Prevalence of Modifiable CV Risk Factors High in Young Adults With First AMI

electrocardiogram, STEMI
The most prevalent risk factors in patients between the ages of 18 and 44 years with a first acute myocardial infarction were smoking, dyslipidemia, and hypertension.

A study found smoking, dyslipidemia, and hypertension to be highly prevalent in young adults with a first acute myocardial infarction (AMI), and disparities exist between sexes for many of these modifiable cardiovascular risk factors. The findings from this study were published in the Journal of the American College of Cardiology.

The researchers retrospectively collected data of adults from the US National Inpatient Sample between 2005 and 2015. Patients were included in the retrospective cohort if they were hospitalized for a first AMI (n=1,462,168; mean age 50±7 years). Modifiable cardiovascular risk factors, including hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, and drug abuse, were assessed. Prevalence rates, race, and sex differences, as well as temporal trends in the risk factors, were examined.

The most prevalent risk factors in patients between the ages of 18 and 44 years were smoking (56.8%), dyslipidemia (51.7%), and hypertension (49.8%), with 90.3% of individuals in this age group having at least 1 cardiovascular risk factor. In patients between ages 45 and 59 years, the most prevalent risk factors were hypertension (59.8%), dyslipidemia (57.5%), and smoking (51.9%), with 92% of patients in this group having at least 1 risk factor.

During the first AMI, women had a significantly higher prevalence of diabetes mellitus than men (29.8% vs 19.9%, respectively; P <.001; rate difference, 9.9%). In addition, women had a higher prevalence of obesity (26.9% vs 18.6%; P <.001; rate difference, 8.3%) and hypertension (51.0% vs 49.3%; P <.001; rate difference, 1.7%).

Conversely, men had a significantly higher prevalence of smoking (58.1% vs 53.4%; P <.001; rate difference, 4.7%), dyslipidemia (54.6% vs 44.1%; P <.001; rate difference, 10.5%), and drug abuse (10.1% vs 8.4%; P <.001; rate difference, 1.7%).

The prevalence of all 6 modifiable risk factors was higher in 2015 compared with 2005 in young adults who had a first AMI (Ptrend <.001). In patients between the ages of 18 and 44 years, the researchers found respective increases in hypertension (going from 42.7% to 57.2%), dyslipidemia (from 47% to 51.3%), smoking (from 54.5% to 60.3%), diabetes mellitus (from 18.8% to 26.1%), obesity (from 14.6% to 28.9%), and drug abuse (from 8.8% to 11.9%; Ptrend <.001 for all) between 2005 and 2015.

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The study was unable to collect data on clinical and laboratory level data, including blood pressure, body mass index, and cholesterol, which may limit the findings.

The researchers concluded that modifiable atherosclerotic risk factors were highly prevalent in young patients for whom preventive measures are more likely to be effective.

Yandrapalli S, Nabors C, Goyal A, Aronow WS, Frishman WH. Modifiable risk factors in young adults with first myocardial infarction. J Am Coll Cardiol. 2019;73(5):573-584.