In a study of over 7,000 women aged 45 years and younger, diabetes produced a six times higher risk of heart attack. The study also showed that smoking was a stronger risk than older age in women.

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Cardiovascular disease rates have been on the increase among younger women.

The results on heart attack (myocardial infarction, or MI) are being presented in London at the congress of the European Society of Cardiology. Prof. Hanna Szwed, one of its authors and head of a department of coronary artery disease at the Institute of Cardiology in Warsaw, Poland, says:

"Cardiovascular diseases affect mainly the elderly, but for many years an increase in incidence has been observed in young people as well, regardless of gender."

"The World Health Organization (wHO) estimates that cardiovascular diseases cause more than 52% of all deaths in women and the number continues to rise," she adds. "Up to 1% of all heart attacks are in young women."

Compared with young women who did not have a history of MI, young women with MI showed the following prevalence of risk factors: 48.8% arterial hypertension (compared with 16.7%), 48.7% current smoking (versus 40.0%), 65.5% past smoking (versus 42,7%), 36.1% high cholesterol, or hypercholesterolemia (versus 12.5%), 22.3% obesity (versus 15.3%), 10.6% diabetes mellitus (versus 1.4%).

The young female MI patients ranged from 21 to 45 years of age and averaged 42. Their strongest independent heart attack predictors were:

  • Diabetes, which increased MI risk six-fold
  • Arterial high blood pressure (four-fold)
  • High cholesterol (three-fold)
  • Current smoking (1.6 times).

There was no statistical significance for obesity measured by body mass index (BMI) as a predictor of MI. Prof. Szwed offers an explanation:

"The lack of a correlation with obesity could be because of the overwhelming influence of diabetes in this population.

We also found that the risk of MI in young women increased with the number of coexisting factors."

Older and younger women compared

The retrospective study found that young healthy women had an average of 1.1 risk factors, while young women with a history of MI had 1.7. Older women with MI had an average of 2.0 risk factors.

Compared with young healthy women, those with MI more often had arterial hypertension, hypercholesterolemia and diabetes and were current or past smokers.

Prof. Szwed picks up on a smoking disparity:

"We found that the risk factor profile in young women with MI was similar to the older population apart from the greater occurrence of tobacco smoking in young women."

"This finding correlates with other research which shows that smoking is a growing problem in young women," she adds. "This is clearly an area where prevention efforts are needed."

This study of 7,386 women included 1,941 aged 45 years and younger with MI who were compared retrospectively with two control groups: 1,170 healthy women in the same age range but with no MI history, and 4,275 women aged 63-64 years with MI.

Data came from three national registries: the Polish Registry of Acute Coronary Syndromes, the Multicentre Study of State National Population Health and the National Survey of Risk Factors for Cardiovascular Diseases.