A young woman's chances of surviving a heart attack depend on her postcode

March 14, 2000

Regional variation in incidence and case fatality of myocardial infarction among young women in England, Scotland, and Wales 2000; 54:293B8

Young women in Scotland are four times more likely to have a heart attack than young women in the South of England, but almost twice as likely to survive as their English counterparts. These findings were not affected by age or whether the women smokedCrisk factors traditionally implicated in the likelihood of heart disease and survivalCshows the research in the Journal of Epidemiology and Community Health.

The research team examined the rate of heart attacks and resulting deaths among more than 1000 women aged between 16 and 44 in the UK between 1993 and 1995. National rates were deduced from population data and mortality statistics.

The results showed striking regional variations in both the likelihood of suffering a heart attack and dying from it, with women in Scotland four times as likely to have a heart attack as women in the South of England. As well as Scotland, relatively high rates were found in North Wales and a belt stretching from Liverpool to Hull, South Wales and South West England. But women from the South of England were almost twice as likely to die from their heart attack as women in Scotland, and rates in London alone were twice those of Liverpool.

The authors suggest that among the various possible explanations, differences in the likelihood of dying may be related to ambulance response times. Previous research has indicated that if a heart attack victim has to wait more than eight minutes for an ambulance, they are significantly more likely to die. During the period of study, the average ambulance response time of eight minutes or less was 61 per cent in Scotland and 54 per cent in England; in London it was 13 per cent compared with 75 per cent in the Liverpool area.

Dr Nick Dunn, Drug Safety Research Unit, Southampton. ndunn@dsru.u-net.com

BMJ Specialty Journals

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