Why Are Young Women Having More Heart Attacks?

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In a disturbing new trend, researchers find that heart attacks are on the rise for young women.

When you imagine the typical heart attack victim, do you see an older male? Most people do. Thankfully, deaths due to heart disease have been declining steadily over the last 40 years due to progress in the prevention and treatment of coronary heart disease. But curiously, the overall numbers have leveled off recently and researchers weren't sure why.

Now, they think they have an answer: Heart attacks in older people may be waning, but heart attacks in younger people, especially women, are on the rise, according to a new study published in the American Heart Association journal, Circulation. As Viola Vaccarino writes in the study's accompanying editorial:

The authors report a staggering increase in the annual incidence of hospitalized MI [myocardial infarction] among young women (35–54 years old), whereas the incidence decreased among men in the same age bracket.

Indeed, between 1995 and 1999 women between the ages of 35 and 54 accounted for 21 percent of those hospitalized for heart attacks. Between 2010 and 2014, that number rose to 31 percent. For men of the same age, the number went from 30 to 33 percent. While the percentage of heart attacks occurring in young men increased slightly during the 20 years span of the study, the actual number of heart attack in men in the age group went down – young women did not see a similar drop.

How unfair is that? Really unfair, especially since, remarkably, the increase appears to be related to the fact women are not treated for heart disease in the same way men are.

The researchers found that women hospitalized for heart attacks were less likely than men to receive therapies to open clogged arteries (21 percent less likely), or to receive guideline recommended medications such as non-aspirin blood thinners (17 percent less likely), beta-blockers (4 percent less likely), and cholesterol lowering drugs (13 percent less likely) to reduce the risk of another heart attack.

Young women with MI were also more likely than their male counterparts to have comorbidities, including hypertension, diabetes mellitus, chronic kidney disease, and prior stroke – modifiable risk factors that are not being addressed.

Since avoiding illness through preventative medicine (and improved lifestyle habits) saves lives, expenses, and precious environmental resources – why isn't more attention being paid here?

"The increasing incidence of hospitalized MI in young women, together with the similar case fatality in women and men in this study, points to primary prevention as pivotal to improve cardiovascular health in women and curb these adverse disease trends," writes Vaccarino.

Vaccarino notes it is likely that women are not getting advice on prevention from their doctors, writing that "the treatment differences observed during the MI hospitalization suggest a tendency toward underutilization of cardiovascular prevention strategies among women, which might have extended to the preinfarction phase and contributed to their risk."

Traditionally misconceived as a “man’s disease,” the study notes that recognition of cardiovascular risk in female patients is lower than for male patients with similar risk profiles.

Cardiologist Dr. Elizabeth Piccione, who was not involved in the study, told Today that part of the problem is that doctors perceive women differently. "For example, if a woman comes in and has high blood pressure she’s often told it’s because she’s anxious," Piccione said. "When a man comes in with the same numbers, he’s told his blood pressure is high."

The study authors conclude that there is an "enduring need for effective preventive strategies to reduce the burden of cardiovascular disease in the young population, especially among young women." Given that atherosclerotic cardiovascular disease is the leading cause of death in women, it's about time the message is getting out.

For more information, visit the American Heart Association's initiative, Go Red for Women, a movement aimed at ending heart disease and stroke in women.