Heart attacks: Patients are younger and more obese than 20 years ago

Heart attack patients have become younger and more obese in the last two decades, scientists say. Despite important improvement in care and a better understanding of the lifestyle factors driving heart disease, prevention approaches are still failing.

In a study, due to be presented at the American College of Cardiology's 65th Annual Scientific Session, the experts reveal that the number of people who report risky habits has risen since 1995. They are also now aged on average 60 as opposed to 64 20 years ago. The scientists say this trend is unlikely to be reversed unless the whole medical community acts conjointly to boost prevention efforts.

More smoking and more obesity

This new research focuses on the heart disease risk factors of more than 3,900 patients, who had been hospitalized at the Cleveland Clinic, USA, between 1995 and 2014. The reason for this was that they had suffered a ST-elevation myocardial infarction (STEMI), a full blown heart attack caused by the complete blockage of an artery.

In particular, scientists assessed looked at the age and the Body Mass Index (BMI) of the participants, and also investigated a certain number of lifestyle factors such as whether they smoked, ate well and exercised regularly.

To study the prevalence of each factor in the population at different point in time, the researchers divided the records of STEMI patients into four quartiles, each representing a five year span. This allowed them to make precise comparisons between 1995 and 2014. They not only found that average age not only decreased by four years, but also that the proportion of STEMI patients considered obese rose from 31 to 40%.

Chronic diseases, often associated with obesity were also more present. The percentage of patients with diabetes increased from 24 to 31 % and they were more likely to report high blood pressure (55% against 77% 20 years later). These evolutions are consistent with the ones observed in the general population, suggesting problems affecting STEMI patients are part of a wider public health crisis affecting the larger public.

Surprisingly, one result appeared to go against trends in the general population. While people seem to smoke less today than in 1995, smoking actually increased in the STEMI patients group studied.

The scientists hope their findings will be a call for action, not only for cardiologists, but for every medial professional. "Prevention must be kept in the forefront of primary care. Cardiac health is not just dependent on the cardiologist. The primary care physicians and the patient need to take ownership of this problem," concludes lead author Samir Kapadia.