What Are Your Odds of a Heart Attack?
Each year heart attacks kill more than 150,000 Americans, nearly half of them women. If such a grim statistic can have a bright side, it’s this: Most heart attacks today aren’t fatal.
About 75% of men and 60% of women live at least one year after an attack.
Who is most at risk?
While most heart attack victims are middle-aged or older—the average age for a first attack is 66 for men and 70 for women—people in their 20s and 30s suffer attacks too.
The risk of a heart attack climbs for men after age 45 and for women after age 55.
When do heart attacks strike?
Heart attacks occur roughly every 35 seconds in the United States, and most occur in the morning, a time when the platelets in the blood are especially “sticky” and prone to form clots.
At least one study, however, has found that morning isn’t a prime time for heart attacks among people who regularly take aspirin, which helps keep platelets from sticking together.
Beating the odds
Survival odds for people who have had a heart attack keep getting better thanks to advances in diagnosis, medication, and lifesaving technology.
It’s worth noting that survival rates for heart attack patients are better on weekdays compared to weekends, because medical personnel are more likely to use invasive procedures (including angioplasty and bypass surgery) during the week.
Nonetheless, cardiologists are optimistic about the rate of improvement in cardiac care. When Sharonne Hayes, MD, director of the Mayo Clinic’s Women’s Heart Clinic, started practicing in the mid-1980s, doctors couldn’t do much for people having heart attacks. “Now we can stop a heart attack in its tracks,” she says. “Patients have a much better chance at recovery.”
Heart attacks increasingly common in young adults
The study, which is the first to compare young (41-50 years old) to very young (40 or younger) heart attack survivors, found that among patients who suffer a heart attack at a young age overall, 1 in 5 is 40 or younger. Moreover, during the 16-year study period (2000 to 2016), the proportion of very young people having a heart attack has been increasing, rising by 2 percent each year for the last 10 years.
“It used to be incredibly rare to see anyone under age 40 come in with a heart attack — and some of these people are now in their 20s and early 30s,” said Ron Blankstein, MD, a preventive cardiologist at Brigham and Women’s Hospital, associate professor at Harvard Medical School in Boston and the study’s senior author. “Based on what we are seeing, it seems that we are moving in the wrong direction.”
Also, despite being 10 years younger on average than those having heart attacks in their 40s, very young patients have the same rate of adverse outcomes, including dying from another heart attack, stroke or any other reason.
“Even if you’re in your 20s or 30s, once you’ve had a heart attack, you’re at risk for more cardiovascular events and you have just as much risk as someone who may be older than you,” Blankstein said, explaining that young age isn’t necessarily protective. “It’s really important for us to understand why people are actually having heart attacks at a younger age, when there is even more productive life lost.”
As part of their analyses, Blankstein and colleagues tried to identify possible risk factors behind the increase in heart attacks among younger adults. They said that traditional risk factors for heart attack, including diabetes, high blood pressure, smoking, family history of premature heart attack and high cholesterol, were similar between the two groups. However, the youngest patients were more likely to report substance abuse, including marijuana and cocaine (17.9 percent vs. 9.3 percent, respectively), but had less alcohol use.
The study included a total of 2,097 young patients (<50 years) admitted for a heart attack in two large hospitals. Of these, 20 percent were 40 or younger. Researchers compared young heart attack victims (<50 years vs. ?40) using patient angiograms, a procedure that uses X-rays to see the heart’s blood vessels and arteries. People in the very young heart attack group were more likely to have disease in only one vessel, suggesting that this disease was still early and confined, yet they had the same rate of bad outcomes. The very young group also had more spontaneous coronary artery dissection — a tear in the vessel wall — which, while rare, tends to be more common in women, especially during pregnancy.
There was a non-statistical trend toward less use of aspirin and statins upon discharge among very young patients, which Blankstein said might suggest a bias in terms of clinicians believing these patients are at lower risk because of their age. However, data showed patients in both groups were at equal risk of dying post-heart attack.
“It all comes back to prevention,” Blankstein said. “Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors. My best advice is to avoid tobacco, get regular exercise, eat a heart healthy diet, lose weight if you need to, manage your blood pressure and cholesterol, avoid diabetes if you can, and stay away from cocaine and marijuana because they’re not necessarily good for your heart.”
Young heart attack victims who also have diabetes fare much worse
In a related study, Blankstein and his team found that 1 in 5 patients who suffer a heart attack at a young age overall — defined as younger than 50 years of age — also have diabetes. Data show that if someone has diabetes they are more likely to die and have repeat events than heart attack survivors without diabetes. Not only is diabetes one of the strongest risk factors for having a heart attack, it also predicts future events in young people who have previously had a heart attack. These patients need to be aggressively treated and clinicians should pay very close attention to all other modifiable risk factors.
The good news, Blankstein said, is that there are now two classes of diabetes medications that have also been shown in clinical trials to significantly reduce the likelihood of cardiovascular events, including heart attack or stroke, or dying from one.
Men and Heart Disease
What are the risks for heart disease?
High blood pressure, high LDL (low-density lipoprotein) cholesterol, and smoking are key risk factors for heart disease. About half of Americans (47%) have at least one of these three risk factors.7
Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including
- Overweight and obesity
- Unhealthy diet
- Physical inactivity
- Excessive alcohol use
How can I reduce my risk of heart disease?
To reduce your chances of getting heart disease, it’s important to do the following:8
- Know your blood pressure. Having uncontrolled blood pressure can result in heart disease. High blood pressure has no symptoms so it’s important to have your blood pressure checked regularly. Learn more about high blood pressure.
