Young women now more vulnerable to heart disease, cardiac woes

The old stereotype of a heart attack patient being a middle-aged man no longer applies. Young women are now joining those unwanted ranks.

American women are increasingly susceptible to heart disease at a younger age — and they are getting inferior care compared to men, a recent study shows.

A report in the American Heart Association’s journal “Circulation” revealed the rate of patients ages 35-54 who were hospitalised with heart attacks in the US increased from 27 per cent in 1995-1999 to 32 per cent between 2010-2014.

Among those, the incidence for women rose from 21 per cent to 31 per cent, compared with men going up from 30 to 33 per cent.

Just as strikingly, women are less likely to receive guidance-based treatment when they suffer these life-threatening incidents because they often do not fit the profile of a patient in cardiac distress.

“The ever-deteriorating lifestyle of the American populace, with obesity and diabetes, is changing the face of medicine,’’ said Joseph A. Hill, a University of Texas professor of medicine and editor-in-chief of “Circulation”. “We’re seeing lifestyle deterioration in younger women starting in college. The face of cardiovascular disease in our society is changing.’’

According to the Centres for Disease Control and Prevention, every year about 735,000 people in the US have a heart attack — an episode where the heart muscle does not get enough blood flow. Heart disease is the nation’s number one  killer, claiming about 635,000 lives a year and accounting for one of every four deaths for both men and women.

But while women typically develop heart disease 10 years later, and are believed to get a protective benefit from hormones released during the menstrual cycle, the latest study indicates they are now at risk at a younger age.

The CDC says only about half the women realise heart disease is their most likely cause of death, 10 times more so than breast cancer.

“We have to recognise that, now in 2019, women in their 30s have heart disease, whereas 20-30 years ago that was quite rare,’’ Hill said. “The changes that have occurred in the last 20 years are astonishing.’’

The study looked at nearly 29,000 hospitalisations for heart attacks from 1995-2014 at four spots in the nation, in Washington County, Maryland; Jackson, Mississippi; Forsyth County, North Carolina and the Minneapolis suburbs.

The patients ranged in age from 35-74 and the group considered young — 35-54 — made up 8,737 of the total hospitalisations, or 30 per cent.

Harlan Krumholz, professor of cardiology at Yale University, said the study has some limitations in part because its last data point was gathered more than four years ago, but it provides an important warning nonetheless.

“This study is a signal flare that we need to double down on promoting healthy heart lifestyles and preventive strategies — and, in particular, focus on younger women,’’ Krumholz said. “We may be in danger of losing the substantial gains we have made in earlier decades.’’

Researchers also found young women were less likely to receive treatments to open clogged arteries or to be recommended blood-thinners and cholesterol medication to prevent a future heart attack.

Hill and Krumholz emphasised the disparities in treatment were not due to intentional discrimination, but rather the occasional differences in symptoms between men and women experiencing what is known as an acute myocardial infarction or, more likely, different expectations from health providers.

Krumholz pointed out that when he was in med school and the lesson was about heart attacks, the images used to illustrate them always showed men.

“When doctors see young women with risk factors, they are not necessarily thinking of them as being at high risk for heart disease. In general, that is not the typical profile,’’ Krumholz said.

“We have to get it out of our minds that there is a typical profile. In a society where obesity is getting more common and many of these risk factors are returning, if we continue to gain weight, that is going to complicate our risk for heart disease.’’