Having a heart attack is dangerous at any age, but new research suggests heart attacks are more deadly for young and middle-age women than men of the same age.

A study published in the Feb. 6 Archives of Internal Medicine found women under the age of 50 are almost three times as likely to die in the hospital immediately after a heart attack. The study also found women under 60 are more likely to die within two years after a heart attack.

"Younger and middle-age women--for reasons we're not sure about yet--carry a high mortality risk than men of a similar age after a heart attack," says study author Viola Viccarino, MD, PhD, assistant professor of medicine at Emory University in Atlanta.

Although researchers had initially thought that those women who had survived their heart attack and been discharged from the hospital would be healthier and more likely to survive long-term, the study found women under 60 were still more likely die after a heart attack than their male counterparts. In fact, the risk of death rose as the woman's age decreased.

Researchers examined the medical records of 6,826 patients who had suffered a heart attack between 1975 and 1995 in the Worcester, Massachusetts area. Viccarino says her study did not examine the reasons why women were at increased risk, but there are several biological, behavioral, psychological, and social factors that merit further research.

"I think that women come to the hospital later, or with a more advanced disease--especially if they are younger or middle age--because they may not think they are having a heart attack. Or they might not even think that they could be at risk for a heart attack," says Viccarino. She says when they do get symptoms, they may dismiss them, which can further delay treatment and lead to complications.

According to the American Heart Association (AHA), coronary heart disease is the single biggest killer of American women, and one in five women has some form of heart or blood vessel disease.

"Being aware of the risk factors and certainly the warning signs of a heart attack can really save a woman's life," says AHA spokesperson Nieca Goldberg, MD, chief of the women's heart program at Lenox Hill Hospital in New York City. "Now we can stop a heart attack in its tracks by using clot-busting medications or using balloons through angioplasty to open up blocked arteries and save heart muscle damage."

Warning signs of a heart attack may differ in women than those typically experienced by men, according to Goldberg and may include the following:

Pressure in the center of the chest, which in women may be felt lower down in their stomach

Unexplained fatigue

Shortness of breath

Back discomfort, especially in the upper back
　　"More women who have heart attacks are over 60, but if a woman is under 60 and has a heart attack, it may be more deadly," says Goldberg. She says that means women of all ages should be more vigilant about reducing their risk through diet and exercise, and if they smoke, they should stop.

"Women don't realize that smoking triples their risk of having a heart attack," says Goldberg.

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