By Tamara Mathias

(Reuters Health) – Young women are largely unaware of the risks they face from cardiovascular disease, even though it remains the top cause of death for American women, researchers warn.

Only one in 10 young women surveyed cited heart disease as the number one killer for women and fewer than one in 20 believed it was the leading health problem for women.

“More than half of adult women surveyed are aware of this fact, so the very low awareness we found was surprising, especially given we sampled a population of young women with access to health care,” study authors Dr. Holly Gooding and Courtney Brown of Harvard Medical School in Boston said in an email.

In the short term, young women have a low risk for diseases of the heart and blood vessels, but their lifetime risk is high, the authors write in the Journal of the American Heart Association.

“There is clear evidence that traditional cardiovascular disease risk factors, including elevated blood pressure, blood cholesterol and blood glucose, have their origins in childhood and adolescence,” they add.

Gooding and Brown and colleagues posed survey questions from the American Heart Association (AHA) to 331 young women, ages 15 to 24, to assess their awareness of cardiovascular disease – including atherosclerosis, heart attacks, stroke and heart failure -and how it can be prevented.

Then they compared participants’ responses to those from a 2012 AHA survey of 1,227 women above age 25.

Adolescents tend to focus on the present and don’t think long-term, which might partly explain the results, the authors say. Dr. Claire Duvernoy, who started the women’s heart program at the University of Michigan in Ann Arbor, agrees.

“That’s just the way that adolescents tend to be and that’s a barrier to an education like this, where the risk is more of a long-term thing,” Duvernoy, who was not involved with the study, told Reuters Health by phone.

Focus on benefits they’ll get now, while they’re young, from a healthy lifestyle, she advises.

The authors believe the most effective way to improve cardiovascular health is by addressing risk factors before symptoms develop. But promoting awareness of heart health to young people can be challenging as adolescents don’t tend to discuss cardiovascular disease with their doctors, they point out.

What’s needed, they say, is a multifaceted approach: improving curricula in schools, training pediatricians and promoting heart health online.

Independent expert Dr. Maryl Johnson of the University of Wisconsin School of Medicine and Public Health believes the message for young people “needs to be reinforced at every opportunity and in a helpful, not perjorative, way,” especially regarding lifestyle factors over which they have direct control, such as smoking and lack of exercise.

Dr. Beth Abramson, Director of the Cardiac Prevention Centre at St. Michael’s Hospital, Toronto, told Reuters Health, “We are seeing an epidemic of risk factors in younger individuals…(and) it is still true that women sometimes can’t believe (heart disease) can happen to them.”

“The face of heart disease has changed. It’s no longer a disease of solely white, grey-haired men. So we need to make sure that these young women…are aware of their future risk,” Abramson said.

SOURCE: Journal of the American Heart Association, online March 5, 2019.