There has been a sharp drop in heart disease death rates among Americans 65 and older in recent decades, but declines in death rates are slowing in those younger than 55, particularly women, a new study says.
The findings appear Aug. 24 in the journal Circulation.
“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,” senior author Dr. Viola Vaccarino, professor and chair of epidemiology at Emory University’s Rollins School of Public Health, said in a news release from the journal.
One expert cardiologist agreed.
“This is a true wake-up call — as much as progress is being made, we are falling behind in a group of young women who should be aggressively treated, managed and where prevention is essential,” said Dr. Suzanne Steinbaum, director of Women’s Heart Health at Lenox Hill Hospital in New York City.
In the study, Vaccarino’s group tracked year-by-year changes from 1979 through 2011 for heart disease death rates among U.S. adults age 25 and older.
They found that heart disease death rates among adults 65 and older fell steadily between 1979 and 2011, with the rate of decline accelerating since 2000.
Death rates among adults younger than 55 decreased 5.5 percent among men and 4.6 percent among women between 1979 and 1989. However, the death rate among women in that age group showed no change between 1990 and 1999, and then it fell by only 1 percent between 2000 and 2011, the study found.
The death rate among men in that age group fell 1.2 percent between 1990 and 1999, and dropped 1.8 percent between 2000 and 2011.
Vaccarino said that younger adults have typically “not been studied as much as older groups, partially because they are generally considered to be at low risk [for heart disease death].” The new findings show that “there is an urgent need for more research,” she said.
Rising rates of obesity and diabetes among younger adults could be working against efforts to curb heart disease death rates in this age group, the researchers said.
“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,” Vaccarino said.
Other risk factors may also be playing a role.
“Nontraditional risk factors may be especially important in the younger age group,” Vaccarino said. “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.”
For her part, Steinbaum agreed that more research is needed into heart risk factors for the young, especially younger women.
“In the group, considered to be a low-risk population, death rates have not gone down significantly, and the decrease has been less than men,” she noted. “We have an obligation to make these statistics known, so we can change the realities of heart disease in young women — these death rates are truly unacceptable.”
The American Heart Association outlines how to prevent heart disease.