July 22, 2014
News Review From Harvard Medical School -- No Heart-Attack Drop for Younger Adults
Though heart attacks have declined among older adults, a new study finds that rates have stayed the same for those under 55. And younger women continue to do worse than younger men after heart attacks. The new study covered the years 2001 through 2010. Researchers looked at records of nearly 231,000 hospital stays for heart attacks. All of the patients were ages 30 to 54. About one-quarter of them were women. Hospital-stay rates for heart attack remained about the same throughout the decade. This was true for both men and women. Women tended to stay longer in the hospital than men. They also were more likely to die in the hospital, though their death rates fell during the decade. Death rates remained the same for men. Black women were more likely than white women to have a hospital stay for a heart attack. There was not much difference between the rates for black and white men. An American Heart Association spokesman said rising obesity and diabetes among younger adults may be keeping heart attacks up in this group. The Journal of the American College of Cardiology published the study. HealthDay News wrote about it July 21.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Hospital stays and deaths resulting from heart attacks have declined dramatically for older people. But for adults under the age of 55, the decrease is much less impressive.
During the last 10 years, doctors have become more aware of the differences in coronary artery disease between men and women. This is important because most of the studies done to help determine the best way to diagnose heart attacks and other heart problems were done on men. The lessons learned were applied to women.
At the time, doctors thought that the symptoms and outcomes would be very similar. They clearly are not.
In fact, the differences are quite striking. Many women do not have the classic squeezing chest pain of heart attack. Instead, they might have extreme fatigue, profuse sweating, shortness of breath or all of these. And women of all ages have a greater risk of dying from a heart attack than men.
This particular study was designed to look at trends in hospital stays and deaths from heart attacks in men and women younger than 55. For men, there was little change during the 10 years covered by the study.
Younger women were just as likely to have a hospital stay after a heart attack in 2010 as in 2001. But there were fewer deaths. Even with the decrease, women's risk of dying in the hospital from a heart attack was consistently higher than the risk for men.
The authors did not look at why heart attacks rates and deaths were not falling as much for younger adults as for older ones. Perhaps it is related to less active lifestyles and rising rates of obesity and diabetes.
What Changes Can I Make Now?
Heart and blood vessel diseases still cause the most deaths in the United States and most developed countries. Prevention must start early in life.
The symptoms and outcomes for women with heart disease may be different than those for men. But the way to prevent a heart attack is similar for both sexes.
- Don't smoke. Quitting reduces your heart attack risk within weeks.
- Stick to a heart-healthy diet, such as a Mediterranean-style diet.
- Stay physically active and exercise regularly.
- Maintain a healthy weight.
- Keep your blood pressure under control.
- Work to keep your LDL cholesterol and triglyceride levels down and HDL cholesterol up. Start with diet changes and increased exercise. Add medicines prescribed by your doctor if needed.
What Can I Expect Looking to the Future?
Most people know what to do to help prevent heart disease. But far too few are actually doing it. What we need most are new ways to motivate people to reduce heart disease risk and the research to prove that those ways are effective.