Abstract Body: Background: Cardiovascular disease (CVD) is increasingly recognized among younger adults, yet age-, sex-, and race/ethnicity-specific incidence patterns across subtypes remain underexplored.
Methods: We analyzed electronic health records from 1,178,551 individuals aged 18–49 years old within a large, diverse healthcare system. Incident myocardial infarction (MI), heart failure (HF), and stroke were ascertained. Incidence rates were estimated per 1,000 person-years (1000 py), stratified by sex, age group (18–29, 30–39, 40–49), and race/ethnicity.
Results: Among women across all age groups, stroke had the highest incidence followed by HF then MI. Among men, this pattern held in the 18–29 age group; however, MI incidence rose sharply with age and surpassed HF and stroke in the older groups. MI incidence in men aged 40–49 (i.e., 1.183/1000 py) was over triple that of women (0.369/1000 py). Racial/ethnic differences were notable: HF incidence was highest among non-Hispanic Black patients across all age groups. In contrast, among Hispanic patients, incidences of MI, HF, and stroke were similar across age strata. Non-Hispanic Asian patients demonstrated lower overall incidence compared with other racial and ethnic groups, yet MI was the leading subtype among men aged 40–49 (1.229/1000 py for MI compared to <0.65/1000 py for HF and stroke).
Conclusions: Distinct age-, sex-, and race/ethnicity-specific patterns of CVD incidence are evident in young adults. Stroke predominates among women while MI predominates among men. HF rises steeply in men with advancing age among non-Hispanic Black patients, while MI has the highest incidence among non-Hispanic Asian men above age 30. These findings suggest different underlying etiology for CVD subtypes across age, sex, and racial and ethnic groups, and underscore the need for tailored prevention strategies in diverse young populations.