Study Finds Rising Rates of Heart Disease Death in Young Women in the United States

February 10, 2021—The European Society of Cardiology (ESC) announced that a nationwide study in the United States has found increasing death rates from heart disease in women age < 65 years. Safi U. Kahn, MBBS, et al published the findings online in ESC’s European Heart Journal: Quality of Care and Clinical Outcomes.

The study investigators stated in the ESC press release, “If extreme public health measures are not taken to mitigate cardiovascular risk factors, focusing on high-risk groups, heart disease mortality may supersede cancer to become the leading cause of death in young women.”

As noted by ESC, heart disease is the main cause of death worldwide. In the age group under-65 in developed countries, most deaths are due to cancer; heart disease is the second leading cause. 

This study compared heart disease- and cancer-related deaths in women age < 65 years in the United States. The investigators analyzed death certificates between 1999 and 2018 from a national database. They found that death rates from cancer declined every year between 1999 and 2018; however, after an initial drop, heart disease death rates have been rising since 2010.

According to ESC, the study reported that during the 19-year period, the age-adjusted mortality rates for cancer and heart disease were 52.6 and 24 per 100,000, respectively. The most common cause of heart disease death was ischemic heart disease (56%). Respiratory tract/lung cancer (23%) was the leading cause of cancer death.

Across the entire study period, age-adjusted mortality rates decreased for both cancer and heart disease. But while cancer death rates consistently declined throughout the 19 years, heart disease death rates fell initially and then increased between 2010 and 2018. As a result, the absolute mortality gap between cancer and heart disease significantly decreased from 32.7 to 23 per 100,000 per year.

In the ESC announcement, the study’s senior investigator Erin Michos, MD, commented, “Young women in the United States are becoming less healthy, which is now reversing prior improvements in heart disease deaths. With worsening epidemics of diabetes and obesity across developed countries, our findings are a warning sign that we need to pay more attention to the health of young women.”

Dr. Michos further observed, “Women frequently put others’ health and needs before their own, often caring for children and parents and working full-time. But if they have a fatal heart attack, they won’t be there for loved ones. Women must prioritize their own health, especially since heart disease is largely preventable.

“There is a misconception that women are not at risk for heart disease before the menopause, yet one-third of their cardiovascular problems occur before 65. Studies of young heart attack patients show that compared to men, women were less likely than to have been told they were at risk for heart disease before the attack and less often received stents and medications.

“Most heart disease can be avoided with a healthy balanced diet, physical activity, not smoking, and maintaining a healthy blood pressure, blood glucose, cholesterol level, and body weight. Just because a woman is before menopause does not mean she is not at risk. Unfortunately, the first attack can be fatal, so we need to do better with prevention.”