here’s the study itself:

Background: Deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.

Methods: National Vital Statistics System mortality data for the period 2001–2010 were analyzed. Avoidable deaths were defined as those resulting from an underlying cause of heart disease (ischemic or chronic rheumatic), stroke, or hypertensive disease in decedents aged <75 years. Rates and trends by age, sex, race/ethnicity, and place were calculated.

“Preventable” deaths aren’t as easy to define as you might hope. But previous work has defined any death under the age of 75 due to heart disease, stroke, or high blood pressure to be preventable. By that definition, about one quarter of all such deaths, of 200,000 of them, are preventable. The highest rates of preventable deaths were among males, non-Hispanic blacks, and Southerners.

News stories such as this one focus on the preventable deaths, and on public health and lifestyle measures that can make them less common. But I think it’s also important to focus on the fact that three quarters of such deaths aren’t preventable. We’re all going to die of something, eventually. For many, it’s heart disease or stroke. But every time I hear someone describe a death from one of these things, it’s followed by questions as to what that person did wrong (ie eating, drinking, or smoking). Most deaths from these causes aren’t someone’s fault, and they’re not avoidable.

I have long maintained that preventive care is important, but not the silver bullet for fixing everything that’s wrong with our health care system. That’s still the case. We should work on preventing the deaths we can by changing what we do every day, but there are still other improvements to make, too.


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