Greek financial crisis increased heart attacks



SAN FRANCISCO – Heart attacks at a regional Greek hospital spiked 44% during the country’s financial crisis, with higher rates in women, older people, and the indigent or uninsured, a study has shown.

The findings, reported by Dr. Emmanouil Makaris at the annual meeting of the American College of Cardiology, highlight some of the health costs to be paid by the populace when governments, politicians, or bankers send economies into tailspins or at least stress their underpinnings.

The retrospective study of data on 22,093 patients admitted to the cardiology department at the General Hospital of Kalamata found 1,406 incident heart attacks among the 10,870 patients admitted from 2004 through 2007, before the Greek financial crisis, and 1,508 heart attacks among the 11,223 patients admitted in 2008 through 2011, during the ongoing crisis. The relative 44% increase in the incidence of acute MI was significant, said Dr. Makaris, a consulting cardiologist at the hospital.

In women, the incidence of acute MI rose by 51% from the period before the crisis (251 acute MIs) to the crisis era (394). The incidence of acute MI in men increased by 40% from precrisis (795) to the crisis era (1,114).

The incidence of acute MI increased by 41% for patients older than 45 years (from 944 heart attacks before to 1,363 during the crisis). In comparison, the incidence increased by 30% for patients aged 45 years or younger (from 64 before to 83 during the crisis).

The indigent or uninsured faced a 76% increased incidence of acute MI (66 heart attacks before the crisis and 116 since then), while insured patients saw a 42% increased incidence (980 before and 1,392 during the crisis).

Dr. Makaris said that many doctors at the meeting have asked him to explain how the crisis contributed to heart attacks. He described one woman who could no longer afford to buy clopidogrel, and suffered an acute MI. A man who lost his job and had no means to support his family had a heart attack, presumably with stress as a contributor.

Some people are losing their homes, unable to pay huge tax increases. Greek women are more likely to be unemployed than men and more likely to be responsible for children. Families are searching through trash bins for food, and some children faint in school from hunger. At the same time, the government’s fiscal austerity measures have slashed medical staff levels and supplies when there is greater need, he said.

Greece’s crisis is much more severe than the latest U.S. recession, in which more than 8 million people lost their jobs, but the findings should add extra concern about the effects of our homegrown financial crises.

In the United States, more women now are unemployed than men, the Los Angeles Times reported.

The U.S. Government Accountability Office reported in late 2012 that workers aged 55 years and older are less likely to be laid off in our recession than are younger workers, but once unemployed, older people have a harder time getting rehired and are more likely to take a pay cut if they do find work.

A separate study showing cardiovascular harm from Argentina’s 1999-2002 financial crisis support the Greek findings, Dr. Makaris said (Thromb. J. 2005;3:22). And a more recent U.S. study showed that employment instability increased the risk of cardiovascular events (Arch. Intern. Med. 2012;172:1731-7).

At a press briefing, moderator Dr. Fred Bove suggested that the United States should heed this warning from Greece. "I think we all see ourselves as potential victims if we don’t manage our finances," said Dr. Bove of Temple University, Philadelphia.

Dr. Makaris reported having no relevant financial disclosures.

*This story was updated on March 12, 2013.

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