Smoking is the overriding cause of heart attacks for people between the ages of 30 and 50, and register-based studies from Aarhus University and Aarhus University Hospital can now contribute with figures and ratios: Three out of four younger patients with a major heart attack are smokers – and for women the figure is eight out of ten.

2019.06.12 | Nanna Jespersgård

Three out of four younger patients with a major heart attack are smokers – and for women the figure is eight out of ten, studies from Aarhus University and Aarhus University Hospital shows. Photo (model) Colour Box.

Unfortunately, we’re seeing that an increasing number of young people are smoking, and if policy is to be based on knowledge, then the data we present here should naturally be part of the discussions about prevention and health promotion, Michael Mæng says. Photo: Novo Nordisk.

“If we want to prevent major heart attacks in people aged 30-50, then from a medical standpoint there is only one option, which is to ensure that they don’t start smoking,” says Michael Mæng who is consultant in cardiology at Aarhus University Hospital and associate professor at the Department of Clinical Medicine at Aarhus University.

He is also co-author of two comprehensive register-based studies, which outline the correlation between major heart attacks and the self-reported smoking habits of the patients. One of the studies has already been published in the European Heart Journal Acute Cardiovascular Care, while the other is currently awaiting publication after being presented at the European Cardiology Congress.

The risk of a major heart attack increases ten times

The studies document that three out of four patients between the ages of 30 and 50 who are treated for a large major heart attack – referred to as STEMI in medical circles – are active smokers. In the case of women, the figure is higher with eight out of ten being smokers. The final two out of the ten typically suffer a heart attack due to other special circumstances such as e.g. a spontaneous dissection in the artery or drug abuse with cocaine and similar drugs, where there is no correlation with arteriosclerosis.

“We’ve been aware that smoking is a significant cause of heart attacks for a long time, but we haven’t been aware that the risk of a heart attack was so drastically elevated. It’s also important to know that the risk of a heart attack generally increases ten-fold if you are under the age of fifty and a smoker,” says Michael Mæng. He does not hesitate to name smoking as the single most significant risk factor among those which society has the opportunity to influence.

These are parents with jobs

Michael Mæng points out that a heart attack is a serious condition, which places patients at risk of cardiac arrest and heart failure. Heart attacks are relatively uncommon in people younger than 50 years of age, but when they are struck, however, it has the hardest impact and the highest cost to society, as they often have small children and regular jobs. Each year 1,000 people in Denmark aged 30-50 suffer a heart attack while by comparison, the 50-80 age group has 9,000 cases.

”A heart attack among the younger group is very costly for both the individual patient, their children and relatives, and also for our society in general,” says Michael Mæng. He is pleased to see that some politicians were using the Danish election campaign to discuss cigarette prices and availability, but he is not impressed with the ambition being shown. At the turn of the millennium, 32 percent of the population smoked and that figure has been as low as 21 percent. Today, the figure has risen to 23 percent and has increased among the young in particular.

"Unfortunately, we’re seeing that an increasing number of young people are smoking, and if policy is to be based on knowledge, then the data we present here should naturally be part of the discussions about prevention and health promotion. We unequivocally document that smoking is a very significant risk factor for heart attacks among all age groups – and a surprisingly high risk factor among younger people and not least for younger women," he says.

In the video below (by Tonny Foghmar) Michael Mæng speaks directly to young smokers, who really only have one option:

The research results – more information

• The two studies are register-based studies and are based on a total of 14,083 patients who have been registered with a large heart attack in the West Denmark Cardiac Database during the period from 2005 to 2015. The information gained has then been correlated with data from Statistics Denmark on the control population.
• The most important collaborative partner is Hanne Gleerup from the Department of Cardiology at Aarhus University Hospital.
• Neither of the two research projects have received external funding and none of the authors have any conflicts of interest.
• The press release is based on both an as yet unpublished study, where the conclusions were presented at the European Cardiology Congress, and also the scientific article Smoking is the dominating modifiable risk factor in younger patients with STEMI, which is published in the European Heart Journal: Acute Cardiovascular Care.

Contact

Consultant, PhD, Clinical Associate Professor, Michael Mæng
Aarhus University, Department of Clinical Medicine and
Aarhus University Hospital, Department of Cardiology
Mobile: (+45) 2670 3237
Email: michmaen@rm.dk