"Factors such as stress and depression are especially common among young women with early-onset heart disease, and are powerful predictors of heart disease or its progression," says Kobina Wilmot. (Credit: Erin Nekervis/Flickr)

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Why is heart disease still killing young women?

Heart disease deaths among older Americans have fallen dramatically over the past 40 years, but the same is not true for younger people—especially women.

For a new study, researchers analyzed coronary heart disease (CHD) mortality data and changes in trends between 1979 and 2011 for US adults 25 and older.

The findings, published in the journal Circulation, suggest Americans 65 and older show consistent mortality declines, which became even more significant after 2000.

Younger men and women under the age of 55 showed stagnation with minimal improvement. Young women showed no improvements between 1990 and 1999 and minimal improvement thereafter.

Sluggish improvements

“Our findings reveal large differences across demographic groups,” says Kobina Wilmot, fellow in the cardiology division at Emory University’s School of Medicine.

“The causes of the sluggish improvements in CHD mortality among young adults, especially women, are unclear but we think that these trends reflect lack of effective preventive strategies for young people, particularly women.”

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Lower awareness and recognition of CHD in women have long been reported. Low socioeconomic resources affecting access to preventive care is also a possible variable. Escalating rates of diabetes and obesity in younger adults, especially women, may be implicated as well.

“A possible reason for the slow decline in CHD mortality among young people in recent decades is that prevention guidelines may disproportionately underestimate risk in a younger population,” says Viola Vaccarino, chair of cardiovascular research in the epidemiology department.

“We may need to look beyond traditional risk factors currently included in risk prediction algorithms. For example, factors such as stress and depression are especially common among young women with early-onset heart disease, and are powerful predictors of heart disease or its progression in this group,” she says.

“Reasons underlying these different trends urgently require further study and closer attention to primary prevention strategies for the younger population.”

Source: Emory University

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