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Young adults heart disease factors reported to major conference

Tuesday August 24th 2021

People who suffer acute myocardial infarction under the age of 45 are more likely to be smokers, obese, and have high blood pressure or diabetes compared to their peers, researchers will reveal today.

A German study, which is to be presented at ESC Congress 2021, shows that parental history of premature disease is not the only contributing factor.

Researchers compared the clinical characteristics of consecutive patients admitted to hospital with acute myocardial infarction at 45 years old or younger with randomly selected individuals from the general population in the same geographic region in Germany.

Cases and controls were matched according to age and gender, with 522 patients being enrolled from the Bremen STEMI registry and 1,191 matched controls identified from the German National Cohort (NAKO).

The proportion of active smokers was found to be more than three times higher in the young heart attack group compared to the general population at 82.4% compared with 24.1%, and they were also more likely to have high blood pressure (25.1% compared with 0.5%), diabetes (11.7% compared with 1.7%) and a parental history of premature heart attack at 27.6% compared with 8.1%.

The young heart attack patients were more likely to be obese, with a median body mass index (BMI) of 28.4 kg/m2 compared to 25.5 kg/m2 for controls.

However, the control group were far more likely to drink alcohol at least four times a week at 11.2% compared to heart patients (7.1%).

Professor Harm Wienbergen, of the Bremen Institute for Heart and Circulation Research, said: “Our study shows that smoking and metabolic factors, such as hypertension, diabetes and obesity, are strongly associated with an increased likelihood of premature acute myocardial infarction. A protective effect of moderate alcohol consumption has been described by other studies and is confirmed in the present analysis of young patients.”

• The conference will also hear from a UCL, UK, study that shows drinking alcohol during adolescence to young adulthood is associated with accelerated arterial stiffening.

The study included 1,655 participants of the Avon Longitudinal Study of Parents And Children (ALSPAC) aged 17 to 24 years.

Alcohol and smoking were measured at ages 17 and 24 and results at the two time points were combined.

Using carotid-femoral pulse wave velocity to assess aerial stiffness at ages 17 and 24, the researchers found that arterial stiffness increased by an average of 10.3% from age 17 to 24, with a slightly greater increase observed in women than in men.

Arterial stiffness increased with each point rise in the average alcohol score, but no graded increase in arterial stiffness was seen with the average smoking score.

Study author Mr Hugo Walford, a UCL medical student, said: “The results suggest that arterial damage occurs in young drinkers and young women who smoke heavily. Never smokers and ex-smokers had similar alterations in arterial stiffness, indicating that quitting can restore vascular health at this young age.”

• The findings of a study from the University of Adelaide, Australia, is to be presented at the Congress, which shows that a six-month exercise programme helps to maintain normal heart rhythm and reduces the severity of symptoms in patients with atrial fibrillation (AF).

An observational study found that patients who gained cardiorespiratory fitness over a five-year follow-up were significantly less likely to have recurrences of AF. A randomised controlled trial showed that 12 weeks of aerobic interval training reduced the time spent in AF compared to usual care but the study enrolled just 51 patients and follow-up was only four weeks.

• A nationwide US study has shown that the rate of opioid-related cardiac arrests has steeply risen and is now on par with the rate of cardiac arrest from other causes, the conference will hear.

The study, by the University of New England, Biddeford, examined the trends and outcomes of opioid-related cardiac arrest in 2012 to 2018, using the US Nationwide Readmissions Database (NRD).

Of 1,410,475 cardiac arrest hospitalisations, 43,090 (3.1%) occurred in opioid users and the rate of in-hospital mortality in cardiac arrest patients with and without opioid use was 56.7% compared with 61.2%, respectively.

However, in an analysis adjusted for several factors, there was no difference in the risk of mortality between cardiac arrest patients with or without opioid abuse.

Study author Ms Senada S. Malik, a medical researcher at the University of New England, said: “The rise in opioid-related cardiac arrests during the study period was significant. By 2018, opioids were related to a similar number of cardiac arrests as all other reasons put together.”

Tags: Diet & Food | Europe | Fitness | Heart Health | UK News

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