Thursday, December 29, 2016

Heart attack risk 8 times higher for younger smokers

 

Despite greater awareness of risk factors for heart disease and the need for healthy lifestyle changes, heart attack patients are becoming younger and more obese, according to new research from the Cleveland Clinic.
The study, being presented at the American College of Cardiology's 65th Annual Scientific Session, also found that these patients were more likely to have preventable risk factors such high blood pressure and diabetes and were more likely to be smokers.
"On the whole, the medical community has done an outstanding job of improving treatments for heart disease, but this study shows that we have to do better on the prevention side," the study's primary investigator, Dr. Samir Kapadia, a professor of medicine and interventional cardiologist at Cleveland Clinic, said in a statement. "When people come for routine checkups, it is critical to stress the importance of reducing risk factors through weight reduction, eating a healthy diet and being physically active."
For the study, Kapadia and his team analyzed heart disease risk factors among nearly 4,000 patients who were treated for the most severe and deadly type of heart attack -- known as ST-elevation myocardial infarction, or STEMI -- at Cleveland Clinic over two decades, from 1995 to 2014.
This type of heart attack occurs when the coronary artery is completely blocked and a large part of the heart muscle is unable to receive blood. Though immediate medical assistance can increase the chance of survival, STEMI heart attacks come with a high risk of death and disability.
There are a number of known risk factors for STEMI, including some that can be controlled and some that can't. For example, while there's nothing an individual can do about age or family history, steps can be taken to lower the risk of heart attack through lifestyle changes, such as quitting smoking, exercising more, and eating a heart-healthy diet.
The Cleveland Clinic team divided the records of the hospital's STEMI patients into four groups, each representing a span of five years. The results yielded some surprising findings.
"Very amazingly, what we found was the patients presenting with ST-elevation myocardial infarction were getting younger," Kapadia said in a press briefing.
Specifically, the results showed the average age of STEMI patients decreased from 64 years old to just 60 between the first five-year span of the study and the last five-year span. The prevalence of obesity also increased over this time period, from 31 percent to 40 percent, as did the proportion of patients with diabetes (from 24 to 31 percent), high blood pressure (from 55 to 77 percent), and chronic obstructive pulmonary disease (COPD) (from 5 to 12 percent).
Perhaps most strikingly, the researchers found an increase in smoking rates -- from 28 to 46 percent -- which goes against the national trend of an overall decline in smoking rates over the past 20 years.
The results also showed a significant increase in the number of patients who have three or more major risk factors, which rose from 65 to 85 percent.
Experts say the results are surprising and worrisome. "We thought we were doing better prevention," Kapadia said.
Dr. Mary Norine Walsh, vice president of the American College of Cardiology, told CBS News: "Risk factor reduction in the broader population has been documented, so it is concerning that, at this institution, risks seem to have risen over 20 years."
Walsh notes that since the study only looked at patients at the Cleveland Clinic, the results can't be generalized to the entire U.S. population.
"Much larger studies, involving large population groups and many hospitals would be needed to determine if these finding hold true more broadly," she said.
Another caveat is that during the course of the study period, the hospital brought in a greater number of patients from surrounding rural areas by helicopter, making it possible that that the observed trends reflect changes in the patient population. However, the study authors said this factor was likely to have had only a minor, if any, effect.
Despite the limitations, Kapadia said the study carries an important public health message for both doctors and patients.
"Prevention must be kept in the forefront of primary care," he said. "Cardiac health is not just dependent on the cardiologist. The primary care physicians and the patient need to take ownership of this problem."
Patients can also be more proactive in reducing their heart disease risk. "Don't wait until you have a diagnosed heart problem to start taking care of yourself and paying attention to your lifestyle and dietary choices," Kapadia said. "You should be working hard to avoid developing heart disease in the first place."

As printed on almost every cigarette pack, smoking increases the risk of heart disease. While this is a known fact, the actual numbers often remain ignored. A new study looks at the risk of developing heart attack in younger smokers.

New research finds younger smokers are at much greater risk of heart attack.
According to the Centers for Disease Control and Prevention (CDC), over 16 million Americans live with a disease caused by smoking.
Cancer, heart disease, and stroke are only a few of the conditions caused by smoking. Tobacco use also causes lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD).
The CDC report that 1 in 3 deaths from cardiovascular disease (CVD) are caused by tobacco.
CVD includes several types of heart conditions. The most common form of CVD in the United States is coronary heart disease, which ultimately leads to heart attacks.
New research examines the link between smokers' age and the risk of developing a specific type of heart attack.

