Women under age 65 with coronary artery disease are more likely to die if they live in rural areas of the United States, and premature deaths among them have surged, a new study finds.
Researchers analyzed nationwide data on premature deaths from coronary artery disease between 1999 and 2017. While premature deaths decreased overall, they remained consistently higher in rural areas — regardless of sex, race or age group.
Roughly 20% of Americans live in rural areas.
Deaths have not risen among men overall, but the rate in those 55 to 64 stopped improving in small to medium towns in 2011, and in rural areas in 2008, the study found.
In rural areas, death rates due to coronary artery disease rose 11.2% for 55- to 64-year-old women between 2010 and 2017. They also rose 11.4% among 45- to 54-year-old women between 1999 and 2017.
The study was published April 22 in the Journal of the American Heart Association.
“Women living in rural areas of the United States have for the first time suffered an increase in premature deaths from coronary artery disease. This is in stark contrast to their urban counterparts, who have experienced a virtually uninterrupted reduction in premature coronary artery disease deaths,” said senior author Dr. Federico Moccetti.
Moccetti, a former research fellow at Oregon Health and Sciences University in Portland, is now a cardiologist at Heart Centre Lucerne in Switzerland.
“This significant increase in coronary artery disease deaths among young women in the rural U.S. is shocking,” he said in a journal news release. “Disparities in the prevention and control of cardiovascular disease risk factors in these communities are likely the reason for this upswing.”
Moccetti pointed out that blockages in the heart stem from decades of exposure to risk factors such as smoking, high blood pressure, high cholesterol, diabetes, obesity, lack of exercise and poor diet. They don’t happen overnight.
“Since the increase in deaths is among younger women, this means that it is the result of exposure to risk factors that occurred during young adulthood, adolescence and even childhood,” he said.
The findings underscore the need to step up public health campaigns aimed at promoting the heart health of rural women during childhood, adolescence and young adult years, Moccetti said.
The U.S. Office on Women’s Health has more on heart disease.
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