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Frequently Asked Questions: Heart Attack
What is a heart attack (acute myocardial infarction)?
How common are heart attacks?
What are the risk factors for heart attack?
What can I do to protect my family and myself?
What is known about heart attacks and the environment?
Why is EPHT tracking heart attacks?
Links for more information about heart attacks

What is a heart attack (acute myocardial infarction)?

An acute myocardial infarction is also called a heart attack. If the blood supply to the heart is severely reduced or completely blocked, heart muscle cells may not receive enough oxygen and begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart.
 
This damage can cause irregular heart rhythms or even sudden cardiac arrest or stopping of the heart beat. Death can result. Coronary artery disease is the chief underlying cause of a heart attack. A less common cause of a heart attack is a severe spasm of a coronary artery that reduces the blood supply to the heart.
 
A heart attack survivor may have a damaged heart that affects the heart rhythm, pumping action, and blood circulation. This puts heart attack victims at greater risk of having another heart attack or other events such as a stroke, kidney problems, and peripheral arterial problems.
 
 

How common are heart attacks?

In 2007 the American Heart Association estimated 565,000 new attacks and 300,000 recurrent attacks of myocardial infarction. Among Americans age 20 and older, new and recurrent heart attack prevalence for both men and women represented 3.7% of the US population or 7,900,000 (4.9 million men and 3.0 million women). Corresponding percentages by race are 5.4% for white males, 2.5% for white females, 3.9% for black males, and 3.3%for black females.

What are the risk factors for heart attack?

There are two types of risk factors for heart attack, inherited and acquired. Inherited (or genetic) risk factors are characteristics that we are born with that cannot be changed, but can be improved with medical management and lifestyle changes. Acquired risk factors are those that are caused by activities that we choose to include in our lives that can be managed through lifestyle changes and clinical care.
 
Inherited (genetic) factors include:
  • Inherited hypertension (high blood pressure)
  • Inherited low levels of HDL (high-density lipoprotein) or high levels of LDL (low-density lipoprotein) blood cholesterol
  • Family history of heart disease (especially with onset before age 55)
  • Age (generally men are at risk at an earlier age than women but after the onset of menopause, women are equally at risk)
  • Diabetes mellitus (type 1 diabetes)    
Acquired risk factors:
  • Acquired hypertension (high blood pressure)
  • Acquired low levels of HDL (high density lipoprotein) or high levels of LDL (low density lipoprotein) blood cholesterol
  • Cigarette smoking and secondhand smoke
  • Stress
  • Sedentary lifestyle
  • Overweight by 30% or more
 

What can I do to protect my family and myself?

Managing your risks for a heart attack begins with becoming aware of conditions like hypertension or abnormal cholesterol levels, which may be "silent killers"; examining which risk factors apply to you and taking steps to eliminate or reduce them, and consulting your healthcare provider to determine if you have risk factors that cannot be changed but can be managed medically and through lifestyle changes.

What is known about heart attacks and the environment?

Investigators in the both the U.S. and abroad have shown significant relationships between air pollutants and increased risk of heart attack and other forms of coronary heart disease, particularly for older adults (>65 years old).
 
Models have demonstrated increases in heart attack hospitalization rates in relation to fine particles in the air (PM 2.5) particularly in sensitive subpopulations such as the elderly, and patients with pre-existing heart disease, especially those who are survivors of heart attacks or those with chronic obstructive pulmonary disease. 
 

Why is EPHT tracking heart attacks?

There is no single heart attack surveillance system in place in the US. Death records are currently the sole national descriptor for heart attacks. Estimates of incidence and prevalence of heart attacks have been largely based on survey samples (e.g., National Health and Nutrition Examination Survey) or large cohort studies such as the Atherosclerosis Risk in Communities (ARIC) study. 
 
Tracking heart attack hospitalizations will allow examination of hospitalization trends over seasons and over years, assessment of geographic differences in hospitalization rates, evaluation of differences in heart attack hospitalizations by age, gender, and race/ethnicity, analysis of disparities in heart attack hospitalizations by factors such as age, race/ethnicity, gender, education, and/or income, and identification of populations in need of targeted interventions.
 

Links for more information about heart attacks

American Heart Association, Diseases & Conditions, Heart Attack: http://www.americanheart.org/presenter.jhtml?identifier=1200005
 
Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC): http://www.cdc.gov/DHDSP/index.htm
 
Mayo Clinic, Heart Disease: http://www.mayoclinic.com/health/heart-attack/DS00094
 
National Environmental Public Health Tracking (NEPHT) Program, Centers for Disease Control and Prevention (CDC): http://www.cdc.gov/nceh/tracking/default.htm;
 
National Library of Medicine, National Institute of Health (NIH), MedLine Plus, Heart Attack: http://www.nlm.nih.gov/medlineplus/ency/article/000195.htm
 
National Heart, Blood, and Lung Institute, National Institute of Health (NIH), Heart Attack Signs: http://www.nhlbi.nih.gov/actintime/
 
Oregon Health & Sciences University, Health Topics, Heart Attack: http://www.ohsu.edu/health/health-topics/topic.cfm?id=8653
 
Oregon Hospital Quality Indicators, Department of Human Services (DHS): http://www.oregon.gov/OHPPR/HQ/AMI.shtml
 
World Health Organization (WHO), Cardiovascular Diseases: http://www.who.int/cardiovascular_diseases/en/
 
Oregon Environmental Public Health Tracking (EPHT): /DHS/ph/epht/index.shtml