The Pharmaceutical Journal
Vol 273 No 7314 p281
28 August 2004

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Smokers under 40 at five times risk for heart attack

Smokers under 40 years of age are five times more likely to have a heart attack than non-smokers in the same age group, say researchers from Finland. They also estimate that more than half of the non-fatal heart attacks that occur in young middle aged people can be attributed to smoking and are therefore preventable.

The researchers warn that young people may think that the risks involved with smoking are only of concern in older age. “Every effort should be put to use to make young people realise the true and imminent risks of smoking,” they say.

The researchers examined data from the World Health Organization international monitoring study of cardiovascular disease (MONICA), which included information on risk factors for cardiovascular disease from over 130,000 men and women aged between 35 and 64 years.

Episodes of non-fatal heart disease occurring between 1985 and 1994 were recorded — 18,762 events in men and 4,047 events in women. Of those who had a non-fatal heart attack between the ages of 35 and 39 years, 80 per cent were smokers. In this age group, the relative risk of non-fatal myocardial infarction for male smokers was 4.9 per cent (95 per cent confidence interval, 3.9 to 6.1) and 5.3 (3.2 to 8.7) for female smokers. The researchers also calculated that smoking accounted for 65 per cent of non-fatal heart attacks in men of this age and for 55 per cent in women.

The researchers suggest that the interaction between smoking and other factors, such as hereditary coagulation defects, may be important in the occurrence of MI in young people. “Many of these other factors may not be easily treatable. Indeed, smoking cessation programmes will probably be the mainstay of prevention available for such patients,” they comment.

Data from the study revealed that the risks for smokers aged 60 to 64 years were lower, because of other contributory factors. Smoking still carried a higher risk for older women compared with men, possibly because they are more sensitive to the effects of smoking (Tobacco Control 2004;13:244).