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The risk factors for ischemic heart disease in young adults
S Tomono1, S Ohshima, K Murata
1Second Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.
Insights
Hypercholesterolemia is the primary risk factor for ischemic heart disease in young patients under 40. Traditional factors like hypertension and diabetes also contribute, but high cholesterol is most significant.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Ischemic heart disease (IHD) typically affects older individuals.
- Understanding risk factors in younger populations is crucial for early intervention.
Purpose of the Study:
- To identify the primary risk factors for ischemic heart disease in patients under 40 years of age.
- To compare the prevalence of risk factors in young IHD patients with control groups.
Main Methods:
- Retrospective review of medical histories and laboratory data for 67 young patients (under 40) with IHD.
- Analysis of risk factors including hypercholesterolemia, hypertension, diabetes mellitus, and smoking.
- Comparison of risk factor incidence with age-matched healthy subjects and older IHD patients.
Main Results:
- Hypercholesterolemia was present in 23 young IHD patients, with 10 cases of familial hypercholesterolemia.
- Significant atherosclerotic coronary stenosis was found in 51 patients.
- Incidences of hypercholesterolemia, hypertension, and diabetes were significantly higher in young IHD patients compared to controls and older IHD patients.
- No obvious risk factor was identified in 18 young IHD patients, including 12 with myocardial infarction.
Conclusions:
- Hypercholesterolemia is the most significant risk factor for ischemic heart disease in young patients.
- Hypertension, diabetes mellitus, and smoking are associated risk factors.
- Myocardial infarction in young individuals can occur without apparent risk factors, sometimes linked to strenuous exercise or excessive alcohol intake.
Abstract:
We reviewed the histories and laboratory data of 67 young patients with ischemic heart disease under the age of 40 years. Twenty-three cases were associated with hypercholesterolemia. Of these, 10 were of the familial type. Twenty patients had hypertension, while 14 were diabetics and 13 were heavy smokers. It is noteworthy that 13 of 17 patients with multi-vessel disease and hypercholesterolemia. Significant atherosclerotic coronary stenosis was demonstrated in 51 cases. The incidences of hypercholesterolemia, hypertension and diabetes mellitus in these 51 patients were not only significantly higher than those in age-matched normal health subjects and young patients with non-ischemic heart disease, but also higher than those in patients with ischemic heart disease over the age of 40 years. The results indicated that hypercholesterolemia is the most important risk factor for ischemic heart disease in young patients, although the three previously accepted risk factors (hypertension, diabetes mellitus and cigarette smoking) were all associated with the development of the disease. We could not find any obvious risk factor in 18 young patients with ischemic heart disease, including 12 cases of myocardial infarction. Myocardial infarction in the absence of any obvious risk factor occurred during strenuous physical exercise in 5 patients and following excessive alcohol consumption in 4.