While deaths from heart disease have declined quickly and consistently among older adults over the last 3 decades, the same cannot be said for young adults, according to the findings of a new study.
The research, published in Circulation, examines heart disease death rates from 1979-2011, revealing that improvement slowed for adults under the age of 55 - especially among women.
"We think that these trends are not related to differences in treatment and hospitalization, but rather to a lack of effective preventive strategies for young people, particularly women," says senior author Dr. Viola Vaccarino, professor and chair of epidemiology at Emory University in Atlanta, GA.
For the study, the researchers calculated the yearly changes in heart disease death rates for three separate time periods: 1979-1989, 1990-1999 and 2000-2011.
Mortality data were obtained for all individuals aged 25 years and older in the US during these periods from the Centers for Disease Control and Prevention's (CDC) Compressed Mortality File of US National Vital Statistics.
Among adults under the age of 55, clear declines in annual death rates were observed between 1979-1989 for adults under the age of 55, with death rates falling by 5.5% in men and 4.6% in women. However, the rate of this improvement slowed dramatically in subsequent time periods.
From 1990-1999, no improvement in heart disease death rates was observed among women under the age of 55. For men, death rates only fell by 1.2% during this time.
Heart disease death rates improved from 2000-2011, but only slightly. For women, the death rate fell by 1% and for men it fell by 1.8%
In contrast, heart disease death rates among adults aged 65 and over fell consistently from 1979 onward, with the rate of improvement accelerating from 2000 onward.
Dr. Vaccarino states that the younger adult population has not been the subject of research as much as older individuals, "partially because they are generally considered to be at low risk. There is an urgent need for more research."
Efforts toward understanding cardiovascular disease 'should be refocused'
"Some reports suggest that diabetes and obesity may pose a greater heart disease risk in younger women than in other groups, and women need to become more aware of the heart risks of these conditions," Dr. Vaccarino reports.
Alongside obesity and diabetes, other recognized risk factors for developing heart disease include aging, physical inactivity, smoking, poor diet and a family history of coronary heart disease.
Dr. Vaccarino also believes that non-traditional risk factors may be especially important in this younger age group:
"For example, in other research we and others have done, factors such as stress and depression are particularly common among young women with early-onset heart disease, and are powerful predictors of heart disease or its progression in this group."
In an accompanying editorial, Dr. Elizabeth Nabel, of Brigham and Women's Health Care in Boston, MA, states that the findings highlight "the value of looking 'behind the curtain' at health data, in particular teasing apart age- and sex-related outcomes."
She states that efforts toward better understanding cardiovascular disease risk should be refocused, particularly among younger women and men. Younger individuals should be routinely screened for cardiovascular disease risk and, where warranted, primary prevention should be engaged, she suggests.
"The promise of a life free from [cardiovascular disease] should be within reach of all Americans," Dr. Nabel concludes.
Earlier in the year, Medical News Today ran a Spotlight feature on heart disease in women, taking a look at some of the unique problems faced by women. These include experiencing heart attacks differently, shared symptoms with pregnancy and menopause and medical practices favoring men.