Cardiology is one of the areas of medicine that has advanced the most in the last 40 years. Survival rates have climbed accordingly.
The Heart and Stroke Foundation of Canada reports that people today are five times less likely to die from a heart attack than in the past. Nowadays, nearly 95% of Canadians who have a heart attack and get to a hospital survive. Cardiology treatment options and recovery techniques have advanced to such an extent that specialists currently consider death by heart disease at age 75 as a premature death.
Evolution over the decades
Treatments have evolved tremendously over the last few decades. In cardiac surgery, the rib cage is no longer "opened" as often for coronary artery bypass grafting. Much less invasive procedures such as angioplasty are now available. This non-surgical procedure, the Heart and Stroke Foundation explains, involves placing stents to open up blood vessels in the heart that have been narrowed by plaque build-up.
The first angioplasty was performed in 1977 in a German hospital. A catheter is introduced into the blood vessel through the groin or wrist. It is carried through the blood vessels to the heart, where the coronary artery is narrowed. Once the tip of the catheter is securely in place, the balloon covered with a stent is inflated. Once the plate is compressed and the stent is in place, the balloon is deflated and removed. The stent remains inside to hold the artery open.
This technique has given rise to interventional cardiology, which can be used in all areas of the specialty: infarction, rhythm disorders, congenital malformations, heart failure and cardiomyopathies, and valve pathologies. Interventional cardiology not only reduces the risks associated with general anesthesia and major surgery, but it also shortens hospitalization time and therefore costs, and diminishes pain and post-operative after-effects for the patient. Notably, recovery is faster and scars are less visible.
Another major advantage of less invasive cardiac procedures is that they can be performed on patients ages 80 and older who could not have been operated on in the past. These people’s lives can now be prolonged for many years.
Multiplication of drugs
On top of that, the number of drugs to manage risk factors and heart disease, which were very limited 60 years ago, has multiplied in recent decades. About ten different classes of drugs exist today, with hundreds within each class. The main drugs used to manage blood pressure are:
- Beta-blockers, which protect the heart from future attacks.
- ACE inhibitors, which cause blood vessels to relax and decrease blood volume, thus lowering blood pressure.
- Statins, which are used to lower cholesterol levels. They are effective in preventing and treating cardiovascular disease and in reducing the risk of recurrence.
- Anticoagulants and anti-platelets, such as acetylsalicylic acid (ASA, commonly known as aspirin), which can be used to prevent dangerous blood clots.
Survival and life expectancy for coronary heart disease victims has improved dramatically in the last 60 years. Thanks to numerous advances in cardiology, the number of Canadians living with coronary heart disease continues to rise. The number of people with this condition soared from approximately 1.5 million in 2000-2001 to 2.4 million in 2012-2013.
