ARTICLE: Encouraging Young Women to Move More: Linking Physical Activity in Young Adulthood to Coronary Risk in Women

AUTHORS: Erin Michos and Michael Blaha

JOURNAL: Circulation. 2016 Jul 26;134(4):300-3. doi: 10.1161/CIRCULATIONAHA.116.023400.

In Western populations, atherosclerotic cardiovascular disease (ASCVD) mortality has dramatically declined in the past 4 decades, in part because of an increased emphasis on prevention. Before 2000, this decline was largely observed in men. The American Heart Association (AHA) published the first women-specific prevention guidelines in 1999,1 and subsequently there has been progress in the prevention, detection, and treatment of ASCVD with associated declines in mortality. Unfortunately, this improvement has not been observed equally among all subgroups. Younger women <55 years have experienced stagnation in the rates of decline of coronary heart disease (CHD) over the past 2 decades.2,3 Among younger women aged 35 to 54 years, Framingham Risk Scores and cardiovascular mortality have actually increased,4 likely because of the rise of obesity, diabetes mellitus, and sedentary behavior in modern populations.

Risk factors and CHD outcomes have predominantly been studied among older adults with relatively less attention given to younger individuals. Older individuals may be more likely to be counseled about their ASCVD risk and preventive measures such as healthy lifestyle because of perceived differences in ASCVD risk.5 Recent AHA guidelines endorse the assessment of lifetime risk among adults aged 20 to 59 years not at high short-term risk,6and adoption of this recommendation may help identify at-risk younger women. There remains ample opportunity to further lower ASCVD morbidity/mortality, particularly among the understudied younger women demographic.

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