Department of Research & Evaluation News

In a study published in the American Heart Association scientific journal Circulation, Kaiser Permanente research scientists report a steady decline in heart attacks for both men and women enrolled in the health system from 2000 to 2014, although that rate of decline slowed among women in the last 5 years of the study.

“The study points to the need for continued improvement in the awareness, prevention, recognition, and treatment of risk factors for heart disease in women,” said Kristi Reynolds, PhD, MPH, the senior author on the study and the director of Epidemiologic Research with the Kaiser Permanente Southern California Department of Research & Evaluation. “It also shows that more research needs to be done to understand the disparities between men and women.”

The study was based on 45,331 hospitalizations for heart attacks occurring in patients who were ages 35 years and older within Kaiser Permanente in Southern California between 2000 and 2014.

This research showed the rate of heart attacks:

• Declined overall by nearly 50% between 2000 and 2014
• Declined among men during the study period by about 4.7% annually
• Declined among women from 2000 to 2008 by about 4.6% annually
• Declined among women from 2009 to 2014 by about 2.3% annually

Men have roughly double the risk for heart attack hospitalization compared to women in the United States, although several studies have reported increasing rates of hospitalization for heart attacks among women under the age of 55 years. Heart attacks are the leading cause of death for women.

The study did not determine why the decline in heart attacks was not as great among women.

Researchers said the overall declines in heart attacks reflect a national trend of decreasing heart attack rates and may be due in part to increased use of medications, such as statins, and lifestyle changes.

The heart attack trends at Kaiser Permanente in Southern California may not be generalizable to the United States because the organization has had systemic programs in place to reduce cardiovascular disease since 2001. Systemwide care initiatives resulted in large improvements in cardiovascular health risk factors such as blood pressure and cholesterol control that exceeded the improvements observed in most other health care systems.

“We are very proud the rate of heart attacks continues to decline among men and women within Kaiser Permanente Southern California,” said study co-author Ronald Scott, MD, a family physician at the Kaiser Permanente West Los Angeles Medical Center, and the cardiovascular co-lead for the Southern California Permanente Medical Group.

Most heart attacks and strokes are preventable, Dr. Scott said.

“And we want to continue the trend of lowering the rate of heart attacks among both men and women by prescribing statins as a preventive medication and continuing to recommend lifestyle changes such as improved diet and exercise,” he said.

Matthew Mefford, PhD, the lead author on the research, suggested that the takeaway message from the research is that women especially should talk with their doctors to find out what they can do to reduce their risk of heart attacks.

In addition to Dr. Reynolds, Dr. Scott, and Dr. Mefford, other authors on the study are Bonnie H. Li, MS, Lei Qian, PhD, Teresa N. Harrison, SM, and Steven J. Jacobsen, MD, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena, Calif.; Stephanie R. Reading, PhD, MPH, formerly of the Department of Research & Evaluation, and currently the Center for Observational Research, Amgen, in Thousand Oaks, Calif.; Jeffrey J. Cavendish, MD, of the Southern California Permanente Medical Group; Michael H. Kanter, MD, Kaiser Permanente Bernard. J. Tyson School of Medicine, Pasadena, Calif.; and Mark Woodward, PhD, of the George Institute for Global Health, University of New South Wales, Sydney, Australia.

This study was funded by the Southern California Permanente Medical Group.

Cardiovascular disease is an active area of study for Kaiser Permanente research scientists.

About the Kaiser Permanente Southern California Department of Research & Evaluation

The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiologic research, health services research, biostatistics research, and behavioral research as well as clinical trials. Major areas of study include chronic disease, infectious disease, cancer, drug safety and effectiveness, and maternal and child health. Headquartered in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general public. Visit kp.org/research.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.3 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health.