And use of blood-pressure-lowering drugs increased from 28 percent of those who needed them in the mid-1990s to 46 percent in recent years -- "an improvement, but not ideal," Wijeysundera said.
"From patients' perspective, the news is that there are multiple and very good medical and surgical therapies available for people with diabetes and coronary heart disease," he said. "Also, that exercising, watching the diet, avoiding diabetes and taking other preventive measures continues to be important. That is the take-home message of our study."
Those thoughts were echoed by Dr. Timothy J. Gardner, medical director of the Heart Center at the Christiana Health Care System in Bloomington, Del., and a past president of the American Heart Association.
"We've seen a steady decline in coronary artery deaths going back to the 1970s, half from improved treatments such as coronary care units and emergency medical services, the other half from improved prevention, including important things like a decline in smoking," Gardner said.
"The worry we have now is that the continued steady decline in coronary artery deaths will slacken off because people are acquiring risk factors for heart disease," he said. "Attention must be paid to measures such as weight reduction and exercise and control of diabetes."
The American Heart Association has more on the risk factors for coronary heart disease.
SOURCES: Harindra C. Wijeysundera, M.D., staff cardiologist, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto; Timoth
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