When a young woman survives a heart attack or stroke, she will still face long-term risks of death and illness, according to an article published in JAMA Internal Medicine.
Death rates from the acute phase of cardiovascular events have fallen, but the disease burden remains high among the growing number of survivors.
This is especially important for those who suffer such an event at a young age.
But little information is available about the long-term outcomes, especially for young, female patients, who survive cardiovascular events.
Dr. Frits R. Rosendaal, PhD, of Leiden University Medical Center in the Netherlands, and coauthors studied long-term mortality and morbidity in young women who survived myocardial infarction (heart attack) or ischemic stroke compared with a control group.
They looked at data for 226 women who had a heart attack at an average age of 42, 160 women who had ischemic stroke at an average age of 40, and 782 women with an average age of 48 in a control group with no history of arterial thrombosis (blood clot in an artery).
The women were followed up for a median of nearly 19 years.
In the control group, the number of fatalities was 2.4 per 1,000 person-years. Compared with this, death rates were 3.7 times higher in women who had a heart attack than in the control group – and 1.8 times higher in women who had ischemic stroke. This elevated mortality lasted over time and was mainly due to a high rate of deaths from acute vascular events.
When both fatal and nonfatal cardiovascular events were counted, the incidence rate was highest in women who had an ischemic stroke (14.1 per 1,000 person-years) compared with the control group. The rate was 12.1 per 1,000 person-years in women who had a heart attack.
In women who had a heart attack, the risk of cardiac events was 10.1 per 1,000 person-years, and the risk of cerebral events was 1.9 per 1,000 person-years. In women who had an ischemic stroke, the risk of cerebral events was 11.1 per 1,000 person-years, and the risk of cardiac events was 2.7 per 1,000 person-years.
Limitations of the study include a problem common to all long-term follow-up studies: procedures and risk factors change over time.
However, the researchers conclude:
“Our findings provide direct insight into the consequences of cardiovascular diseases in young women, which persist for decades after the initial event, stressing the importance of life-long prevention strategies.”
Medical News Today recently reported that the BCAR1 gene indicates a higher risk of heart disease in women.