Asked by P.J. Wallace, Los Angeles, California
It seems more and more young people are dying of heart attacks/disease. When I was growing up (1960-70) a heart attack was an older person's disease. Today I'm hearing of people in their 30s and 40s dying.
Is this my imagination? If not, why is this happening? Is it diet or stress?
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
You are not alone in your observation that it seems that so many people are having heart attacks. I went to the American Heart Association and the U.S. Centers for Disease Control and Prevention to get the actual statistics. It was incredibly enlightening: It turns out death rates actually are going down.
The death category called cardiovascular disease includes mostly coronary artery disease, which causes heart attacks, and some blood vessel disease that causes stroke. This disease is due to atherosclerosis, which is a buildup of cholesterol plaque and blockage of the blood vessels that carry oxygenated blood to tissues. In the case of a heart attack, there is obstruction of coronary blood vessels that carry oxygenated blood to the heart muscle.
Cardiovascular disease is the single leading cause of death in the U.S. and Western world. accounting for about one of every three deaths. In the U.S., more than 831,200 people died of cardiovascular disease in 2006. It is estimated that more than 17.6 million Americans have diagnosed cardiovascular heart disease. It is slightly more prevalent in men than women. Prevalence also increases with age.
Despite these very significant numbers, the risk of death from cardiovascular disease in the U.S. declined by 29.2 percent from 1996 to 2006. In a slightly different, perhaps easier-to-understand statistic, the overall number of cardiovascular deaths in the U.S. went down by 12.9 percent from 1996 to 2006. The risk of death and number of people aged 40 to 60 dying of cardiovascular disease has been declining. The risk of death and number of deaths among people in their 30s has remained relatively stable.
While overall deaths are declining, our ability to diagnose this disease early has increased and our ability to treat it has improved. Compared with 40 years ago, there are more people walking around with the diagnosis and getting treatment. Medications to treat high blood pressure, lower cholesterol and even treat diabetes are used to prevent cardiovascular disease from worsening. Increased awareness of the disease and the large number of people being treated for it may be the reason it seems more common.
I must note that there is tremendous concern that the downward trend in death rate from cardiovascular disease is going to reverse in the near future. Major risk factors for cardiovascular disease such as obesity, hypertension and diabetes are increasing in the U.S. and western Europe. The other significant risk factor for cardiovascular disease is cigarette smoking. Smoking rates are declining in some countries but increasing in others. There are significant increases in the number of young female smokers.
The growing obesity epidemic is especially bad in the U.S. In the early 1970s, 15 percent of Americans were obese. By the year 2006, the obesity figure was 35 percent, and more than half of all American adults are obese or overweight. Among American teenagers, the proportion who are obese rose from 6 percent in 1970 to 18 percent in 2006.
Prevention of heart disease is far better than treating it. Most organizations recommend a healthy diet of five to nine servings of fruits and vegetables per day with limited amounts of lean meat. The CDC recommends adults get at least 2.5 hours of moderate physical activity per week (such as brisk walking) or at least 1.25 hours of vigorous activity per week combined with some muscle strengthening exercise.
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