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People Under 50 Aren't Safe From Heart Attacks

By Dianne Partie Lange
WebMD Health News

April 3, 2000 (Lake Tahoe, Calif.) -- If you're under 50 and have near-average cholesterol levels, you -- and your doctor -- may think heart disease is something you don't need to worry about just yet. But, according to the findings of a new study, that could be a dangerous assumption.

About one in five of the men and women admitted to a rural Wisconsin hospital with signs of heart disease over a two-year study period were age 50 or younger. According to the study published in the Journal of Cardiology, many of them did not even have high cholesterol levels.

"We're beginning to see more and more heart attacks in young people now, and most of them don't have the typical high-risk profile that allows their doctors to detect [their condition] early and prevent it," researcher Kwame O. Akosah tells WebMD. Akosah is director of the heart failure unit at the Gunderson Lutheran Medical Center in La Crosse, Wis., where the study was conducted.

Twenty-two percent of the 449 patients admitted to the hospital with serious heart symptoms were 50 or younger. Sixty-one percent of these younger patients were diagnosed with heart disease.

Although heart disease is usually thought to affect women over age 65 and men over 55, the researchers found that almost half of the women and two-thirds of the men with heart disease were younger than this. More than three-quarters of the patients had cholesterol levels less than 240. An overall cholesterol level of 200 to 240 is considered slightly elevated; less than 200 is considered normal.

"The sheer number of young people who were admitted with [heart disease] was unexpected," says Akosah. The second surprise, he says, is that many of the patients did not appear to be at high risk for heart disease, meaning they did not have particularly high cholesterol or high blood pressure, nor were they smokers or overweight.

It is important to look at all the risk factors and not just cholesterol, Akosah says. In addition, he says, the current cholesterol guideline "may be too high, so it misses some people."

Current guidelines recommend that patients and doctors strive for an LDL [the so-called "bad" cholesterol] level of less than 160 -- or 130 if the person has two other risk factors, such as diabetes, family history, or smoking. In people who already have heart disease, the LDL should be less than 100, to help prevent a heart attack or further blockage. If these guidelines cannot be met with diet and exercise, medication may be necessary.

"The best way to prevent heart disease is to target all risk factors: smoking, obesity, a sedentary life, [high blood pressure]. ... It's not LDL alone," says Akosah. Interestingly, a significant number of the people admitted to the hospital in this study had not had their blood tested for cholesterol. The study's authors say this suggests a missed opportunity for heart-disease prevention.

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