Furthermore, because our tabulation of specific treatments was limited to details given in the press, a procedure that did not involve lengthy recuperation might have been missed. Leaders and their inner circles have incentives to conceal episodes of ill health because such episodes can create the impression that the leaders are no longer capable of governing. Our data suggest that this impression is not usually valid in the case of coronary heart disease. The advances in cardiology made in western countries over the past 30 years are used throughout the world to care for leaders and may have conferred significant benefit. We conclude that primary and secondary intervention, as well as aggressive treatment of acute coronary heart disease, contributed to improved outcomes.
World leaders are a robust group and have a low rate of coronary heart disease events.
Our data suggest that the incidence rates of coronary heart disease in world leaders over the past decade are similar to those reported in the Framingham Heart Study. After myocardial infarction, leaders are likely to have a procedural intervention, and those who survive the acute coronary heart disease event tend to return to work. Over the past two decades, most leaders who had a coronary event remained in power substantially longer than 1 year, and few departed office for health reasons. Policymakers should not regard news of a myocardial infarction in a head of government with great apprehension. The most probable result will be short-term disability but no major change in governance.