Similarities And Differences Of Myocardial Infarction In Males And Females Of Different Ages

Myocardial infarction (MI), which mainly caused by coronary artery disease, can result in serious heart conditions or even death. Although MI is primarily a disease of older population, young adults can suffer from MI as well. According to the data, the rate of MI is significantly higher in the population of age groups older than 55, and there is no significant difference in the frequency of MI in older males and females. However, in the younger adults, males of 25 – 54 years old demonstrate an incidence of MI almost three times more than that of females. MI among young may present different characteristics from those among the older population.

Numerous studies have done to indicate several factors that cause MI among young males and females. A history of smoking, one of the most common risk factors of heart related disease, has been “increasingly prevalent” among young adults. Other risk factors, such as obesity and diabetes are also growing concerns among young population. Prevalence of recreational drug abuse, such as cocaine use, could be a potential cause of MI in young adults. The data from the table and the chart show that males aged between 25-55 have higher rate of MI than that of female counterparts. In a study of Zimmerman et al, a family history of premature cardiovascular events was more prevalent only in young men. In another study of Aora, et al, young males are more likely to be smokers, which could explain higher rate of MI. One study reported that the gender distribution of MI in young males is “between 75% - 95%. The potential reason indicated by this study is that pre-hospital delay times in young women is much longer than that of in male counterparts, and when presenting with MI, females may be neglected due to culture factors.

Younger males and females more likely experience MI led by a single vessel. However, their older counterparts tend to have MI caused by multiple vessels and have “more severe or unstable angina, congestive heart failure” and other associated illnesses that require operations. In a study of Zimmerman et al, increased prevalence of hypertension and diabetes mellitus were found in both older males and females. One study reported that the rates of previous angina, heart failure, MI and stroke were similar in older males as in older females (Canto, et al, 2002). Though the proportion of younger smokers is much higher than older counterparts, one study found high proportion of smokers still present among older males and females.

It is widely recognized that even with “best practice interventions,” the prognosis after MI in the younger males and females is more favorable than that of their older counterparts. MI of older males and females is associated with type 2 diabetes and hypertension. Lifestyle change among this age group still can be one of important factors in preventing MI. One research expanded evidence from previous studies on impact of smoking on cardiovascular system among older population in both Europe and United. The research indicated that even at older ages, “smoking cessation” showed substantial decrease of cardiovascular risks.

There has been a significant decline in heart-disease related mortality in the past 40 years in US. However, the data appears not to be optimistic in young adults, and younger women in particular. Studies done in US and other developed countries have raised concerns about increasing hospitalization rates for MI in younger females. The proportion of MI hospitalization for young women “increased from 21% in 1995 to 1999 to 31% in 2010 to 2014,” compared to relatively steady rise among young males (30% to 33%). These statistics have raised alarm, and further study needs be done to explain the causes, treatments and preventative measures to promote health among younger females.

References

• Alshahrani, Hassan, et al. “Female Gender Doubles Pre-Hospital Delay Times for Patients Experiencing ST Segment Elevation Myocardial Infarction in Saudi Arabia.” European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, U.S. National Library of Medicine, Oct. 2014, https://www.ncbi.nlm.nih.gov/pubmed/24104612.
• Arora, Sameer, et al. “Twenty Year Trends and Sex Differences in Young Adults Hospitalized With Acute Myocardial Infarction.” Circulation, U.S. National Library of Medicine, 19 Feb. 2019, https://www.ncbi.nlm.nih.gov/pubmed/30586725.
• Canto, John G, et al. “Association of Age and Sex with Myocardial Infarction Symptom Presentation and in-Hospital Mortality.” JAMA, U.S. National Library of Medicine, 22 Feb. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494682/.
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• Shah, Nadim, et al. “Myocardial Infarction in Young versus Older Adults: An Analysis of Differences in Proportion, Risk Factors, Clinical Demographics, Angiographic Findings and in-Hospital Outcomes.” ClinMed International Library, https://clinmedjournals.org/articles/ijcc/international-journal-of-clinical-cardiology-ijcc-3-079.php?jid=ijcc.
• Shah, Nadim, et al. “Myocardial Infarction in the ‘Young’: Risk Factors, Presentation, Management and Prognosis.” Heart, Lung & Circulation, U.S. National Library of Medicine, Oct. 2016, https://www.ncbi.nlm.nih.gov/pubmed/27265644.
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• Zimmerman, F H, et al. “Myocardial Infarction in Young Adults: Angiographic Characterization, Risk Factors and Prognosis (Coronary Artery Surgery Study Registry).” Journal of the American College of Cardiology, U.S. National Library of Medicine, Sept. 1995, https://www.ncbi.nlm.nih.gov/pubmed/7642855.