The study traced changes from 1979 through 1994 in heart attacks that led to hospitalization among residents of Olmsted County, Minn. The Mayo Clinic study examined heart attack trends among all adult age groups; few previous population-based studies have included persons older than age 74. Heart attack rates among 40 year-old men went down by nearly one-third, but increased almost 50 percent for women over 80 years of age. And while heart attack survival improved markedly for younger patients, it remained essentially unchanged for those over 75.
"A quarter century ago heart disease was seen as primarily a mens disease," says Veronique Roger, M.D., a Mayo Clinic cardiologist and lead author of the study. "Given the trends observed in this study, that is clearly not the case now. The burden of heart disease is shifting toward women and older persons."
Many factors are likely involved in the shift. "More cigarette smoking among women is undoubtedly a factor," says Dr. Roger. "With more women entering the workforce, less time for a healthy lifestyle may also play a part. A third factor may be that prevention efforts have typically been targeted at middle-aged men because they were seen as the prime candidates for heart attack."
Dr. Roger says the success of these prevention efforts for younger men is a hopeful sign for women and the elderly. "The good news is those efforts targeted at middle-aged men are paying off in reduced heart attack rates. They are working. This study suggests that we need to invest the same energy in prevention programs for women and older persons."