According to a study published in the August edition of Circulation, coronary heart disease (CHD) mortality rates have fallen dramatically over the past four decades among older Americans but not among the younger populations-- specifically, women. 

Lead researchers Kobina Wilmot, MD, fellow in the Division of Cardiology at Emory's School of Medicine and Viola Vaccarino, MD, PhD, Wilton Looney Chair of Cardiovascular Research in the Department of Epidemiology at Emory's Rollins School of Public Health analyzed CHD mortality data and changes in trends between 1979 and 2011 for US adults 25 and older.

Findings suggest that older Americans 65 and older showed consistent mortality declines which became even more significant after 2000 while younger men and women under the age of 55 showed stagnation with minimal improvement.  Young women showed no improvements between 1990 and 1999 and minimal improvement thereafter.

"Our findings reveal large differences across demographic groups," says Wilmot.  "The causes of the sluggish improvements in CHD mortality among young adults, especially women, are unclear but we think that these trends reflect lack of effective preventive strategies for young people, particularly women." 

Lower awareness and recognition of CHD in women have long been reported. Low socioeconomic resources affecting access to preventive care is also a possible variable. Escalating rates of diabetes and obesity in younger adults, especially women, may be implicated as well. "

"A possible reason for the slow decline in CHD mortality among young people in recent decades is that prevention guidelines may disproportionately underestimate risk in a younger population," suggests Vaccarino. "We may need to look beyond traditional risk factors currently included in risk prediction algorithms. For example, factors such as stress and depression are especially common among young women with early-onset heart disease, and are powerful predictors of heart disease or its progression in this group," Vaccarino said. "Reasons underlying these different trends urgently require further study and closer attention to primary prevention strategies for the younger population."