- Talk to your health care provider about whether you should be tested for diabetes. Having diabetes raises your risk of heart disease.9 Learn more about diabetes.
- Quit smoking. If you don’t smoke, don’t start. If you do smoke, learn ways to quit.
- Discuss checking your cholesterol and triglyceride levels with your health care provider. Learn more about cholesterol.
- Make healthy food. Having overweight or obesity raises your risk of heart disease. Learn more about overweight and obesity.
- Limit alcohol intake to one drink a day. Learn more about alcohol.
- Lower your stress level and find healthy ways to cope with stress. Learn more about coping with stress.
CDC’s Public Health Efforts Related to Heart Disease
- State and Local Public Health Actions Program
- Million Hearts®external icon
For more information on men and heart disease, visit the following websites:
- Centers for Disease Control and Prevention
- American Heart Associationexternal icon
- National Heart, Lung, and Blood Institute (NHLBI)external icon
As you get older, you are more likely to have heart failure — it’s the leading cause of hospitalization for people over age 65. But men and women under 65 also are at risk for developing heart failure. Why does that happen in younger people? And how can you prevent it?
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It’s important to know that, despite its name, “heart failure” does not mean your heart has failed or stopped working. The term describes a medical condition in which the heart is not pumping enough blood to meet the body’s needs for blood and oxygen.
There are a number of factors that may make heart failure more likely, despite your age.
- Cardiovascular risk factors
People with one or more risk factors such as diabetes, obesity or hypertension are at a higher risk of developing heart failure. Hypertension, or uncontrolled high blood pressure, can increase the risk of heart failure two to three times. Meanwhile, physicians are seeing severe obesity — body mass index of 40 or higher — more frequently in younger patients admitted to hospital with heart failure symptoms, says cardiologist Emer Joyce, MD, PhD. Dr. Joyce recently completed a study on severe obesity and heart failure.
- Heart muscle disease, such as dilated cardiomyopathy
Damage to the heart muscle that causes the heart’s main chamber to enlarge and pump less efficiently is a frequent cause of heart failure in younger people. This condition, called dilated cardiomyopathy, has a number of causes. Most common are viral infections; drug or alcohol abuse; a genetic or inherited component; other medical illnesses such as thyroid disease; or medications used to treat cancer. Heart muscle disease caused by alcohol consumption may be reversible if the alcohol intake stops completely, Dr. Joyce says.
- Medical conditions that accompany heart problems
Any other primary heart problem can also create symptoms and signs of heart failure by interfering with the overall efficiency of the heart muscle, Dr. Joyce says. Most common among these are coronary artery disease, in which cholesterol deposits or plaque builds up in the arteries that supply the heart, which can cause blockages that lead to heart attacks. Also, heart rhythm problems such as atrial fibrillation and/or problems with the valves in the heart, such as leaking or narrowing, can create the symptoms and signs of heart failure.
- Family history of heart disease
Family history may be extremely important in determining risk for heart failure in younger people. An inherited cause for dilated cardiomyopathy is found in up to 35 percent of cases, and genetic causes may also be responsible for other types of heart muscle conditions, including hypertrophic (“thickened heart muscle”) cardiomyopathy and muscle disorders that primarily affect the right side of the heart, Dr. Joyce says.
Whether you think you have some risk factors or just want to stay as healthy as possible as you age, here are key steps you can take toward prevention, Dr. Joyce says.
Know your family history — Having two or more relatives who die of heart disease increases your risk, Dr. Joyce says. People who have heart failure symptoms and a family history of heart muscle disease or two or more relatives dying suddenly without explanation should consider genetic testing, she recommends.
Get an annual physical exam — An annual checkup is critical because sometimes the symptoms of heart failure, such as fatigue, are easily overlooked, particularly in active younger people, Dr. Joyce says.
“Other symptoms of heart failure include shortness of breath with activity, leg swelling and abdominal bloating or swelling,” Dr. Joyce says.
During your yearly visit, your doctor will review your history, blood tests, vital signs and EKG results to check the health of your heart and other organs. You doctor may order an echocardiogram or ultrasound of the heart if heart failure is suspected.
Monitor and modify your lifestyle risk factors — Track your BMI, or body mass index, rather than relying on a scale, Dr. Joyce says. BMI is a formula to measure height and weight. Using this formula, BMI of 18.5 to 24.9 is ideal, 25 to 29.9 is overweight and above 30 is obese.
Watch your alcohol intake, too, Dr. Joyce says. The Dietary Guidelines for Americans defines moderate drinking as one drink per day for women and up to two drinks per day for men.
May 2, 2008 — Heart attack symptoms sometimes get missed or dismissed by women aged 55 and younger, a new study shows.
The study included 30 women aged 55 and younger (average age: 48) who had had heart attacks. The women were interviewed within a week of leaving the hospital after their heart attack.
In those interviews, the women talked about their initial recognition of their symptoms — and what they did about those symptoms.
Here are the obstacles the women had in recognizing their symptoms:
- They thought they were too young to be having a heart attack.
- They had atypical symptoms that lasted for more than a day.
- They chalked up their symptoms to other conditions, not to a heart attack.
While some women sought treatment straight away, others hesitated for a broad range of reasons, including uncertainty, preference for self-medication, a perception of negative treatment from health care providers, and even being too busy to get their symptoms checked right away.
“Young women described a complex internal dialogue as they decided when to engage the health care system,” write the researchers, who included Judith Lichtman, PhD, MPH.
The women also noted that health care workers didn’t always immediately recognize the fact that they were having a heart attack.
The findings were presented on May 1 in Baltimore at the American Heart Association’s Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference 2008.