Younger women may be more likely to die in the decade following a heart attack than men of the same age, a new study suggests.
In general, women under age 50 experience fewer heart attacks than men in the same age range. The new study, published Oct. 13 in the European Heart Journal, also reflects this trend; of 2,100 heart attack patients treated at the Brigham and Women’s Hospital and Massachusetts General Hospital in Boston between 2000 and 2016, only about 400 were women. The average age of all the patients in the study was 44 years old.
But over the long-term, these young women were more likely to die than young men. The study authors followed the patients for a median of 11 years, and found that women were 1.6 times more likely to die from any cause than men during that time.
“Notably, the differences in mortality in our study were primarily driven by non-cardiovascular death,” meaning deaths not caused by a heart condition, study author Dr. Ersilia DeFilippis, a cardiology fellow at New York Presbyterian-Columbia University Irving Medical Center, told Live Science in an email. Examples of these non-cardiovascular causes of death included cancer and sepsis, a kind of overblown immune response to an infection.
Unfortunately, “there were no clear explanations as to why women had lower survival,” DeFilippis noted, though the study revealed a number of factors that may be at play.
“The risk factors for disease of other organs overlap with risk factors for heart disease,” Dr. Marysia Tweet, an assistant professor in Cardiovascular Medicine at the Mayo Clinic, who was not involved in the study, told Live Science in an email. “A heart attack and the ramifications of a heart attack may affect the health of other organs. Long-term mortality is likely due to a combination of multiple factors.”
For instance, women in the study had higher rates of diabetes than the men, as well as higher rates of diseases such rheumatoid arthritis , where joint pain and inflammation are often triggered by an immune system attack. This persistent inflammation may drive the formation of fatty plaques in blood vessels, which can block arteries and lead to a heart attack, according to a 2012 report in the journal Arteriosclerosis, Thrombosis, and Vascular Biology. That same inflammation may also affect how patients recover.
In addition, the women showed higher rates of depression than men in the study. “Depression impacts adherence to healthy lifestyle recommendations and medications,” which could impact women’s long-term survival after a heart attack, Tweet wrote in a commentary also published in the European Heart Journal about the research. But it’s also possible that the physiological changes that coincide with depression independently worsen outcomes; for instance, elevated levels of stress hormones and inflammatory molecules called cytokines could worsen a patient’s prognosis, she wrote.
In general, women are about twice as likely as men to experience stress-induced reduction in blood flow to