More than 8-fold higher risk of major heart attack for under 50s who smoke

November 29, 2016

Smokers under the age of 50 are more than eight times as likely as non-smokers to have a major heart attack, making them the most vulnerable of any age group of smokers, reveals research published online in the journal Heart.

All smokers have a significantly higher risk of having a heart attack than non-smokers of the same age, but it's not clear what the magnitude of that risk is among different age groups.

To try and quantify this, the researchers drew on data for 1727 adults undergoing treatment for a classic type of heart attack known as a STEMI at South Yorkshire's regional specialist cardiothoracic centre in Sheffield, northern England, between 2009 and 2012.

A STEMI, or ST-segment elevation myocardial infarction, refers to the typical pattern seen on an electrocardiogram (ECG), indicating that a large portion of the heart muscle is dying.

The researchers also used data from the Office for National Statistics Integrated Household Survey (ONS-IHS), for the South Yorkshire region. Among other things, this collects information on smoking prevalence and other aspects of perceived health.

Almost half of the 1727 patients (48.5%) were current smokers, with roughly a quarter (just over 27%) former smokers, and a quarter (just over 24%) non-smokers.

Current smokers tended to be 10-11 years younger than ex or non-smokers when they had their STEMI. And along with ex-smokers, were twice as likely as non-smokers to have had previous episodes of coronary artery disease.

They were also three times as likely as non-smokers to have peripheral vascular disease, a condition in which a build-up of fatty deposits in the blood vessels restricts blood supply to the legs.

Based on the ONS-IHS data, the overall prevalence of smoking in South Yorkshire was 22.4%, with the highest prevalence among those under the age of 50 (just over 27%). But among STEMI patients under the age of 50, smoking prevalence was almost 75%.

Overall, the data analysis showed that smokers were more than 3 times as likely to have a STEMI than ex- and non-smokers combined.

But the highest risk was among the under-50s who were nearly 8.5 times as likely to do so as former and non-smokers of the same age.

This risk fell with increasing age, dropping to a 5-fold difference among 50-65 year olds, and a 3-fold difference among the over 65s.

The researchers say that the much higher risk of STEMI in younger smokers is not easy to explain as this age group typically don't have many of the other contributory risk factors that might be seen in older smokers, such as high blood pressure, high cholesterol, or diabetes.

Smoking may therefore be the most important risk factor, they suggest, adding that other research shows that the fatty deposits furring up the arteries of smokers differ from those of non-smokers and seem to be more vulnerable to rupture.

This study is based on one regional specialist cardiothoracic centre in England, and it did not include patients who died before admission or who were deemed unsuitable for treatment at the centre.

Nevertheless, the findings prompt the researchers to call for greater efforts to be made to help younger smokers stub out their habit.

"All current smokers must be encouraged into smoking cessation therapy to reduce their risk of acute STEMI, with a focus on the youngest smokers whose increased risk is often unrecognised," they say.

Writing in a linked editorial, cardiologist Dr Yaron Arbel, of the Tel Aviv Medical Center, Israel, agrees.

Efforts need to be directed to prevention and education, he says. "Most smokers know that smoking is bad. However, exact numbers have a tendency to hit home more often. Therefore studies like the present one are especially important."

He adds that as most young smokers don't have the conventional array of risk factors, commonly used treatment approaches are unlikely to make much difference.

"Our goal should be on providing them with the tools to achieve abstinence," he insists, adding that "in difficult cases, even reducing the number of cigarettes smoked daily might make a difference."


Related Smoking Articles from Brightsurf:

Smoking rates falling in adults, but stroke survivors' smoking rates remain steady
While the rate of Americans who smoke tobacco has fallen steadily over the last two decades, the rate of stroke survivors who smoke has not changed significantly.

What is your risk from smoking? Your network knows!
A new study from researchers at Penn's Annenberg School for Communication found that most people, smokers and non-smokers alike, were nowhere near accurate in their answers to questions about smoking's health effects.

Want to quit smoking? Partner up
Kicking the habit works best in pairs. That's the main message of a study presented today at EuroPrevent 2019, a scientific congress of the European Society of Cardiology (ESC).

Smoking and mortality in Asia
In this analysis of data from 20 studies conducted in China, Japan, South Korea, Singapore, Taiwan and India with more than 1 million participants, deaths associated with smoking continued to increase among men in Asia grouped by the years in which they were born.

Predictors of successfully quitting smoking among smokers registered at the quit smoking clinic at a public hospital in northeastern Malaysia
In the current issue of Family Medicine and Community Health, Nur Izzati Mohammad et al. consider how cigarette smoking is one of the risk factors leading to noncommunicable diseases such as cardiovascular and respiratory system diseases and cancer.

Restaurant and bar smoking bans do reduce smoking, especially among the highly educated
Smoking risk drops significantly in college graduates when they live near areas that have completely banned smoking in bars and restaurants, according to a new study in the American Journal of Epidemiology.

How the UK smoking ban increased wellbeing
Married women with children reported the largest increase in well-being following the smoking bans in the UK in 2006 and 2007 but there was no comparable increase for married men with children.

Smoking study personalizes treatment
A simple blood test is allowing Vanderbilt University Medical Center (VUMC) researchers to determine which patients should be prescribed varenicline (Chantix) to stop smoking and which patients could do just as well, and avoid side effects, by using a nicotine patch.

A biophysical smoking gun
While much about Alzheimer's disease remains a mystery, scientists do know that part of the disease's progression involves a normal protein called tau, aggregating to form ropelike inclusions within brain cells that eventually strangle the neurons.

A case where smoking helped
A mutation in the hemoglobin of a young woman in Germany was found to cause her mild anemia.

Read More: Smoking News and Smoking Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to