Heart attack deaths among adults younger than age 55 increased significantly between 2011 and 2022, with women facing higher mortality rates than men, according to new research published in the Journal of the American Heart Association. The study analyzed nearly 1 million hospitalizations and found an absolute 1.2% increase in deaths for the most severe heart attack type, challenging assumptions that cardiovascular disease primarily affects older populations.
Women hospitalized with a first-time severe heart attack (STEMI) died at a rate of 3.1%, compared to 2.6% for men. For less severe heart attacks (NSTEMI), women's mortality was 1% versus less than 1% for men. "We often think heart attacks are mainly an older person's problem; however, our findings indicate that younger adults, especially women, are at real risk," said lead author Mohan Satish, M.D., a clinical cardiovascular disease fellow at New York Presbyterian/Weill Cornell Medical Center.
The research revealed that nontraditional risk factors—including low income, kidney disease, and non-tobacco drug use—were more strongly linked to heart attack deaths than traditional factors like high blood pressure or high cholesterol. Women had a higher prevalence of these nontraditional risk factors, with nearly 35% of women with STEMI in the lowest income level compared to 29% of men. More information about the study's financial disclosures is available here.
Despite similar rates of in-hospital complications, women received fewer cardiovascular procedures to identify and treat heart attack causes. The study analyzed data from the National Inpatient Sample, which includes health insurance claims regardless of payer. Among 945,977 first-time hospitalizations, 40% were for STEMI and 62% for NSTEMI. The research was published in a Go Red for Women spotlight issue, an American Heart Association initiative addressing awareness and clinical care gaps for women's cardiovascular health since 2004.
"Improving heart attack outcomes in adults younger than age 55, particularly women, will require earlier risk identification and consideration of nontraditional risk factors to improve treatment," Satish said. The authors acknowledged limitations including reliance on administrative hospital data that could contain incorrect codes and lack of long-term follow-up information. Additional resources including the manuscript can be viewed online after February 26 at the Journal of the American Heart Association website.
