Young adults, women experience only slight declines in heart disease deaths

Deaths from heart disease have declined dramatically over the last few decades but young people, particularly women, are not sharing equally in that improvement, according to new research in the American Heart Association's journal Circulation.

Using data on adults age 25 and older, researchers tracked annual percentage changes in heart disease death rates between three time periods: 1979-1989, 1990-1999 and 2000-2011. Death rates in adults 65 and over declined consistently over the decades, with accelerating improvements since 2000.

In contrast, men and women under age 55 showed clear declines in annual death rates between 1979 and 1989 -- down 4.6 percent in women and 5.5 percent in men -- but then improvement slowed. The annual change in death rates in young women showed no improvement between 1990 and 1999 and has only fallen one percent since 2000. Death rates in young men fell 1.2 percent between 1990 and 1999 and 1.8 percent since 2000.

"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," said Viola Vaccarino, M.D., Ph.D., senior author of the study and professor and chair of epidemiology at Emory University's Rollins School of Public Health in Atlanta, Georgia. "This population has not been studied as much as older groups, partially because they are generally considered to be at low risk. There is an urgent need for more research."

Escalating rates of diabetes and obesity in younger adults could contribute to the lack of improvement.

"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.

Researchers may need to look beyond traditional risk factors such as high blood pressure and cholesterol to improve heart disease prevention in adults under age 55, researchers suggest.

"Non-traditional 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."