Studying the risk of STEMI heart attack in younger smokers

Researchers from the South Yorkshire cardiothoracic center in the United Kingdom examined 1,727 adults who were undergoing treatment for a type of heart attack known as STEMI.
STEMI stands for ST-segment elevation myocardial infarction, and it refers to the electrocardiogram pattern that can be seen when a large portion of the heart muscle is dying. STEMI is a very serious type of heart attack where one of the heart's major arteries is suddenly and completely blocked.
The researchers used data from the Office for National Statistics Integrated Household Survey in South Yorkshire.
Almost half of the 1,727 patients - or 48.5 percent - were current smokers. Just over 27 percent were former smokers, and a quarter were nonsmokers.
The results were published in the journal Heart.

Smokers under 50 more than eight times likelier to have a STEMI

Overall, the study revealed that current smokers had a likelihood of developing STEMI three times higher than ex- and nonsmokers combined.
Current smokers were also three times likelier to have peripheral vascular disease than nonsmokers. In vascular disease, fatty deposits build up in the arteries and stop the blood supply to the legs.
Along with ex-smokers, current smokers were twice as likely to have also had coronary artery disease.
Current smokers were likely to be 10-11 years younger than former or nonsmokers when they had their STEMI.
The highest risk was found among smokers under 50 years of age, who were almost 8.5 times more likely to have a STEMI heart attack than nonsmokers and ex-smokers combined.
The risk was inversely associated with age, meaning that it decreased as the age increased. For instance, among adults aged 50-65, the risk fell to five times higher, while in smokers over the age of 65 the risk was only three times higher.
The smoking prevalence rate among STEMI patients under the age of 50 was 75 percent.

Strengths and limitations of the study

This is the first study that uses population data combined with case data to demonstrate that the risk of acute STEMI heart attack is much higher in younger smokers than older ones.
The study could help guide health policies to target segments of the population where a higher prevalence of smoking was noticed, and where there is a higher risk.
Additionally, the authors note their study could also improve current social perceptions on smoking, age, and associated health risks:
"This study may also help to tackle the misconception by young smokers that acute STEMI is a disease of the elderly, by showing that this group is very vulnerable and has the highest risk from their smoking."
However, given that this is an observational study, it cannot explain the reasons why the risk is so much higher in younger adults. Since younger smokers do not have many of the other risk factors for heart attack, such as high cholesterol, increased blood pressure, or diabetes, the results are all the more difficult to explain.
Authors speculate, however, that smoking may be the most important risk factor, as other cited research shows cigarette smokers are more vulnerable to arterial plaque rupture.
The study is also limited in the sense that it is based on just one regional specialist cardiothoracic center in the U.K., and it did not include patients who died before admission.
Additionally, the study did not account for those considered unsuitable for percutaneous coronary intervention (PCI) treatment at the center. 

