Serious heart attacks affecting younger people

SERIOUS heart attacks are affecting younger and more obese individuals, and rates of high blood pressure, diabetes and chronic obstructive pulmonary disease remain elevated, according to findings due to be presented at the American College of Cardiology’s 65th Annual Scientific Session in Chicago, IL. Factors that increase the risk of heart attack include age and family history, which are beyond the individual’s control.
However, heart health can also depend on dietary habits, exercise and smoking, lifestyle choices that are within the individual’s control. Awareness of cardiovascular disease has increased dramatically in recent years, and people are more aware than ever of the need to address preventable causes. ST-elevation myocardial infarction, or STEMI, is the most severe and deadly type of heart attack, which occurs when one of the heart’s main arteries becomes completely blocked by plaque, stopping the flow of blood. The risk of death and disability is high.
According to the American Heart Association (AHA), STEMI can be treated with clot-busting medications, effective if used within 30 minutes of the attack, or percutaneous coronary intervention (PCI), a mechanical method for opening the arteries. PCI must be performed within 90 minutes, but in 2013, only 39% of hospitals had the capability to deliver this, and many people in rural areas will not be able to access it. In the current study, researchers, led by Dr. Samir Kapadia, professor of medicine and section head for interventional cardiology at Cleveland Clinic, examined the risk factors for heart disease in patients who were treated for STEMI at the Clinic.
The scientists apportioned over 3,900 STEMI patients from 1995-2014 into four quartiles of 5 years each. The average age of STEMI patients fell from 64 to 60 years. Rates of obesity among these patients rose from 31% to 40%, of diabetes from 24% to 31%, of high blood pressure from 55% to 77%, and the percentage of patients with chronic obstructive pulmonary disease (COPD) went up from 5% to 12%. All of the changes are significant and in keeping with national trends.
Meanwhile, the proportion of smokers in this population rose from 28% to 46%, despite an overall decline nationwide over the last 2 decades. In addition, the percentage of patients with three or more major risk factors rose from 65% to 85%. The authors say these are “strong messages” for health care professionals and the public. Dr. Kapadia calls for primary care practice to stay focused on prevention. Not only the cardiologist but also primary care physicians and patients must “take ownership of this problem,” he says. “On the whole, the medical community has done an outstanding job of improving treatments for heart disease, but this study shows that we have to do better on the prevention side.

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