Impact of Age at First Cardiovascular Diagnosis on Future Events by Disease Type

Overview

This prospective study of 5057 patients from the UCC-SMART cohort found that younger age at first cardiovascular disease (CVD) diagnosis is associated with a lower risk of subsequent cardiovascular events in patients with cerebrovascular disease (CeVD) and in women with peripheral artery disease or abdominal aortic aneurysm (PAD/AAA). No significant association was observed in patients with coronary artery disease (CAD) or in men with PAD/AAA. These findings suggest differential prognostic implications of age at diagnosis across CVD subtypes and sexes.

Background

Cardiovascular disease risk generally increases with age due to prolonged exposure to risk factors such as smoking, hypertension, and hypercholesterolaemia, which promote atherosclerosis. While older age is a known risk factor for first CVD events, the relationship between age at first diagnosis and risk of subsequent cardiovascular events in patients with established CVD is less clear. Premature CVD, defined as onset before age 55, affects about 10% of patients but remains understudied, especially regarding prognosis differences by CVD subtype and sex. Understanding these differences may inform more personalized secondary prevention strategies.

Data Highlights

Key Findings

• Higher age at first CVD diagnosis is associated with increased risk of subsequent cardiovascular events in men and women with cerebrovascular disease (CeVD).
• In women with peripheral artery disease or abdominal aortic aneurysm (PAD/AAA), higher age at diagnosis also correlates with increased risk of future events.
• No significant association between age at diagnosis and subsequent events was found in men and women with coronary artery disease (CAD).
• Men with PAD/AAA showed no significant relationship between age at diagnosis and risk of subsequent cardiovascular events.
• These results highlight sex-specific and disease subtype-specific differences in prognosis related to age at first CVD diagnosis.

Clinical Implications

Clinicians should recognize that younger age at first diagnosis confers a lower risk of subsequent cardiovascular events in patients with CeVD and in women with PAD/AAA, suggesting potential benefits from tailored secondary prevention strategies in these groups. Conversely, the lack of association in CAD patients and men with PAD/AAA indicates the need for more intensive secondary prevention regardless of age at diagnosis. These findings support personalized risk stratification and management approaches based on CVD subtype and patient sex.

Conclusion

Age at first cardiovascular diagnosis differentially impacts the risk of future cardiovascular events depending on disease subtype and sex. This underscores the importance of individualized secondary prevention strategies to optimize outcomes in patients with established CVD.

References

1. UCC-SMART Study Cohort Profile 2023 -- Impact of Initial Cardiovascular Diagnosis Age on Future Events