Heart Disease Prevention in Young Women: Sounding an Alarm.

Abstract

We have come a long way in the past 50 years toward reducing death and disability from cardiovascular diseases (CVDs). And yet, as articulated by Wilmot et al in this edition of Circulation ,1 we still have a long way to go, especially for young women and some racial/ethnic groups. These new findings highlight the value of looking “behind the curtain” at health data, in particular, teasing apart age- and sex-related outcomes. Article see p 997 Wilmot et al now build on our understanding of CVD mortality by highlighting recent trends in subpopulations, including young women, and those trends are troubling. These investigators examined mortality data for US men and women ≥25 years between 1979 and 2011 using US National Vital Statistics data that focused on coronary heart disease (CHD).1,2 International Classification of Diseases, 9th Revision and International Classification of Diseases, 10th Revision codes were used to determine the underlying cause of CHD deaths. Analyses of mortality data within 3 age groups ( 65 years) during 3 decades (1979–1989, 1990–1999, and 2000–2011) yielded an initial assessment of mortality trends. Regression modeling then further evaluated trends in the estimated annual percentage change in CHD mortality across the entire time period, permitting calculation of statistically significant differences in estimated annual percentage change from year to year. On one hand, the news is good. The impressive (68%) decline in age-adjusted CHD mortality rate for both men and women across the overall study period is nothing short of remarkable and validates progressive improvements in CVD prevention and treatment. Overall, since 2002, older men and women (>65 years of age) continue to experience large reductions in CHD mortality, which drives this overall mortality decline. Yet, disaggregating the data and recalculating mortality rates by age, sex, race, and …