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Atherosclerotic cardiovascular disease and sudden deaths among young adults in Wayne County
C L Schierer1, I C Hood, H G Mirchandani
1Medical Examiners' Office of Wayne County, Detroit, Michigan.
Insights
Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of sudden cardiac death in young adults. Risk factors like diabetes and alcohol use are associated with ASCVD deaths in this age group.
Area of Science:
- Cardiology
- Public Health
- Forensic Pathology
Background:
- Heart disease is a leading cause of mortality across all age groups.
- Sudden cardiac death in young adults is often attributed to non-atherosclerotic causes.
- Atherosclerotic cardiovascular disease (ASCVD) is typically considered a disease of older populations.
Purpose of the Study:
- To investigate the incidence and causes of heart disease-related deaths in young adults (aged 20-34).
- To identify specific types of cardiovascular disease contributing to mortality in this demographic.
- To explore risk factors associated with sudden cardiac death from ASCVD in young adults.
Main Methods:
- Retrospective analysis of postmortem records from the Wayne County Medical Examiners' Office (1982-1986).
- Categorization of cardiac causes of death, including atherosclerotic cardiovascular disease (ASCVD), hypertensive cardiovascular disease, and cardiomyopathy.
- Statistical review of demographic data and associated medical conditions for individuals who died from ASCVD.
Main Results:
- Heart disease caused 129 deaths in individuals aged 20-34, with ASCVD accounting for 51 cases.
- ASCVD deaths were more prevalent in men (black and white) and increased with age within this young adult group.
- Diabetes mellitus, left ventricular hypertrophy, seizure history, and recent alcohol ingestion were associated with sudden ASCVD death; obesity was not a significant factor.
Conclusions:
- ASCVD is a notable cause of sudden cardiac death in young adults, not a rare occurrence.
- Risk factors for ASCVD in older populations, such as diabetes and alcohol use, are also relevant in young adults.
- Further research into ASCVD in younger demographics is warranted to inform preventative strategies.
Abstract:
Based on postmortem records at the Wayne County Medical Examiners' Office from 1982 to 1986, autopsy results indicated that the deaths of 129 persons aged 20-34 resulted from heart disease: 51 of these deaths were attributed to atherosclerotic cardiovascular disease (ASCVD), 29 to hypertensive cardiovascular disease, 28 to cardiomyopathy, and 21 to other cardiac causes. The majority of the deaths due to ASCVD occurred among men, both black and white, followed by black women, and the incidence increased with age. All of these deaths due to ASCVD were sudden and accounted for all deaths due to ischemic heart disease in this age group among Wayne County residents. Diabetes mellitus, left ventricular hypertrophy, a history of seizures, and the recent ingestion of alcohol were all found to be associated with sudden death from ASCVD in this group. Obesity did not seem to be a significant factor. These data suggest that ASCVD is not rare as a cause of death in young adults and some of the risk factors identified in older subjects also operate in this age group.