Heart failure and stroke are increasing in men under 40, according to a study
Heart failure and stroke are unusual diagnoses in younger people. According to a study by the University of Gothenburg, men under 40 are clearly on the rise. The scientists found links to obesity and low fitness in the upper teens.
The present study, published in the Journal of Internal Medicine, includes data on 1,258,432 men who were enrolled for military service in Sweden between 1971 and 1995, averaging 18.3 years of age.
Information on the weight, height and physical fitness of the men at admission was merged with data in the National Patient Register and the Causes of Death Register of the National Health and Social Services for the period 1991-2016. From the time they were hired, the men were monitored for more than 20 years.
The proportion of participants who were overweight at the time of admission, i.e. with a body mass index (BMI) of 25 to 30, rose from 6.6 to 11.2 percent between 1971 and 1995, while the proportion of obesity ( BMI over 30) rose from 1.0 to 2.6 percent. During the same period, her fitness level also decreased slightly at the time she was discontinued.
Increases in heart failure and stroke
These factors – that is, being overweight, obese, and poor fitness – partly explain the sharp rise in heart failure that we see in the study, as well as the rise in stroke. “
David Åberg, first author and associate professor at the Sahlgrenska Academy, Gothenburg University
Åberg is a specialist at Sahlgrenska University Hospital.
“It is gratifying to see a fairly large decrease in heart attacks among these younger men, and also their decreased mortality from cardiovascular disease, in spite of increasing obesity,” he continues.
Heart failure cases within 21 years of admission rose 69 percent, according to the study – from 0.49 per 1,000 of men who came forward in the first five years (1971-75) to 0.83 / 1,000 of those who did had reported the last five in the group (1991-95).
The number of strokes – cerebral infarction and cerebral hemorrhage – showed a similar trend. The increase in cerebral infarction was 32 percent, from 0.68 for the first five-year cohort to 0.9 per 1,000 for the last. For cerebral haemorrhages, the increase was 20 percent, from 0.45 to 0.54 per 1,000.
Strong physical activity support
In contrast, within 21 years of admission, myocardial infarction decreased 43 percent, from 1.4 to 0.8 per 1,000 of the first and last admitted cohorts. The proportion of deaths from all cardiovascular diseases also decreased by 50 percent – from 1.5 to 0.74 per 1,000.
The fact that trends in cardiovascular disease have moved in different directions over time suggests that other, unknown factors are also involved. According to the researchers, weight trends after ingestion can be one such factor, but stress and drug use can be others. In the case of heart attacks in particular, researchers believe that a sharp drop in smoking is behind the drop. However, the fact remains that being overweight and obese have an impact.
“We see that without the rise in overweight and obesity, heart attacks would have decreased even further. Our results therefore support the assumption that obesity and, to some extent, poor fitness occur early by the age of 18 cardiovascular disease. At the societal level it is therefore important to be more physically active and to establish good eating habits in adolescence while being less sedentary, “concludes David Åberg.
Åberg, ND, et al. (2021) Different Trends in Acute Myocardial Infarction, Heart Failure, Stroke, and Mortality Incidence in Young Men: Role of Changes in Obesity and Fitness. Internal Medicine Journal. doi.org/10.1111/joim.13285.