Study highlights the need for prevention among younger patients

"All current smokers must be encouraged into smoking cessation therapy to reduce their risk of acute STEMI, with a focus on the youngest smokers whose increased risk is often unrecognized," the authors note.
In a linked editorial, cardiologist Dr. Yaron Arbel, of the Tel-Aviv Medical Center in Israel, further insists on the need for prevention campaigns aimed at the younger age groups.
"Most smokers know that smoking is bad. However, exact numbers have a tendency to hit home more often. Therefore studies like the present one are especially important."
He adds that since most young patients lack conventional risk factors, common treatment practices are less beneficial for them. Therefore, efforts should concentrate on prevention, not treatment.
"Our goal should be to provide them with the tools to achieve abstinence," Arbel notes. "In difficult cases, even reducing the number of cigarettes smoked daily might make a difference."
A new study found that people who experience the most severe heart attack in the last 20 years were younger and more obese. Moreover, many of them were smokers.
These individuals also suffer from other serious health conditions including chronic obstructive pulmonary disease, diabetes and high blood pressure.
The study also analyzed the incidence of smoking and obesity among people with ST-elevation heart attacks (STEMI), which is a serious heart attack type that can lead to disability and death. They found that the rate of obesity among these individuals surged to 40 percent from 31 percent in the last two decades.
While the joint initiatives of the government and health care providers succeeded in lowering smoking rates in the last 20 years, the study still found that among STEMI patients, 46 percent still smoked. The rate increased from 28 percent two decades ago.
The researchers recommended that, to reduce the risk of developing heart attack, health care must advise their patients to embrace a healthier diet, becoming more physically active and lose weight.
"Prevention must be kept in the forefront of primary care," said the study's lead researcher, Dr. Samir Kapadia from the Cleveland Clinic.
What Is Fueling Unhealthy Lifestyles And Obesity Rates?
A 2015 report from the U.S. Centers for Disease Control and Prevention said that more than 36 percent of Americans are still obese. The report also found that women (38.3 percent) are becoming more obese than men (34.3 percent).
A related 2015 study found that, prior to the obesity outbreak in 1970s, Americans are now eating more calories. In the analysis of approximately 5,000 American participants, researchers found no association between the person's body mass index and the amount of junk or fast food they consume.
Although, this doesn't mean that junk or fast food is not a contributing factor to the rising obesity rates. The findings suggested that Americans are eating more calories than before. Health experts advised that instead of cutting calories, focusing on healthier calories and eating less processed foods are better options in the fight against obesity.
- See more at: http://www.techtimes.com/articles/144879/20160328/smoking-obesity-may-drive-increase-in-heart-attack-rate-among-young-americans.htm#sthash.N6tcrefU.dpuf
A new study found that people who experience the most severe heart attack in the last 20 years were younger and more obese. Moreover, many of them were smokers.
These individuals also suffer from other serious health conditions including chronic obstructive pulmonary disease, diabetes and high blood pressure.
The study also analyzed the incidence of smoking and obesity among people with ST-elevation heart attacks (STEMI), which is a serious heart attack type that can lead to disability and death. They found that the rate of obesity among these individuals surged to 40 percent from 31 percent in the last two decades.
While the joint initiatives of the government and health care providers succeeded in lowering smoking rates in the last 20 years, the study still found that among STEMI patients, 46 percent still smoked. The rate increased from 28 percent two decades ago.
The researchers recommended that, to reduce the risk of developing heart attack, health care must advise their patients to embrace a healthier diet, becoming more physically active and lose weight.
"Prevention must be kept in the forefront of primary care," said the study's lead researcher, Dr. Samir Kapadia from the Cleveland Clinic.
What Is Fueling Unhealthy Lifestyles And Obesity Rates?
A 2015 report from the U.S. Centers for Disease Control and Prevention said that more than 36 percent of Americans are still obese. The report also found that women (38.3 percent) are becoming more obese than men (34.3 percent).
A related 2015 study found that, prior to the obesity outbreak in 1970s, Americans are now eating more calories. In the analysis of approximately 5,000 American participants, researchers found no association between the person's body mass index and the amount of junk or fast food they consume.
Although, this doesn't mean that junk or fast food is not a contributing factor to the rising obesity rates. The findings suggested that Americans are eating more calories than before. Health experts advised that instead of cutting calories, focusing on healthier calories and eating less processed foods are better options in the fight against obesity.
- See more at: http://www.techtimes.com/articles/144879/20160328/smoking-obesity-may-drive-increase-in-heart-attack-rate-among-young-americans.htm#sthash.N6tcrefU.dpuf
A new study found that people who experience the most severe heart attack in the last 20 years were younger and more obese. Moreover, many of them were smokers.
These individuals also suffer from other serious health conditions including chronic obstructive pulmonary disease, diabetes and high blood pressure.
The study also analyzed the incidence of smoking and obesity among people with ST-elevation heart attacks (STEMI), which is a serious heart attack type that can lead to disability and death. They found that the rate of obesity among these individuals surged to 40 percent from 31 percent in the last two decades.
While the joint initiatives of the government and health care providers succeeded in lowering smoking rates in the last 20 years, the study still found that among STEMI patients, 46 percent still smoked. The rate increased from 28 percent two decades ago.
The researchers recommended that, to reduce the risk of developing heart attack, health care must advise their patients to embrace a healthier diet, becoming more physically active and lose weight.
"Prevention must be kept in the forefront of primary care," said the study's lead researcher, Dr. Samir Kapadia from the Cleveland Clinic.
What Is Fueling Unhealthy Lifestyles And Obesity Rates?
A 2015 report from the U.S. Centers for Disease Control and Prevention said that more than 36 percent of Americans are still obese. The report also found that women (38.3 percent) are becoming more obese than men (34.3 percent).
A related 2015 study found that, prior to the obesity outbreak in 1970s, Americans are now eating more calories. In the analysis of approximately 5,000 American participants, researchers found no association between the person's body mass index and the amount of junk or fast food they consume.
Although, this doesn't mean that junk or fast food is not a contributing factor to the rising obesity rates. The findings suggested that Americans are eating more calories than before. Health experts advised that instead of cutting calories, focusing on healthier calories and eating less processed foods are better options in the fight against obesity.
- See more at: http://www.techtimes.com/articles/144879/20160328/smoking-obesity-may-drive-increase-in-heart-attack-rate-among-young-americans.htm#sthash.N6tcrefU.dpuf

