Risk factors like smoking, high BP common among younger patients with repeat heart attacks

Heart attacks reoccurred more frequently in younger patients with several modifiable risk factors, including smoking and high blood pressure. Researchers on the new study, presented at the American College of Cardiology Asia Conference 2018 in Shanghai, suggested secondary preventive programs for younger patients should target modifiable risk factors.

"When treating younger patients with a history of heart attack, clinicians should emphasize better control of high blood pressure, high cholesterol and diabetes," said Joanne Karen Recacho-Turingan, MD, a Cardiology Fellow at The Medical City in Manila, Philippines. "Other modifiable risk factors to highlight in patient history and address with these patients include smoking habits and obesity."

Researchers analyzed 133 young patients admitted at The Medical City for a heart attack between 2013 and 2016. During the study period 22 patients had a reoccurrence. All patients who experienced a second heart attack were male with an average age of 40.9 years. Patients who did not experience a reoccurrence were 90.1 percent male and 9.9 percent female with an average age of 39.6 years.

Risk factors such as smoking, high blood pressure, family history of heart disease and chronic kidney disease were more prevalent among the patients who experienced a reoccurrence. In these patients, chest pain was the most common presenting symptom at 81.8 percent while 90.9 percent had unstable vital signs at the time of admission.

"Heart attack in young patients can cause disability and even death at the prime of life," Recacho-Turingan said. "There are often serious consequences for these patients, their families and the health system, which can lead to an increased economic burden. We must make sure to work with these patients on their modifiable risk factors to reduce their risk not just for a second heart attack, but hopefully, even preventing the first."

Previous studies have defined young heart attack patients as less than 45 years old while some used a less than 40-year old cut-off. Prior research has found these patients have a high prevalence of smoking, family history and high cholesterol.