Risk factors for fatal heart attack in young women

Abstract

Deaths of 338 women at ages 15-44 years attributed to myocardial infarction (MI) on death certificates during an 18-month period in five metropolitan areas were investigated. Evidence of recent MI or evidence that death occurred suddenly was obtained for about half (163) from records of hospitals or medical examiners or from relatives. A case-control study (involving one deceased control, and one hospitalized living control) of risk factors for heart attack was then conducted using interviews with relatives and abstracts of records of hospitals and physicians identified by the relatives as sources of medical care. Information was obtained on history of prior MI, other heart disease, diabetes, thromboembolism, stroke, hypertension, high cholesterol, obesity, oophorectomy, oral contraception and cigarette smoking. Data are presented on the prevalence of these potential risk factors for the case group and each control group, and for subsets of cases consisting of those without prior heart disease, definite MI only, sudden death only, and white women only. Multivariate analyses identify somewhat different sets of risk factors and different levels of risk for the various subgroups. In general, the risk factors are those that have been reported for men, despite the major difference in level of mortality.

PIP: An investigation was conducted of the deaths of 338 women (15-44 years of age) attributed to myocardial infarction (MI) on death certificates during an 18-month period in the metropolitan areas of New York City, Los Angeles, Chicago, Philadelphia, and Detroit. For 163 of the women evidence of recent MI or evidence that death occurred suddenly was obtained from records of hospitals or medical examiners or from relatives. A case-control study (involving 1 decreased control and 1 hospitalized living control) of risk factors for heart attack was then conducted. Interviews with relatives were used along with abstracts of records of hospitals and physicians identified by the relatives as sources of medical care. Information was obtained on history of prior MI, other heart disease, diabetes, thromboembolism, stroke, hypertension, high cholesterol, obesity, oophorectomy, oral contraception (OC), and cigarette smoking. Data are presented on the prevalence of these potential risk factors for the case group and each control group, and for subsets of cases consisting of those without prior heart disease, definite MI only, sudden death only, and white women only. Multivariate analyses identify somewhat different sets of risk factors and different levels of risk for the various subgroups. The prevalence of several factors--high cholesterol, obesity, diabetes, hypertension, and thromboembolism--was higher in the total group of cases than those without a history of MI or other heart disease. In general, the risk factors were those that have been reported for men, despite a major difference in level of mortality.