Silent heart attacks are becoming more common and are targeting more women than men, a new study has revealed.

Researchers have found that silent heart attacks, which occur without the classic symptoms of a heart attack such as shortness of breath and chest pain, account for about 45 percent of all heart attacks. They also found that women are more at risk than men.

Experts are concerned that those who have experienced the silent type of heart attack are not aware that they have had one and therefore do not seek treatment to prevent future attacks.

The Wake Forest Baptist Medical Center's Epidemiology Cardiology Research Center Director Dr. Elsayed Soliman and his colleagues studied the differences of the heart attacks experienced by men and women as well as blacks and whites. They examined the data of almost 10,000 middle-aged adults who participated in the Atherosclerosis Risk in Communities (ARIC) study from 1987 to 1989. Five additional studies through 2013 were also conducted. The ARIC data comprised 20 percent African-American individuals and 57 percent women.

Researchers used ARIC data because atherosclerosis, the plaque build-up in arteries and blood vessels, is a risk factor for heart attack.

The researchers found that by the fourth check-up, more than 317 of the participants experienced a silent heart attack, which was detected by an electrocardiogram (ECG) screening, compared to 386 of participants with clinical heart attacks.

The study also found that men were at a higher risk to develop silent and clinical heart attacks. Whites are more likely to experience clinical heart attacks than blacks. