Smoking and other lifestyle factors continue to jeopardize heart health.

Heart health greatly depends on dietary habits, exercise and smoking, lifestyle choices that are within the individual’s control.

ST-elevation myocardial infarction, or STEMI, is the most severe and lethal kind of heart attack, which happens when one of the heart’s main arteries becomes wholly congested by plaque, discontinuing the flow of blood. The risk of death and disability is high.

According to the American Heart Association (AHA), STEMI can be treated with clot-busting medications, effective if used within 30 minutes of the attack, or percutaneous coronary intervention (PCI), a mechanical method for opening the arteries.

PCI must be performed within 90 minutes, but in 2013, only 39% of hospitals had the capability to deliver this, and many people in rural areas will not be able to access it.

In the current study, researchers, led by Dr. Samir Kapadia, professor of medicine and section head for interventional cardiology at Cleveland Clinic, inspected the risk factors for heart disease in patients who were treated for STEMI at the Clinic.

The average age of STEMI patients fell from 64 to 60 years. Rates of obesity among these patients rose from 31% to 40%, of diabetes from 24% to 31%, of high blood pressure from 55% to 77%, and the percentage of patients with chronic obstructive pulmonary disease (COPD) went up from 5% to 12%.

The writers say these are “strong messages” for health care professionals and the public.

Dr. Kapadia calls for primary care practice to stay focused on prevention. Not only the cardiologist but also primary care physicians and patients must “take ownership of this problem,” he says.