BMJ No 7137 Volume 316
Press Releases Saturday 4 April 1997
Embargoed: 00:01 hrs, Friday 3 April 1998
MITIGATING THE CONSEQUENCES OF CARDIAC ARRESTS
WOMEN WHO SMOKE HAVE A GREATER RISK OF HEART PROBLEMS THAN
THEIR MALE
CONTEMPORARIES
LOWER MEAT AND BUTTER INTAKE LINKED TO SHARP FALL IN DEATHS
FROM HEART
DISEASE
INEFFECTIVE ASSESSMENT OF FUNDS FOR RESEARCH MUST CHANGE
CAMBODIA - AFTER THE KILLING FIELDS
MITIGATING THE CONSEQUENCES OF CARDIAC ARRESTS
Three papers in this week's BMJ consider the efforts that could be made to
reduce fatalities from heart attacks.
(Patients action during their cardiac event: qualitative study exploring
differences and modifiable factors)
Every year around 333,000 people in the UK have a heart attack. One of the
key factors affecting the consequences of a heart attack is patients delay
in seeking help for their symptoms. In this week's BMJ, Ruston et al
investigate why people having a heart attack delay seeking medical
assistance and find that generally it is because they do not realise what
they are actually experiencing. The authors conclude that the myth that a
heart attack is always a dramatic event in which people collapse with
crushing chest pain needs to be dispelled and that there should be greater
awareness of more common symptoms such as pain in the arms and neck,
sweating, breathlessness and nausea.
contact:
Professor Michael Calnan,
Centre for Health Services Studies,
George Allen
Wing,
University of Kent at Canterbury,
Canterbury
t: 01227 827645 email: m.calnan@ukc.ac.uk
(Fatality outside hospital from acute coronary events in three British
health districts 1994-5)
In a study of patients who had heart attacks in the health districts of
Brighton, South Glamorgan and York over a two year period, Norris, on
behalf of the UK heart attack study investigators found that nearly three
quarters (74 per cent) of all fatal cases happened before it was possible
to transfer patients to hospital. Norris notes that hospital treatment for
coronary conditions has improved greatly over the past 20 years but
fatality rates outside hospital remain very high. The total case fatality
for people under 55 years of age was 27 per cent, but once patients reached
hospital it fell to three per cent.
With these statistics in mind Norris and colleagues say that opportunities
for reducing fatality from acute coronary attacks lie mainly outside
hospitals and in the wider community. They make four recommendations.
Firstly, the authors believe that the survival rate from cardiac arrests
occurring at home or work, for example, might be trebled by an improved
ambulance response. Secondly, they recognise that in 60 per cent of cases,
cardiac arrests are witnessed by bystanders, of whom less than one-third
attempt resuscitation procedures. Therefore, citizen training in
cardiopulmonary resuscitation could be crucial. Thirdly, since many more
heart attack victims survive if they arrest in the presence of a paramedic,
the public should be educated to call the emergency services if they or a
relative are with someone who has experienced chest pain lasting for more
than 15 minutes. Finally, Norris advocates the benefits of secondary
prevention of coronary attack in the form of medication which lowers
cholesterol concentrations, antiplatelet drugs and beta blockers, not to
mention strenuous advice to stop smoking.
contact:
R Norris, Honorary Consultant Cardiologist,
Cardiac Department,
Royal
Sussex County Hospital,
Brighton
t: 01273 696955 ext 4096 f: 01273 673106
(Cardiac arrests outside hospital - Survival could be improved by better
public awareness of symptoms)
In a related editorial in this week's BMJ, Evans reiterates the
recommendations made by Ruston and Norris and in particular stresses that
as two-thirds of all cardiac patients die at home, basic life support
training should be targeted at close relatives and friends of patients with
known coronary artery disease. The author also draws attention to the
proposed use of intelligent defibrillators by policemen, firemen and
other lay first responders such as security guards, airline cabin
attendants and voluntary first aiders.
contact:
Dr David Lipkin,
Consultant Cardiologist,
Royal Free Hospital,
London
t: 0171 830 2963 f: 0171 830 2961
WOMEN WHO SMOKE HAVE A GREATER RISK OF HEART PROBLEMS THAN THEIR MALE
CONTEMPORARIES
(Smoking and risk of myocardial infarction in women and men: longitudinal
populations study)
Over the last twenty or thirty years, female smoking habits have become
more like those of their male counterparts, making a comparison of the
effects of smoking on both sexes more meaningful. In a paper in this week's
BMJ Prescott et al report on a study of 24,000 people over 12 years.
