Longer hospital stays, higher mortality typical

Women fare worse than men after a heart attack, with longer hospital stays and a greater likelihood of dying in the hospital afterward, a recent study says.

The good news is that the death rates for women after a heart attack are declining significantly.

The study, by researchers at Yale University, analyzed the largest hospital inpatient care database in the United States. Researchers compared data on clinical characteristics, heart attack hospitalization rates, length of hospital stays and in-hospital deaths for heart attack patients ages 30 to 54.

Among the study’s other findings:

• Heart attack hospitalization rates for young people have stayed the same from 2001 to 2010.
• Older adults saw a 20 percent  decline in hospitalization rates for heart attacks during the same time period.
• Young women – especially African-American women – who have heart attacks often have other serious medical conditions such as high blood pressure, diabetes and heart failure at the time of their heart attack.
• Among heart attack patients younger than 55, men were more likely to have high cholesterol.

Lifestyle choices

Cardiologist Leslie Cho, MD, says the study is noteworthy in that the number of women who experienced heart attacks has remained unchanged in the last decade. Dr. Cho did not take part in the study.

“I think it’s a little disappointing to see that a difference in mortality remains between men and women,” Dr. Cho says.

The study’s researchers say younger women could benefit from more aggressive control of cardiovascular risk factors. These include high blood pressure, high cholesterol, obesity, smoking and diabetes. People can control these factors through diet and behaviors such as exercising and not smoking.

“There’s a lot now published about the fact that Americans are getting worse about heart disease prevention,” Dr. Cho says.

“People are getting more obese, and as they do, they are developing more problems with their cholesterol and their blood pressure,” she says. “These are things that are often easily modified through lifestyle changes.”

The researchers say a lack of awareness among younger adults, as well as poorer ability to control the risk factors probably contribute to the unchanging hospitalization numbers.

Complete finding for the study, “Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race 2001 to 2010” are in the Journal of the American Academy of Cardiology.

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