Not so young | Harvard Medical School

Deaths from heart disease are declining among older people, but the trend is less encouraging among younger people, especially women. In fact, studies have shown that heart disease and heart disease mortality in these young groups have not changed or may even have increased slightly.

To understand the factors that increase the risk of early coronary heart disease (CHD) in young people, researchers at Harvard Medical School at Brigham and Women’s Hospital and colleagues at the Mayo Clinic have joined 28,024 people over decades. We analyzed over 50 risk factors for women. Women’s health survey.

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Analysis published on January 20 JAMA CardiologyFound that women under the age of 55 with type 2 diabetes were 10 times more likely to develop CHD in 20 years than women without diabetes.

Researchers have analyzed about 50 biomarkers associated with cardiovascular health.

One of the biomarkers that has emerged as a powerful predictor of heart disease risk is lipoprotein insulin resistance, which uses the size and concentration of lipid particles in the blood as a gauge of the body’s ability to process sugar in response to insulin. Sex (LIPR).

Commonly used indicators such as low-density lipoprotein cholesterol (LDL or “bad” cholesterol) and hemoglobin A1C, an important indicator of blood glucose, are more associated with CHD development in women under 55 years of age than LPIR. It was much weaker. Bad cholesterol (LDL) was associated with a 1.4-fold increased risk of developing CHD in women younger than 55 years, while LPIR showed a 6-fold increase.

“Unfortunately, you’ll see young people having heart attacks,” said the author of the study. Samia Mora, Associate Professor of HMS, Director of the Lipid Metabolomics Center of the Department of Prevention and Cardiovascular Medicine in Brigam and Women. “When a young person has a cardiovascular event, it affects their future quality of life, productivity, and contribution to society.”

In otherwise healthy women, analysis has shown that insulin resistance, type 2 diabetes, and its sister diagnosis, metabolic syndrome, are the major causes of early coronary events.

“Women under the age of 55 who are obese, like women in that age group who smoke or have high blood pressure, have about a four-fold increased risk of coronary events,” Mora said. “Lack of physical activity and family history are all part of the big picture.”

The findings emphasize the need to maintain optimal heart health through lifestyle prevention rather than medical intervention, the researchers said.

“Prevention is better than treatment and many risk factors for heart disease are preventable. This study shows the impact of lifestyle on the heart health of women of all ages, especially young women.” Sagar Dugani, a hospital physician at May York Clinic and co-lead author of the study.

Researchers acknowledged that the generalization of this study was limited. Beyond the focus on women, which have been shown to have worse results after earlier cardiac events than men, more than 95 percent of study participants were white. According to Mora, the findings could be even more dramatic in ethnic and racial groups with a high prevalence of risk factors such as metabolic syndrome, insulin resistance, and diabetes.

“Diabetes is almost preventable, but it’s a system-wide problem, and there is an urgent need for further research into new strategies to address it,” Mora said. “These could be innovative lifestyle-based strategies such as community efforts, larger public health efforts, methods of medically targeting metabolic pathways, or new surgical approaches.”

Researchers emphasize the urgency of developing effective interventions, as the prevalence of diabetes and its associated risk factors have increased dramatically, affecting more women than men. I am.

“We need new strategies to improve the outcomes of these young individuals and address the risk of diabetes, because we are just seeing the beginning of this epidemic,” Mora said. Said.

This work is from the National Institutes of Health (Grant CA-047988, HL-043851, HL-080467, HL-099355, UM1CA182913, R01 HL134811, HL 117861, R01 DK112940, and K24 HL136852), Molino Family Trust (Grant K01). HL135342), and United Arab Emirates-HMS Joint Research Award.

Adapted from Brigam and Women news release..