Composition of risk factors among acute myocardial infarction patients in Israel: Sub-analysis of the Israeli National Prospective Survey on Acute Myocardial Infarction in 2000

Background: Risk factor modification has been shown to reduce cardiovascular morbidity and mortality. Nevertheless, there is a debate regarding the relative importance of risk factors when analyzed by age, gender and ethnical background. The aim of the study was to define sub-populations with different classes of risk factors that may enable targeted and improved preventive approaches. Methods: The study is a sub-analysis of the Israeli National Prospective Survey on Acute Myocardial Infarction in the year 2000. We evaluated the interactions between the classical risk factors and their correlation with the patients' age and gender. Results: A total of 1,683 patients with acute myocardial infarction were hospitalized in 26 hospitals in Israel during February and March 2000. Seventy-three percent were men and 27% were women and their mean age was 66 ± 13 years. Younger patients had significantly more risk factors than the older ones (P ≤ 0.0001). Women were significantly older and had less risk factors than males (73 ± 12 vs. 63 ± 14, P < 0.01; 2.02 ± 1.10 vs. 1.84 ± 1.03, P ≤ 0.002, respectively). One hundred and twenty-eight patients (7.8%) had no risk factors. Hyperlipidemia, current smoking and family history were common in younger patients, while hypertension and diabetes mellitus were more common in the older ones. Family history and smoking were significantly more common in males, whereas diabetes mellitus and hypertension were more common in females. Conclusions: There were defined sub-populations with different risk factors for acute myocardial infarction. Our findings suggest that in young patients cessation of smoking and control of hyperlipidemia are of crucial importance. Hypertension and diabetes mellitus are more common in women and older patients and their impact on the atherosclerotic process is gradual and manifests later in life. Further studies should clarify the relative importance of each risk factor and its control.