Researchers Say 7 Factors Drive Most Heart Attacks in Young Adults—Especially in Women

New research has identified risk factors that are the most likely to trigger a heart attack, also known as an acute myocardial infarction (AMI), for men and women aged 55 and under. The study also teased out important sex differences in risk factors associated with heart attacks.

The study, which was published in JAMA Network Open, analyzed data from 2,264 patients between the ages of 18 and 55 with heart attacks, along with 2,264 people from a control group.

The researchers found that young men and women typically have different risk factors for heart attacks.

“An increasing proportion of people in the U.S. hospitalized for acute myocardial infarction (AMI) are younger than 55 years, with the largest increase in young women,” the researchers wrote. “Effective prevention requires an understanding of risk factors associated with risk of AMI in young women compared with men.”

Lead study author Yuan Lu, ScD, assistant professor of cardiovascular medicine at the Yale School of Medicine, told Verywell that the overall risk of heart attack in young people is “generally low.” However, she added, “incidents in young women are increasing and they have a worse prognosis.”

Heart attacks are a “leading cause of death in this age group, even though the incidence is low,” Lu said, emphasizing the need for people need to understand their risk factors.

What Were the Risk Factors?

The researchers found a distinct difference in heart attack risk factors for men and women.

The greatest risk factors for heart attacks in women were:

• Diabetes
• Depression
• Hypertension
• Smoking
• Family history of heart attacks
• Low household income
• High cholesterol

The leading risk factors in men were:

• Smoking
• Family history of heart attacks

Why Do These Risk Factors Drive Heart Attacks in Young Adults?

Experts said they were not shocked by the findings.

“We have known for quite some time that diabetes and smoking and more recently hypertension were more powerful risk factors in women,” Holly S. Andersen, MD, an attending cardiologist and associate professor of clinical medicine at the New York-Presbyterian Hospital, Weill Cornell Medical Center, told Verywell. “It is also not surprising that the psychosocial stressors of depression and low household income impact women more.”

But, she said, “we need to learn more about genetics—those efforts are underway—and we need more research on sex-specific differences in cardiovascular disease.”  

These risk factors “are all risk factors for cardiovascular disease, regardless of the population,” Rigved Tadwalkar, MD, a board-certified cardiologist at Providence Saint John’s Health Center in California, told Verywell. “We now have somewhat of a ranking of how much these risk factors contribute. We also haven’t seen research in sex differences like this.”

Many of the risk factors for heart attacks are modifiable. Taking steps to reduce your risk is important, Preethi Pirlamarla, MD, cardiologist and assistant professor in the Mount Sinai Health System, told Verywell.

“Reducing risk factors is of utmost importance,” she said. You can reduce your risk by stopping or never starting smoking, maintaining a heart-healthy diet, and regularly exercising.

“Equally important is regular visits with your primary care physician to ensure you are being screened and treated for your risk factors including high cholesterol, high blood pressure, diabetes, and depression,” she added.

Lu stresses the importance of being aware of your heart attack risk. “In the past, people may have thought that this is a disease for older people,” she said. “But people should understand that there is still a possibility to develop this at a younger age and that the prognosis is worse for women than men.”