According to a study supported by the National Institutes of Health, women aged 55 and under are almost twice as likely to be re-hospitalized within a year of a heart attack as men of the same age. This disparity may be due to higher rates of risk factors such as obesity, heart failure and depression among women. The study recommends closer monitoring of the health of the approximately 40,000 American women in this age group who suffer heart attacks each year. Non-cardiac factors such as depression and low income levels, which are more common in women, also contribute to higher rehospitalization rates.
The NIH-backed findings identify risk factors in women and suggest the need for closer monitoring.
A study funded by the National Institutes of Health shows that women aged 55 and under are nearly twice as likely to be re-hospitalized within a year of a heart attack as men of the same age. This is potentially due to higher rates of risk factors such as obesity, heart failure, depression and low income levels. The study calls for closer monitoring and further research to improve women’s health outcomes after discharge.
According to a study supported by the National Institutes of Health, women aged 55 and under have nearly double the risk of rehospitalization in the year immediately following a heart attack compared to men of the same age. Higher rates of risk factors such as obesity, heart failure and depression among women most likely contributed to the disparity.
The findings suggest the need for closer monitoring of the health of the approximately 40,000 American women aged 18 to 55 who have heart attacks each year after discharge from hospital, and a better understanding of the reasons behind the different results. The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH, was published today in the Journal of the American College of Cardiology.
“We have shown for the first time that rehospitalizations following a heart attack in women aged 55 and under are accompanied by certain non-cardiac factors, such as depression and low income, which seem to be more frequent in women than in men and are associated with greater adverse effects. results,” said corresponding author Harlan M. Krumholz, MD, cardiologist and professor of medicine at Yale School of Medicine, New Haven, Connecticut. He is also the director of the school’s Center for Outcomes Research and Evaluation (CORE). “The study reveals the need for greater attention to these non-cardiac risk factors in young women to help design better clinical interventions and improve outcomes following heart attack recovery.”
“Further study of these risk factors could allow physicians and their patients to focus on ways to improve a woman’s health after discharge from hospital,” said Yuan Lu, Sc.D. ., the study’s principal investigator, a CORE researcher, and an assistant professor at the Yale School of Medicine.
Researchers have known for some time that women aged 55 and under are about twice as likely to die of a heart attack in hospital as men of the same age. However, it was unclear whether women were also at higher risk for cardiovascular and non-cardiovascular complications one year after leaving hospital following treatment for a heart attack.
To learn more, the researchers analyzed data from NHLBI’s VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study, which examines a wide range of risk factors related to outcomes in women and men who have had heart attacks. The study included 2,979 patients – 2,007 women and 972 men – at 103 US hospitals. Participants were on average 48 years old and from ethnically and racially diverse populations.
The analysis showed that nearly 30% of these patients were rehospitalized within a year of their first discharge from hospital following a heart attack. Most of these visits peaked within the first month after a patient was discharged and then slowly declined over the following months. The researchers found that women had nearly twice the risk (1.65 times higher risk) of rehospitalization than men.
For both men and women, coronary complications – such as heart attacks and angina pectoris which are linked to blocked blood vessels – were the leading cause of rehospitalization. Yet the rate of coronary complications in women was nearly 1.5 times higher than in men, largely due to risk factors such as obesity and diabetes.
The greatest gender disparities were in non-cardiac rehospitalizations, which were more than twice as high (or 2.10 times higher) in women than in men. These were hospitalizations caused by events unrelated to heart disease or stroke, such as digestive problems, depression, bleeding and pneumonia.
The reasons for these higher non-heart rates are unclear, but the researchers found that a higher percentage of women than men tended to identify as having low income (48% versus 31%) and had a higher history of depression (49% versus 24%). . Although low income is not a medical measure, it is often associated with poor health due to limited access to health care. The risk of depression is known to increase following a heart attack and may be a risk factor in higher hospitalization rates partly due to undertreatment of the disease in women. However, further studies will be needed to further explore how these factors affect disparate hospitalizations following a heart attack.
“Future research on non-cardiac risk factors after discharge from hospital following a heart attack may lead to the development of targeted strategies that can reduce this equity gap,” said Gina S. Wei, MD, MPH , Associate Director of NHLBI’s Division of Cardiovascular Sciences and NHLBI’s Senior Scientific Advisor on Women’s Health. “We look forward to further studies in this area.”
Reference: “Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients” by Mitsuaki Sawano MD, PhD, Yuan Lu ScD, Cesar Caraballo MD, Shiwani Mahajan MBBS, MHS, Rachel Dreyer PhD, Judith H. Lichtman PhD, MPH, Gail D ‘Onofrio MD, MS, Erica Spatz MD, MHS, Rohan Khera MD, MS, Oyere Onuma MD, MSc, Karthik Murugiah MBBS, John A. Spertus MD, MPH and Harlan M. Krumholz MD, SM, May 1, 2023, Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2023.03.383
This study was supported by National Heart, Lung, and Blood Institute grant R01HL081153 and used data from the VIRGO study (NCT00597922).