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September 21, 2020

Ten-Year Trends Demonstrate Decline in Repeat MI but Drop in Public Awareness in Women

September 21, 2020—The American Heart Association (AHA) announced the publication of new findings showing that the percentage of survivors of a myocardial infarction (MI) who experienced a repeat MI within 1 year fell between 2008 and 2017. Women experienced the greatest overall decline. However, a new survey of women shows heart disease awareness also has declined over the past decade among those women age 65 and younger.

Deaths from heart attacks have been declining since the 1970s, but survivors still are at increased risk to have another heart attack, or to die within a year after they leave the hospital.

The study, which investigated trends in recurrent coronary heart disease after an MI in women and men in the United States between 2008 and 2017, was published by Sanne A.E. Peters, PhD, et al online in Circulation.

According to AHA, the investigators used Medicare and commercial health insurer data on 1.5 million men and women hospitalized for a heart attack between 2008 and 2017. They then looked at the rates of recurrent MIs, revascularization procedures, and hospitalizations to treat heart failure during the first year after hospital discharge.

Though both sexes showed declines, the study found repeat heart attacks decreased more steeply in women, from 89.2 per 1,000 person-years to 72.3. In men, the rate fell from 94.2 to 81.3.

“We expected to see a decline in the rate of events, (but) we did not expect the rates to differ between the sexes,” commented Dr. Peters in the AHA’s announcement. She is Senior Lecturer at The George Institute for Global Health in collaboration with Imperial College London in the United Kingdom.

Dr. Peters continued, “It may be that the improvements in men were achieved before our study period, leaving less room for improvement in the most recent decade. It could also be that the attention paid to heart disease in women over recent years has resulted in the greater gains. However, regardless of the improvements, the rates of recurrent events in people who survived a heart attack are still very high in both sexes. Patients should speak with their doctors to ensure that they get the right treatments to prevent secondary events and must make sure that they adopt or maintain a healthy lifestyle.”

Additionally, the results of the AHA’s new national online survey showing 10-year trends in women’s awareness of heart disease as the leading cause of mortality found awareness declined in the last decade—from 65% in 2009 to 44% in 2019. The drop was observed in all racial, ethnic, and age groups, except women age ≥ 65 years.

The survey findings were published by Mary Cushman, MD, et al in published Circulation of > 1,500 women over 25 in the United States. The survey was conducted in the month of January in 2009, 2012, and 2019.

“We found that women who were younger versus older, and non-Hispanic Black, Hispanic, or Asian versus White had lower awareness that heart disease was the leading cause of death,” commented Dr. Cushman, chair of the report's writing group, in the AHA announcement. Dr. Cushman is Professor of Medicine at Larner College of Medicine at the University of Vermont in Burlington, Vermont.

Specifically, there was an 81% decline in awareness among women age 25 to 34 years, an 86% decline among Hispanic women, and a 67% decline in Black women.

According to AHA, awareness of heart attack symptoms also declined among all women, only half of whom knew chest pain was a symptom, and even fewer identified other symptoms such as shortness of breath and pain that spreads to shoulders, neck, or arms.

“This signals an urgent call for organizations ranging from public health, government, and health care professionals, to community organizations such as churches and employers to take on the challenge with full gusto to better inform women of their risk for heart disease," said Dr. Cushman. “This survey gives us the data we need to better inform the women in our lives to take charge of their health." She added, that the AHA is poised to “evolve to reach younger generations of women in new, innovative ways.”

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