 

A new study found that people who experience the most severe heart attack in the last 20 years were younger and more obese. Moreover, many of them were smokers.
These individuals also suffer from other serious health conditions including chronic obstructive pulmonary disease, diabetes and high blood pressure.
The study also analyzed the incidence of smoking and obesity among people with ST-elevation heart attacks (STEMI), which is a serious heart attack type that can lead to disability and death. They found that the rate of obesity among these individuals surged to 40 percent from 31 percent in the last two decades.
While the joint initiatives of the government and health care providers succeeded in lowering smoking rates in the last 20 years, the study still found that among STEMI patients, 46 percent still smoked. The rate increased from 28 percent two decades ago.
The researchers recommended that, to reduce the risk of developing heart attack, health care must advise their patients to embrace a healthier diet, becoming more physically active and lose weight.
"Prevention must be kept in the forefront of primary care," said the study's lead researcher, Dr. Samir Kapadia from the Cleveland Clinic.
What Is Fueling Unhealthy Lifestyles And Obesity Rates?
A 2015 report from the U.S. Centers for Disease Control and Prevention said that more than 36 percent of Americans are still obese. The report also found that women (38.3 percent) are becoming more obese than men (34.3 percent).
A related 2015 study found that, prior to the obesity outbreak in 1970s, Americans are now eating more calories. In the analysis of approximately 5,000 American participants, researchers found no association between the person's body mass index and the amount of junk or fast food they consume.
Although, this doesn't mean that junk or fast food is not a contributing factor to the rising obesity rates. The findings suggested that Americans are eating more calories than before. Health experts advised that instead of cutting calories, focusing on healthier calories and eating less processed foods are better options in the fight against obesity.
- See more at: http://www.techtimes.com/articles/144879/20160328/smoking-obesity-may-drive-increase-in-heart-attack-rate-among-young-americans.htm#sthash.N6tcrefU.dpuf
A new study found that people who experience the most severe heart attack in the last 20 years were younger and more obese. Moreover, many of them were smokers.
These individuals also suffer from other serious health conditions including chronic obstructive pulmonary disease, diabetes and high blood pressure.
The study also analyzed the incidence of smoking and obesity among people with ST-elevation heart attacks (STEMI), which is a serious heart attack type that can lead to disability and death. They found that the rate of obesity among these individuals surged to 40 percent from 31 percent in the last two decades.
While the joint initiatives of the government and health care providers succeeded in lowering smoking rates in the last 20 years, the study still found that among STEMI patients, 46 percent still smoked. The rate increased from 28 percent two decades ago.
The researchers recommended that, to reduce the risk of developing heart attack, health care must advise their patients to embrace a healthier diet, becoming more physically active and lose weight.
"Prevention must be kept in the forefront of primary care," said the study's lead researcher, Dr. Samir Kapadia from the Cleveland Clinic.
What Is Fueling Unhealthy Lifestyles And Obesity Rates?
A 2015 report from the U.S. Centers for Disease Control and Prevention said that more than 36 percent of Americans are still obese. The report also found that women (38.3 percent) are becoming more obese than men (34.3 percent).
A related 2015 study found that, prior to the obesity outbreak in 1970s, Americans are now eating more calories. In the analysis of approximately 5,000 American participants, researchers found no association between the person's body mass index and the amount of junk or fast food they consume.
Although, this doesn't mean that junk or fast food is not a contributing factor to the rising obesity rates. The findings suggested that Americans are eating more calories than before. Health experts advised that instead of cutting calories, focusing on healthier calories and eating less processed foods are better options in the fight against obesity.
- See more at: http://www.techtimes.com/articles/144879/20160328/smoking-obesity-may-drive-increase-in-heart-attack-rate-among-young-americans.htm#sthash.N6tcrefU.dpuf

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