Can physical activity, stress be actually detrimental to your heart?

Is the age of heart attacks getting younger due to smoking, lack of physical activity and stress?

• Answer:

  An article in the New England Journal of Medicine 2010 recognised that there have been few studies which have characterised incidence and outcome of myocardial infarction. However, after a review of 46,000 patients who attended after suffering a Myocardial Infarction between 1999-2008, they concluded that:- 'Within a large community-based population, the incidence of myocardial infarction decreased significantly after 2000, and the incidence of ST-segment elevation myocardial infarction decreased markedly after 1999. Reductions in short-term case fatality rates for myocardial infarction appear to be driven, in part, by a decrease in the incidence of ST-segment elevation myocardial infarction and a lower rate of death after non–ST-segment elevation myocardial infarction.' [1] Furthermore, a study comparing rates of Myocardial Infarction between patients in Denmark and Sweden found that:- 'The incidence of myocardial infarction and the case fatality declined significantly among all subgroups of patients.' [2] Clearly these figures are for Myocardial Infarction rates across all age groups and not specifically for those in the younger groups. However, the conclusion could be drawn that rates in younger patients haven't increased or, certainly, haven't increased significantly. A further review also showed that amongst adult patients, the incidence rate of CHD and stroke has remained essentially the same although the incidence of hypertension has increased. [3] It is impossible to predict accurately whether the rate of hypertensive heart disease due to factors like smoking in younger age groups will increase but research into smoking trends has found:- Many northern European countries are in the fourth stage of the tobacco epidemic, with falling smoking rates and widening socioeconomic differences in smoking. Southern European countries have mostly reached the third stage of the tobacco epidemic.[4] Anecdotally, in our ED, there has been no noticeable increase in the incidence of Myocardial Infarction in the younger age groups. We have noticed that there are patients suffering MI at a younger age due to the consumption of cocaine but this is occasional and not particularly significant in terms of numbers. 1. Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction Robert W. Yeh, M.D., Stephen Sidney, M.D., M.P.H., Malini Chandra, M.B.A., Michael Sorel, M.P.H., Joseph V. Selby, M.D., M.P.H., and Alan S. Go, M.D. N Engl J Med 2010; 362:2155-2165June 10, 2010) 2.Trends in incidence and case fatality rates of acute myocardial infarction in Denmark and Sweden S Z Abildstrom,S Rasmussen, M Rosén, and M Madsen 3.Heart Disease and Stroke Statistics—2007 Update A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee 4.smoking statistics: Cancer research UK