▎ WuXi AppTec content team editor
In recent years, cardiovascular diseases such as myocardial infarction (myocardial infarction) have become the first cause of Chinese deaths, with a high fatality rate and a large number of patients.
Myocardial infarction, generally referred to as acute myocardial infarction, is a cardiovascular disease of myocardial ischemia necrosis due to coronary artery blockage and insufficient blood supply, and is also one of the most common and important causes of heart failure.
According to the "China Cardiovascular Health and Disease Report 2020", the overall mortality rate of acute myocardial infarction in China from 2002 to 2018 showed an upward trend; moreover, more and more young people suffered from acute myocardial infarction.
Why do more and more young people get acute myocardial infarction? According to a new study led by yale University researchers, about 85 percent of young (<55 years old) patients who had an acute myocardial infarction for the first time were associated with seven risk factors; and a significant portion (4) of these seven risk factors could be altered.
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The researchers conducted a controlled analysis of 4492 participants, of whom 2246 had an acute myocardial infarction for the first time, and 2246 were age- and gender-matched control populations without acute myocardial infarction.
All participants were between the ages of 18-55 and 68.9% (3122) were female. Among patients with acute myocardial infarction, 82.2% (1861) were type 1 acute myocardial infarction, 3.8% (86) were type 2 acute myocardial infarction, and 14% were other subtypes.
Through a questionnaire, the researchers counted participants' basic health information, lifestyle information, and family history of multiple chronic diseases, treatment history, and other information to assess the association between 13 factors and the risk of acute myocardial infarction, including:
6 diseases: hypertension, diabetes mellitus, hypercholesterolemia, obesity (body mass index [BMI] ≥30 kg/m2, or waist circumference >102 cm in men, waist circumference >88 cm in women), depression, congestive heart failure;
3 lifestyles: current smoking, lack of physical activity, unmarried or not living with a partner;
Family history of 2 diseases: family history of early-onset myocardial infarction (any blood-related relative who had a myocardial infarction before the age of 50), family history of diabetes;
2 other factors: early menopause (menopause before age 45), low household income.
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After removing other factors, the researchers found that there were 7 risk factors: diabetes, depression, hypertension, current smoking, family history of early-onset myocardial infarction, low household income, and hypercholesterolemia, which had a significant effect on the risk of acute myocardial infarction. However, these 7 risk factors did not have the same effect among participants of different genders.
Specifically, among women, having diabetes had the greatest impact on the risk of acute myocardial infarction, followed by current family history of smoking, depression, hypertension, low household income, and early-onset myocardial infarction, which were associated with a 259%, 228%, 209%, 187%, 79%, and 48% increased risk of acute myocardial infarction, respectively. There was no clear association between hypercholesterolemia and the risk of acute myocardial infarction in women.
Among men, current smoking had the greatest impact on the risk of acute myocardial infarction, followed by a family history of early-onset myocardial infarction, hypertension, hypercholesterolemia, depression, diabetes, and low household income, which were associated with a 205%, 142%, 119%, 116%, 77%, 76%, and 35% increased risk of acute myocardial infarction in male participants, respectively.
Obesity and physical inactivity were associated with a 54% and 41% increased risk of acute myocardial infarction in male participants, respectively, and had no significant effect on women; congestive heart failure was associated with a 47% increased risk of acute myocardial infarction in female participants, but not significantly in men.
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The findings also show that approximately 85% of acute myocardial infarction is associated with the above 7 risk factors. In men and women, 85.1% and 83.9% had acute myocardial infarction, respectively, which can be attributed to 7 risk factors.
Acute myocardial infarction in 63.2% and 80.2% of men and women, respectively, can be attributed to 4 preventable risk factors – current smoking, hypertension, diabetes and depression.
In addition, in the subtype analysis of acute myocardial infarction, the researchers found that diabetes, hypercholesterolemia, obesity and current smoking had a significantly higher impact on the risk of acute myocardial infarction type 1 than other subtypes.
Since this study is observational, it only shows the effect of different risk factors on the risk of acute myocardial infarction in people of different sexes, and does not show a causal relationship. Moreover, the study also has some limitations, such as some data relying on participant recall, which may also have an impact on the results of the study.
The study concludes by highlighting that the incidence of acute myocardial infarction in young people has increased in recent years, and a better understanding of the risk factors for acute myocardial infarction in young people, as well as pathophysiological characteristics, can help improve the prevention and treatment strategies of myocardial infarction in this part of the population and promote cardiovascular health.
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The researchers suggest that even at a young age, awareness should be made of the importance of slowing the development of coronary artery disease. Prevention should be done in life, risk factors, especially modifiable risk factors - current smoking, hypertension, diabetes and depression - early interventions, and if necessary, drug treatment should be taken to reduce the risk of acute myocardial infarction.
Specifically, the following 4 points should be done in daily life:
People with conditions such as hypertension, diabetes, hypercholesterolemia and depression should take relevant therapeutic drugs or control blood pressure, blood sugar and cholesterol through other means under the guidance of medical personnel to improve mood.
Lifestyle changes, quit smoking as soon as possible, while balanced nutrition, healthy diet, eat more fruits, vegetables and fish; eat less meat; limit alcohol consumption, avoid alcohol abuse and preferably quit alcohol; 20-30 minutes a day to achieve mild panting physical activity, if you can not reach this standard, you can gradually increase the duration and intensity of exercise.
Taking medications on time, certain medications can reduce the risk of heart attack, take medications as recommended by your doctor, and don't stop, modify medication regimens, or take new medications without your doctor's consent.
If you have symptoms of acute myocardial infarction or chest discomfort, such as shortness of breath, cold sweat, fatigue, dizziness or sudden dizziness, seek medical treatment as soon as possible.
Resources
[1] Yuan Lu, et al.,(2022). Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults. JAMA Netw Open, DOI: 10.1001/jamanetworkopen.2022.9953.
[2] China Cardiovascular Health and Disease Report Writing Group, (2021). China Cardiovascular Health and Disease Report 2020 Summary. Chinese Journal of Recycling, DOI: 10.3969/j.issn.1000-3614.2021.06.001.
[3] Surprising risk factors may predict heart attacks in young women . Retrieved May 10 ,2022,from https://medicalxpress.com/news/2022-05-factors-heart-young-women.html
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