Studies show that heart attacks are on the rise among young women

ATLANTA (CNN) – A new study suggests that heart attack risk is on the rise among young women, and researchers are trying to understand why.

When analyzed every five years, the overall proportion of heart attack-related hospitalizations in the United States attributable to young patients aged 35 to 54 has increased steadily from 27% in 1995 -1999 to 32% in 2010-2014. the largest increase observed among young women, according to the study, recently published in the journal Circulation.

During these periods, these admissions increased from 21% to 31% among young women, compared with 30% to 33% among young men, the study showed.

"The message to remember is that an increasing percentage of heart attacks occur in younger patients, even as our population ages, and the biggest increase seems to be in young women," said Melissa Caughey, lead author of Study and researcher. in the Division of Cardiology at the Chapel Hill School of Medicine at the University of North Carolina.

A heart attack or acute myocardial infarction occurs when part of the heart is not getting enough blood. Each year, about 790,000 Americans have a heart attack, according to US Centers for Disease Control and Prevention. Heart attacks occur most often as a result of heart disease, the leading cause of death in the United States.

According to the World Health Organization, 85% of cardiovascular deaths are attributable to a heart attack or stroke.

The new study included 28,732 hospitalizations for heart attack in patients aged 35 to 74 between 1995 and 2014.

The data come from the study on the risk of atherosclerosis in communities (ARIC) and hospitalizations concerned four communities: Forsyth County, North Carolina; Washington County, Maryland; Jackson, Mississippi; and eight northwest suburbs of Minneapolis.

The researchers looked closely at young patients aged 35 to 54, who accounted for 30% of hospitalizations.

In this group, the annual incidence of hospitalizations for heart attack decreased from 1995 to 2014 among young men, but an increase was observed among young women, the researchers found.

"When we looked at the incidence – that is, the number of patients having a heart attack each year, divided by the total patient population in the group – we found that there was actually had a decrease in incidence among young men, and this kind of parallel to what we see in older populations, but we found a slight increase for young women, "said Caughey.

"It was surprising because it goes against other trends in other demographic groups," she said. "Earlier studies of the same ARIC surveillance system showed a decline and it was mostly about older populations or older patients … National trends also show the same thing, ie there is a decrease in the number of heart attacks. "

Compared to young men in the study, young women were more likely to have health insurance and history of hypertension, diabetes, chronic kidney disease, and stroke, have discovered the researchers. Young women were also more likely to be black and less likely to smoke.

The study, published online in November, had certain limitations, including data from only four communities. More research is needed to determine if similar trends could emerge at the national level.

In addition, the data was limited to medical records and did not include information on obesity, a known risk factor for heart attack.

"When I found the high rate of diabetes in women, I thought at the beginning:" and obesity? "And the study did not have information on whether these women were obese or not," said Dr. Nieca Goldberg, cardiologist and medical director of Joan H. Tisch's Center for Women's Health at NYU Langone Health in New York. York, who was not involved in the study.

Such risk factors – such as type 2 diabetes and high blood pressure – may help to explain the increase in heart attacks in young women, but more research is needed to determine precisely what could lead to this increase, added Goldberg.

"It is complex." Are risk factors and symptoms recognized by providers and patients, even though they have insurance, take the time to make an appointment? difficult to get an appointment so they just gave up? " Goldberg asked.

"It's possible, but observe other behaviors of this age group." People are working and spending more time than before at their desks and are not physically active. Physical activity is also a risk factor, "she said. "Lack of sleep and increased stress increase blood pressure, it is also a risk factor."

The results of the study are "particularly striking because of the aging of the population, and yet we find that a higher proportion of patients with a heart attack are younger patients," he said. Dr. Harmony Reynolds, Co-Head of the Sarah Ross Soter Center for Cardiovascular Diseases. Research and Associate Professor of Medicine at the NYU School of Medicine in New York.

This is probably related to risk factors that have also become increasingly common in patients with heart attacks, such as diabetes and high blood pressure, said Reynolds, who did not participate at the study.

"We particularly see that [increase] among young women and especially young African-American women, "Reynolds added.

In addition, women were less likely to follow certain types of treatments, such as cholesterol-lowering drugs and prevent clotting. However, despite previous research that found higher mortality rates among women with heart attacks, the risk of all-cause death after one year was comparable between men and women.

Reynolds said many people are unaware of their risk factors for heart attack and need to be proactive in talking to their doctors about how to reduce their risk. Many may not be aware that heart attacks may look different in women, who are more likely to have atypical symptoms such as nausea or sweating, she added.

Another study, published last year in the journal Circulation, found that among adults 55 years old and younger, women were more likely than men to experience less familiar heart attack symptoms in addition to pain in the heart. chest – and more than half of the doctors seeing women seeking care for these symptoms did not realize that the symptoms are related to the heart.

Some of these heart attack symptoms may also include shortness of breath; dizziness; or feel pain or discomfort in one or both arms, back, neck, jaw or stomach, according to the American Heart Association.

"Some people expect the heart attack to look like what you see in the movies – as if people were grabbing their chest and lying on the floor for to feel horrible – and for some people it's much more subtle than that, "Reynolds said. "I saw someone last week who felt a heart attack in his two front teeth."

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