The risk of premature death has decreased significantly in heart attack survivors under age 50. However, they are still almost twice as likely to die early – primarily due to heart disease – when compared with the generation population, finds a study published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

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Women were three times more likely to die after a heart attack compared with the general population, whereas men were 1.7 times more likely.

Around 735,000 people in the United States have a heart attack every year.

The leading cause of heart attacks is a condition called coronary heart disease, in which the coronary arteries become obstructed with deposits of cholesterol.

Around 610,000 Americans die of heart disease per year, with coronary artery disease accounting for 370,000 deaths annually.

Key risk factors for heart disease include high blood pressure, high cholesterol, and smoking, and around half of Americans have at least one of these risk factors.

Medical conditions and lifestyle choices can also increase a person’s risk for heart disease, including diabetes, being overweight or obese, a poor diet, physical inactivity, or drinking excessive amounts of alcohol.

The researchers analyzed data from 21,693 people aged 50 or younger who had survived a heart attack and compared them to 216,930 of the general population, with follow-up over an average of 11 years.

Of the heart attack survivors, 4 in 5 were men, with a median age of 45 years. Most of the heart attack survivors – 83.6 percent – were aged between 40-49 years, with only 1.8 percent under the age of 30.

Findings from the study indicate that there was a decline in heart attack deaths between 1980-1989 and 2000-2009 from 12.5 percent to 3.2 percent within 30 days, 5.1 percent to 1.6 percent within 31-365 days, and 24.2 percent to 8.9 percent within 1-10 years.

When compared with the general population, the patients who were age 50 and younger and had survived for 1 year were 1.89 times more likely to die. The leading causes of death among these people were heart disease and other smoking-related diseases.

Among 1-year survivors, women had a three times greater risk of death and men a 1.7 times increased risk of death after a heart attack when compared with the general population. The research team notes that the reason for the difference in results between sexes in unclear.

Dr. Morten Schmidt, Ph.D., lead study author and a researcher at the Aarhus University Hospital in Denmark, says that while the 30-day risk of death following a heart attack has significantly decreased in the last 30 years, younger patients should still be concerned about their long-term health.

“It is estimated that half of the decline in deaths from heart attacks since 1980 is attributable to primary prevention and, in particular, the reduction in the number of patients who smoke,” says Dr. Schmidt.

“The other half is likely attributable to a combination of things such as the introduction of early treatments that restore blood flow to the part of the heart muscle damaged during a heart attack, improvement in hospital organization, and better management of high blood pressure and high cholesterol,” he adds.

Dr. Schmidt points out that quitting smoking, regularly exercising, and following a healthy diet can reduce the risk of heart attack. Changing these behaviors can also help prevent a second heart attack.

“Even though you survive a heart attack at an early age, you remain at an increased risk of another attack later in life. For the same reason, it is important that patients make efforts to reduce this long-term risk by adhering to the prescribed medical therapy and by improving their lifestyle, especially by stopping smoking.”

Dr. Morten Schmidt, Ph.D.

Dr. Schmidt and colleagues found that cardiovascular disease risk factors were highest among the group that had survived a heart attack when compared with the general population.

Risk factors included angina (11.7 percent versus 0.4 percent); high blood pressure (10.6 percent versus 1.2 percent); diabetes (7.4 percent versus 1.1 percent); and obesity (4.6 percent versus 0.8 percent).

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