They found that the smoking related risk of a heart attack was 50 per cent
higher in women than in men and conclude that this could be because women
may be more sensitive to the harmful effects of smoking than men. They
suggest that this sensitivity may be linked to interactions between
components of tobacco smoke and hormonal factors and call for further
research.
contact:
Dr Eva Prescott,
Senior Research Fellow,
Institute of Preventive Medicine,
Kommunehospitalet,
Copenhagen, Denmark
t: +45 3338 3864 f: +45 3391 3244 email: eva.prescott@ipm.hosp.dk
LOWER MEAT AND BUTTER INTAKE LINKED TO SHARP FALL IN DEATHS FROM HEART
DISEASE
(Ecological study of reasons for sharp decline in mortality from ischaemic
heart disease in Poland since 1991)
Social and economic transformation in Poland has been unusually rapid. The
abolition of food subsidies in 1989 and the fall in real disposable income
produced sharp changes in dietary intake from animal to vegetable fats,
while the abolition of import controls improved the supply of fresh fruits
all year round. In this week's BMJ Zatonski et al suggest that these
changes in eating habits maybe responsible for the strikingly sharp decline
in deaths from heart disease since 1991.
contact:
Dr John Powles,
Department of Community Medicine,
Institute of Public
Health,
University of Cambridge
t: 01223 330300 f: 01223 330330
or
Professor Witold Zatonski,
Department of Epidemiology and Cancer
Prevention,
Maria Sklodwska-curie Memorial Cancer Centre and Institute of
Oncology,
Warsaw
email: zatonskiw@coi.waw.pl
INEFFECTIVE ASSESSMENT OF FUNDS FOR RESEARCH MUST CHANGE
(Misleading, unscientific and unjust: the United Kingdom's research
assessment exercise)
In an Education and Debate paper in this week's BMJ, Williams launches a
scathing attack on the research assessment exercise (RAE) conducted by the
Higher Education Funding Councils. (The aim of this exercise is to measure
research activity in British academic institutions and determine how the
councils research budget should be distributed among the universities in
the UK.)
The author says that the exercise gathers misleading data, which it
assesses unscientifically and unaccountably, using an inefficient procedure
that is expensive and extremely wasteful of scientists time. Williams
highlights what he perceives as the inadequacies of the exercise and
concludes by saying that it is a dysfunctional juggernaut, lumbering on
under its own momentum... threatening to crush research creativity, careers
and scientific integrity. The author concludes that the current system
must be replaced with a structure that is 'scientifically and morally
beyond reproach.
contact:
Gareth Williams,
Professor of Medicine,
Department of Medicine,
University
of Liverpool,
Duncan Building,
Liverpool
t: 0151 529 2930 Bleep 0151 525 5980 f: 0151 529 2931
In an accompanying editorial, the Editor of the BMJ joins Williams in his
plea to stop journal impact factors being used as a measure of the
quality of research.
contact:
Dr Richard Smith,
Editor BMJ, BMA House,
Tavistock Square,
London
t: 0171 383 6529 f: 0171 383 6403
CAMBODIA - AFTER THE KILLING FIELDS
In an Education and Debate paper in this week's BMJ, Dr Vivienne Nathanson
recounts her recent visit to the minefields of Cambodia and recalls some
of the scenes that she witnessed. She juxtaposes the positive images of
the excellent rehabilitation work carried out by international agencies,
such as the International Committee of the Red Cross, and mine clearance
groups, such as the Mines Advisory Group, with the desperate realities of a
struggling healthcare system.
Dr Nathanson calls upon the international community to make a long term
commitment to demining and rehabilitation for a people so tragically in
need.
contact:
Dr Vivienne Nathanson,
Head of Professional Resources and Research Group,
BMA, London
t: 0171 383 6529 f: 0171 383 6404 email: vnathanso@bma.org.uk
Embargo: 00:01 hrs, Friday 3 April 1998
Please contact Public Affairs Division for the text of the paper & the authors for further comment
For further information, please contact:
Jill Shepherd on 0171 383 6254
Public Affairs Division,
BMA House,
Tavistock Square,
London,
WC1H 9JP
After 6pm & at weekends: 0181 651 5130, 0181 241 6386, 0181 674 6294, 0171 727 2897, 0181 997 3653
Or fax requests to Public Affairs Division, BMA on 0171 383 6403.
If you currently receive your British Medical Journal press release by mail and you would like it faxed to you please telephone (0)171 383 6123, Fax: (0)171 554 6123 or E-mail: ejacobs{at}mail.bma.org.uk
When dialling the UK from abroad, remember to delete the first zero from the local area code, eg, (00 44) 171...
BMA on Internet page: http://www.bma.org.uk
If you intend to publicise any article in this press release, ensure you quote the British Medical Journal as source
Please note: The BMJ press release is now available on the EurekAlert website, run by the American Association for the Advancement of Science. The address of the site is: http://www.eurekalert.org
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
