Study: Heart failure and stroke increase in men under 40 years of age
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 from the National Patient Register and the Causes of Death Register of the National Health and Welfare Office 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 decreased slightly at the time she was discontinued.
“These factors – being overweight, obese and poor fitness – partly explain the sharp increase in heart failure that we see in the study, as well as the increase in stroke,” explains David Åberg. Åberg is Associate Professor at the Sahlgrenska Academy at the University of Gothenburg and a medical specialist at the Sahlgrenska University Hospital. He is the first author of the study.
“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 the last five (1991-95) registered.
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.
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 the heart attack would have decreased even further if the overweight and obesity had not increased. Our results, therefore, strongly support the belief that obesity and, to some extent, poor fitness by the age of 18 influence early onset cardiovascular disease. On a social level, it is therefore important to achieve more physical activity and to establish good eating habits as early as adolescence while being less sedentary. “
David Åberg, Associate Professor, Sahlgrenska Academy, Gothenburg University
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.