The recent plateaus in death from coronary disease in young adults after decades of progress in reducing mortality may be due to poor lifestyle habits, according to an article in the November 27 issue of the Journal of the American College of Cardiology.

The research, conducted at the Centers for Disease Control and Prevention in Atlanta, Georgia, showed that death rates from coronary disease remain almost unchanged in young men and may even be increasing in women.

The plateau in death rates comes at a time when young Americans are increasingly likely to be obese and to develop diabetes, hypertension, and other cardiovascular risk factors.

"Young adults should take stock of their lifestyles," said Earl S. Ford, MD, MPH, a medical officer in the U.S. Public Health Service. "If you're smoking, you should quit. If you're doing less than 30 minutes of physical activity per day, it's time to find ways to be more active. If you need to lose weight, you should burn more calories than you take in."

For the study, Ford and colleague Simon Capewell, MD, of the University of Liverpool, U.K., analyzed United States vital statistics data between 1980 and 2002 for people aged 35 years and older. Overall, death rates from coronary disease fell by 52 percent in men and 49 percent in women.

The statistics are strikingly different when reviewed by age. Among men aged 35 to 54 years, the average annual rate of death from coronary disease fell by 6.2 percent in the 1980s, slowed to 2.3 percent in the 1990s, and leveled off with an annual decline of just 0.5 percent between 2000 and 2002.

In women aged 35 to 54 years, the average annual rate of death from coronary disease fell by 5.4 percent in the 1980s and slowed to 1.2 percent in the 1990s. Between 2000 and 2002, the death rate actually increased by an average of 1.5 percent per year. This increase was not statistically significant. However, in even younger women-those aged 35 to 44 years-the rate of death from coronary disease increased by an average of 1.3 percent annually between 1997 and 2002, a finding that was statistically significant.

"This should be regarded as a wake-up call for everyone interested in heart disease and heart health," said Philip Greenland, MD, FACC, who co-wrote a companion editorial in the same issue and is the Harry W. Dingman Professor and senior associate dean for clinical and translational research at the Feinberg School of Medicine, Northwestern University, Chicago.

"The take-home message is that heart disease has not gone away, continues to be a problem, and could become a greater problem if Americans fail to pay attention to known warning signs like overweight and obesity, and lack of exercise."