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As part of their analyses, Blankstein and colleagues tried to identify possible risk factors behind the increase in heart attacks among younger adults. They said that traditional risk factors for heart attack, including diabetes, high blood pressure, smoking, family history of premature heart attack and high cholesterol, were similar between the two groups. However, the youngest patients were more likely to report substance abuse, including marijuana and cocaine (17.9 percent vs. 9.3 percent, respectively), but had less alcohol use.
The study included a total of 2,097 young patients (<50 years) admitted for a heart attack in two large hospitals. Of these, 20 percent were 40 or younger. Researchers compared young heart attack victims (<50 years vs. ≤40) using patient angiograms, a procedure that uses X-rays to see the heart’s blood vessels and arteries. People in the very young heart attack group were more likely to have disease in only one vessel, suggesting that this disease was still early and confined, yet they had the same rate of bad outcomes. The very young group also had more spontaneous coronary artery dissection—a tear in the vessel wall—which, while rare, tends to be more common in women, especially during pregnancy.