Younger US women are suffering heart attacks at a higher rate now than 20 years ago – even while the picture has improved for younger men.
Those are the key findings from a new study of four US communities, in which researchers report the heart attack rate among women younger than 55 has steadily inched upward since 1995. In contrast, the rate has dipped among men in that age group.
Increasing obesity rates nationwide
By 2014, those younger women accounted for 31% of hospitalizations for heart attack – up from 21% in the late 1990s.
The findings were published in a special issue of the journal Circulation focusing on women's heart health.
It's not entirely clear why heart attacks rose among younger women. But the study period spanned a time of increasing obesity rates nationwide.
"Young women have a higher prevalence of obesity than men in the same age group, and this is especially true among minorities," said senior researcher Melissa Caughey. She is an instructor in cardiology at the University of North Carolina, in Chapel Hill.
"Obesity can be a risk factor for high blood pressure and diabetes," Caughey said, "and all three can lead to a higher risk for heart attack."
In fact, the study found, high blood pressure and diabetes were more common among younger women who suffered a heart attack, versus their male counterparts.
Rising hospitalisation rate
Dr Suzanne Steinbaum pointed out that "obesity, high blood pressure and diabetes all seem to be more detrimental to women". She is a spokesperson for the American Heart Association who was not involved in the study.
"I wish I could say I'm surprised by these findings, but I'm not," added Steinbaum, who directs women's cardiovascular prevention, health and wellness at Mount Sinai Hospital, in New York City.
The results are based on a 19-year study of adults living in four US communities in North Carolina, Mississippi, Minnesota and Maryland. Over that time, there were nearly 29 000 hospitalisations for heart attack: 30% were among people aged 35 to 54.
But while that hospitalisation rate dipped among younger men over the years, it crept up among younger women – to between two and three heart attacks per 1 000 women by 2014, the findings showed.
At that point, 31% of heart attack hospitalisations were happening among younger women – up from 21% in the late 1990s.
In contrast, the number of young men hospitalised for a heart attack declined over time – though the rate remained higher compared with young women, at roughly four per 1 000 by 2014.
Early attention to prevention
One problem, according to Caughey's team, is the enduring myth that heart disease is a "man's disease".
Steinbaum agreed. Even among doctors, she said, there remains an "unconscious bias" to take conditions like high blood pressure less seriously in women, versus men.
The study did find that younger women with heart attacks were less likely than men to get recommended medications to reduce their risk of another attack.
For women, Caughey said, the findings underscore the importance of early attention to prevention.
"Many of the risk factors for heart attack are modifiable," she said. "Although it's never too late to adopt a heart-healthy lifestyle, earlier is better. And that's something young women can keep in mind."
That can, however, be easier said than done – and that's a big part of the problem, according to Steinbaum. Women in their 30s to 50s are often working and raising kids, and may be caring for ageing parents, too.
'Exercise is the best medicine'
"The lives of women today are really complicated," Steinbaum said. "We need to figure out a way to take care of ourselves, too."
Getting up and moving throughout the day is critical, she said – whether that means going to the gym, taking a walk or turning on music and dancing with your kids.
"Exercise is the best medicine," Steinbaum said. "Make the time, as best you can, to get that 150 minutes of activity every week."
A second study in the same issue highlights the importance of simply getting off the couch. It followed older women, finding that the less time women spent sitting or lying down throughout the day, the lower their risk of eventually suffering a heart attack or stroke.
The effect was independent of how much time women dedicated to exercise, like brisk walking. That, researchers said, suggests that older women benefit just from getting up and moving throughout the day.
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