Trends in Age at CVD Diagnosis in Men and Women Between 2008 and 2017

This article is part of Cardiology Advisor‘s coverage of AHA Scientific Sessions 2020.

There is a trend toward a decreasing age for diagnosis of cardiovascular disease (CVD) and associated risk factors among women, according to study results presented at the American Heart Association Scientific Sessions 2020 held virtually from November 13 to 17, 2020.

Researchers examined data from the Medical Expenditure Panel Surveys for the January 2008 to December 31, 2017 period to determine overall and sex-specific trends in age at CVD diagnosis and risk factors in this a nationally representative sample of adults across the United States. In this database, 100,709 patients (50.2% women) with coronary heart disease, hypertension, hypercholesterolemia, or stroke, were identified. These patient sample was considered to be representative of 91.9 million adults in the United States. Over 40% of participants were between 40 and 64 years, and a majority were white.

Mean age at time of diagnosis was higher in women vs men for: coronary heart disease (59.3 vs 57.4 years, respectively), hypercholesterolemia (51.6 vs 48.7 years, respectively), and hypertension (48.8 vs 46.8 years, respectively). The mean age at diagnosis was higher in women vs men for coronary heart disease (adjusted mean difference, 1.06 years; P <.001), and hypercholesterolemia (adjusted mean difference, 0.92 years; P <.001).

From 2008 to 2017, age at stroke diagnosis decreased by 0.19 years annually for women, and increased by 0.22 years annually for men, and age at hypercholesterolemia diagnosis had a decreasing trend in both genders.

When stratified by sociodemographic factors, the mean age at hypercholesterolemia diagnosis decreased overall and among White women, with no statistically significant change among White men. No statistically significant change in age at CVD diagnosis was detected among Black, Asian, and Hispanic people. 

Limitations to the study include fact that age at CVD diagnosis and risk factors were self-reported, and that differences in healthcare-seeking behaviors that may account for some sex-specific differences were not accounted for.

“In a nationally representative sample of the [United States] adult population from 2008 to 2017, there is a decreasing trend in the age at diagnosis for CVD and its risk factors, which appears to be more pronounced among women,” the researchers concluded. “While earlier identification of CVD risk factors may provide an opportunity to initiate preventive treatments, younger age at diagnosis of CVD highlights the need for prevention…at the earliest opportunity.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Michos E, Okunrintemi V, Tibuakuu M, et al. Sex differences in the age of diagnosis for cardiovascular disease and its risk factors among US adults; trends from 2008-2017, the Medical Expenditure Panel Survey. Presented at: AHA Scientific Sessions 2020 Virtual Meeting; November 13-17, 2020. Presentation 737.

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