The British Have Access to Optimal Medical Therapy Everywhere for Heart Artery Disease
And It Makes a Difference
“Consider revascularisation (coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI)) for people with stable angina whose symptoms are not satisfactorily controlled with optimal medical treatment (OMT).”
The quote above comes from the British Medical Journal Heart. The article was published in 2012 and it comments on the British NICE guidelines on stable chest pain from heart artery disease. The guidelines were published in 2011. That is just four years after the landmark American journal article that proved heart artery stents do not prevent death or heart attack from heart artery disease. They are very simple and they guide British primary care providers in their management of heart artery disease. Optimal medical therapy first is the standard of care in Great Britain and everyone has access. It makes a big difference.
The highest risk patients with heart artery disease are those who just had a heart attack with substantial heart muscle damage. Within 30 days of the heart attack, twenty percent of the victims are dead in the United States. In England, only 13 percent are dead. At one year, thirty percent of American patients are dead. In Great Britain the number is 20%.
Our system is designed around opening arteries and we do that. Seventy-three percent of Americans with a heart attack receive a heart artery stent and most occur during the hospitalization. In England, the number is 40%. The American medical system opens arteries late in the disease process. Very few people get OMT. In England, they don’t open as many arteries, but the emphasis has been on OMT for over a decade. It is the way they do business. More people die after a heart attack in the US and we spend twice as much.
Eight hundred thousand people a year have a heart attack in the United States. According to these statistics, 250,000 more will die because they live in America compared with the number who would have died in Great Britain. The map above shows deaths from heart disease in the US. Some areas of our country have much higher rates of heart deaths than others. This link will show you the rate by state and by county.
Our continuing focus on opening arteries and not adopting OMT is killing hundreds of thousands of Americans. I guess Winston Churchill was right. “Americans will always do the right thing, after exhausting all the alternatives.” This is proof of the value of OMT at a national policy level. Making OMT available to all Americans should be a national priority.