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J Am Coll Cardiol. 2019 Feb 12;73(5):573-584. doi: 10.1016/j.jacc.2018.10.084.

Modifiable Risk Factors in Young Adults With First Myocardial Infarction.

Author information

1
Division of Cardiology, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York. Electronic address: srikanth.yn@gmail.com.
2
Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York.
3
Division of Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
4
Division of Cardiology, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York.

Abstract

BACKGROUND:

Modifiable risk factors (RFs) play an important role in the development and prognosis of acute myocardial infarction (AMI).

OBJECTIVES:

This study sought to study the prevalence rates of modifiable RFs during a first AMI, sex/race differences, and temporal trends in U.S. young adults.

METHODS:

This was a retrospective cohort analysis of the U.S. National Inpatient Sample years 2005 and 2015 to identify adults 18 to 59 years of age hospitalized for a first AMI. Prevalence rates, race and sex differences, and temporal trends of hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, and drug abuse were analyzed in these patients.

RESULTS:

The authors' study included 1,462,168 young adults with a first AMI (mean age 50 ± 7 years, 71.5% men, 58.3% white) of whom 19.2% were 18 to 44 years of age, and 80.8% were 45 to 59 years of age. In the 18- to 44-year group, smoking (56.8%), dyslipidemia (51.7%), and hypertension (49.8%) were most prevalent, and 90.3% of patients had at least 1 RF. In the 45- to 59-year group, hypertension (59.8%), dyslipidemia (57.5%), and smoking (51.9%) were most prevalent, and 92% patients had at least 1 RF. Significant sex and racial disparities were observed in the prevalence of individual RFs. Women had a higher prevalence of diabetes mellitus, hypertension, and obesity, and men had a higher prevalence of dyslipidemia, drug abuse, and smoking. The prevalence of all these RFs increased temporally except for the rate of dyslipidemia, which decreased more recently. Trends were generally consistent across sex and racial groups.

CONCLUSIONS:

During a first AMI in young adults in whom preventive measures are more likely to be effective, modifiable RFs were highly prevalent and progressively increased over time. Significant sex and racial disparities were observed for individual RFs.

KEYWORDS:

acute myocardial infarction; disparities; modifiable risk factors; prevalence; trends

PMID:
30732711
DOI:
10.1016/j.jacc.2018.10.084

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