Annual decline in premature acute MI slowing, varies by age, sex, race, region
The rate of premature acute MI was approximately halved from 1999 to 2019; however, this rate of change slowed in recent years, with higher rates observed among older individuals, men and Black adults, researchers reported.
According to data published the Journal of the American Heart Association, the annual decline in premature acute MI was especially slow in rural communities compared with metro counties.
“Cardiovascular disease is the leading cause of death in the United States, and acute myocardial infarction ... is a major contributor,” Safi U. Khan, MD, MS, cardiology fellow at the DeBakey Heart and Vascular Institute at Houston Methodist Hospital, said in a press release. “The cardiovascular risks among adults younger than age 65 has become increasingly complex during the last 2 decades. Our study focused explicitly on premature deaths due to a heart attack to identify demographic and regional differences, which may help to inform targeted interventions.”
Researchers utilized data from CDC’s Wide-Ranging Online Data for Epidemiologic Research death certificate database to assess the age-adjusted rates of premature acute MI mortality and change in average annual percentage from 1999 to 2019.
According to the study, age-adjusted acute MI mortality was higher among:
- middle-aged adults compared with young adults (34.9 vs. 2.5 per 100,000 people);
- men compared with women (20 vs. 7.3 per 100,000 people);
- Black adults compared with white adults (17.5 vs. 13.7 per 100,000 people); and
- in rural counties compared with urban counties from 1999 to 2019.
Researchers reported that the overall age-adjusted acute MI mortality rate from 1999 to 2019 was 13.4 per 100,000 people, decreasing from 20.4 in 1999 to 9.9 per 100,000 in 2019 (average percent change, –3.4% per year).
Khan and colleagues observed higher annual decline in the percentage of age-adjusted acute MI mortality rates among large (4.2% per year) and medium/small metros (3.3% per year) compared with rural counties (2.4 per year).
Researchers reported that, after an average initial decline in premature acute MI mortality of 4.3% per year from 1999 to 2011, the average change has decelerated in mortality since 2011 to approximately 2.1% per year, a finding that was consistent across sexes, races/ethnicities and county urbanicity.
“Recent medical advancements have reduced major adverse cardiovascular outcomes for patients who have had a heart attack, so we were surprised by the deceleration in the decline of premature death rates during the last decade,” Khan said in the release. “This concerning trend reflects the growing burden of cardiovascular disease among younger adults. Implementing evidence-based strategies to prevent and treat premature cardiovascular disease, and public health efforts targeting high-risk groups may help to narrow some of the disparities and improve outcomes among patients after a heart attack.”
Reference:
- Rates of premature heart attack death vary by sex, race and region in the U.S. https://newsroom.heart.org/news/rates-of-premature-heart-attack-death-vary-by-sex-race-and-region-in-the-u-s. Published Dec. 22, 2021. Accessed Dec. 22, 2021.
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