Young heart attack survivors still at risk

PHOTO: The Straits Times

Young people who survived a heart attack before they hit 40 continue to remain vulnerable to dying earlier than their peers.

The damage stays with them, increasing their risk of death by 10 per cent over a decade.

And their elevated risk of dying could continue to worsen by 1 per cent each year if the trend persists, according to Associate Professor Mark Chan from the National University of Singapore's (NUS) Yong Loo Lin School of Medicine.

The finding was both "unexpected and worrisome", said Prof Chan, who was part of a team of researchers who did a retrospective study of over 15,000 heart attack patients in Singapore.

The data, which spanned 12 years, showed that about 4 per cent, or 601 people, had a heart attack at 40 years old and younger.

"Our initial hypothesis was that younger persons who had a heart attack had a good potential for recovery," he told reporters at a media briefing yesterday.

"Because of their higher resilience and higher potential for repair, we were hoping to see that younger patients over time will match the level of the general population in terms of their long-term survival."

However, this was not the case.

While younger patients were more likely to survive a heart attack, they continued to suffer the effects over the years.

The study was published in The American Journal of Cardiology in August, and is the first that compares the long-term mortality of young heart attack survivors against their peers who did not suffer a heart attack.

Professor Terrance Chua, medical director of the National Heart Centre Singapore, stressed that the risk of heart attacks can be reduced through prevention and control of risk factors such as smoking, diabetes, hypertension, high cholesterol and obesity.

This includes taking medication regularly, exercising and quitting smoking, added Prof Chua, who is also an author of the study.

One in three of the study's younger patients had a family history of premature coronary artery disease.

But what stands out is that most of them, or about 78.4 per cent, are smokers.

Despite the risks, young patients continue to puff.

"You cannot change your genes, but smoking is clearly something that is modifiable," said Prof Chan.

"I think it (smoking) is a major contributor as to why young people get a second heart attack and eventually die from it."

15 sneaky ways smoking ruins your life

  • Lighting up is a guaranteed way to premature aging and accelerating your journey to the grave.
  • The chemicals in tobacco smoke is said to trigger the destruction of collagen and elastin, which are fibers that give your skin its strength and elasticity.
  • According to doctors, inhaling tobacco smoke weakens the building blocks of the skin, resulting in saggy skin and deeper wrinkles.
  • On top of losing the elasticity of the skin that creates deep lines around the lips, smokers often get something called a "smoker's pucker".
  • When smokers suck air through a cigarette, they repeatedly use a certain set of muscles around their lips. Combined with the loss of skin elasticity, this causes the smoker's pucker.
  • Age-related macular degeneration is the leading cause of vision loss. But did you know that the link between smoking and ARMD is as strong as the link between smoking and lung cancer?
  • Toxins associated with smoking can restrict blood flow to the tiny capillaries in the eyes, cutting off vital nutrients and oxygen. It can cause cataracts, glaucoma, Graves' ophthalmopathy and diabetic retinopathy, among many other serious eye conditions.
  • Age spots are blotches of darker colour on your skin that betray your age.
  • Research suggests that smokers may be more susceptible to developing these unsightly spots.
  • Smoking can accelerate the process of thinning hair.
  • Some studies have even suggested that people who smoke are more likely to go bald.
  • Psoriasis is a chronic condition that causes thick, red skin with flaky, silver-white patches called scales. It usually occurs on the knees, elbows, scalp, hands, feet or back.
  • Recent studies have shown that not only can cigarettes worsen psoriasis symptoms, but a number of researchers believe that they may actually cause psoriasis in some patients.
  • Smoking can weaken your bones through osteoporosis - the thinning of bone tissue and loss of bone density over time.
  • This increases the risk of bone fractures.
  • More alarmingly, the bones in the spine can also be affected.
  • Osteoporosis can cause the spine to curve and result in a hunched back.
  • \Smoking causes the blood vessels that carry blood to the heart to become narrower over time, ups blood pressure and makes it easier for the blood to clot.
  • All these increases your odds of getting a heart attack.
  • The impact on the heart, lungs, blood circulation and bones all add up to a poorer performance on the track.
  • Smokers tend to suffer from a more rapid heart rate and shortness of breath even after just a mild workout.
  • In men who smoke, the reduced blood flow can also affect their manhood, leading to an increase in the likelihood of impotency.
  • In women, it can lead to difficulty conceiving and giving birth to a healthy baby. Smoking during pregnancy increases the chances of miscarriage, premature birth or delivering a low-birth-weight baby.
  • As mentioned, smoking causes the skin to lose its elasticity. This not only occurs on the face, but also on the body.
  • Research has pointed out that smoking is one of the top causes of sagging breasts and flabby underarms.
  • According to WebMD, compared to nonsmokers, smokers are more likely to develop oral cancer. Smokers who are also heavy drinkers are 15 times more likely to develop oral cancer.
  • But all is not lost, doctors say quitting smoking lowers the risk of oral cancer substantially within a few years.
  • While most women experience this in their twilight years, a study has found that on average, women who smoke reach menopause 1.5 years earlier than those who don't.
  • The longer you have smoked and the more you smoke, the stronger this effect is likely to be, the study said.
  • Smoking gives your fingernails and skin of your hands a yellowish tint. It doesn't stop there. Smokers are more likely to develop bad breath, gum disease and other oral hygiene issues.
  • Still think smoking is sexy? Think how sexy you'll look with a gaping smile. Smokers are twice as likely to lose teeth than non-smokers.

John (not his real name) was just 22 when he had a heart attack.

After that, he stopped smoking, but lasted only four months before lighting up again, smoking one pack of cigarettes daily.

It was only when he got engaged in 2011 that he stubbed out for good.

Looking back, the clerk said he was naive, thinking he was invincible because of his young age.

Today, the father of one often encourages his smoker friends to quit the habit.

"Don't think it cannot happen to you," he said.

The Cardiovascular Research Institute at NUS will also be leading a two-year study on heart attack patients to find out how lifestyle changes and habits affect their health and risks.

It is expected to be completed in 2019. 

This article was first published on Dec 15, 2016.
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