Black adults, middle-aged adults, men and adults living in rural areas all face a heightened risk of dying from an acute myocardial infarction (AMI) before the age of 65, according to new data published in the Journal of the American Heart Association.
"The cardiovascular risks among adults younger than age 65 have become increasingly complex during the last two decades,” lead author Safi U. Khan, MD, MS, a cardiology fellow at the DeBakey Heart and Vascular Institute at Houston Methodist Hospital, said in a statement. "Our study focused explicitly on premature deaths due to a heart attack to identify demographic and regional differences, which may help to inform targeted interventions.”
Khan et al. analyzed CDC data on more than than 600,000 deaths from 1999 to 2019.
The authors found that the death rate was almost three-times higher among men than women. They were also higher among Black adults than white adults.
Regionally, there were higher death rates observed in Southern states compared to Western and Northeastern states. Moreover, middle-aged adults (ages 45-64) had a higher death rate than younger adults (ages 18-44).
“These trends highlight distinct health care disparities among people from diverse racial and ethnic backgrounds,” Khan said. “For example, low socioeconomic status, higher prevalence of having no health insurance and higher prevalence of cardiovascular risk factors, such as smoking, hyperlipidemia, type 2 diabetes, and high blood pressure, among racial/ethnic minorities—all of these factors widened the health gap for people from diverse racial and ethnic groups. Furthermore, people in rural areas were more likely to have limited access to health care. Based on our analysis, these social determinants of health may influence the death rate due to heart attack among younger adults.”
Another key finding revealed that, between 1999 and 2011, the premature death rate dropped by 4.3% per year. The rate of decline slowed to 2.1% per year from 2011 to 2019, however.
Kahn noted that recent medical advancements have lowered major adverse cardiovascular outcomes for patients who have had an AMI, making these findings quite a surprise.
“This concerning trend reflects the growing burden of cardiovascular disease among younger adults," he said. "Implementing evidence-based strategies to prevent and treat premature cardiovascular disease, and public health efforts targeting high-risk groups may help to narrow some of the disparities and improve outcomes among patients after a heart attack."
Read the full study here.