Common teaching in medical schools is that coronary artery disease is almost unheard of in young women. And, indeed, pre-menopausal women have a significantly lower amount of heart attacks than the elderly and men overall.
But an article in the Journal of the American College Cardiology offers surprising new information. Between 1980 and 2002, the overall death rate from coronary artery disease fell by approximately 50% in both men and women. However, the rate of decline has slowed in the past 10 years, especially in young adults. Those aged between 35 and 54 had a much smaller decrease in the 1990s, and a 1.5% annual increase in women between 2000 and 2002. Even more alarming is that women’s (aged 35 to 44 years) annual mortality rates increased by approximately 1.3% since 1997.
The improved statistics in cardiac death over the past three decades is likely due to a combination of better awareness of cardiac risks (hypertension, diabetes, abnormal cholesterol, smoking, and obesity) as well as the use of medications such as cholesterol-lowering statins.
Why are heart attacks and cardiac death rates increasing in young adults, especially women? Risk factors likely play a role. It’s well documented that obesity, diabetes, and high blood pressure (hypertension) are on the rise in young people. Despite the public’s awareness of cardiac risk factors, optimization of blood pressure, diabetes, and weight is lacking.
Preventing coronary artery disease must involve both lifestyle modification and medication. It is becoming increasingly clear that taking pills without adjusting your diet and exercise routine is not enough to prevent a heart attack.
Sources:
Ford, ES and Capewell, S. Coronary Heart Disease Mortality Among Young Adults in the U.S. From 1980 Through 2002. J Am Coll Cardiol 2007;50(22):2128-32.
Greenland, P and Lloyd-Jones, D. Time to End the Mixed-and Often Incorrect-Messages About Prevention and Treatment of Atherosclerotic Cardiovascular Disease. J Am Coll Cardiol 2007;50(22):2133-5.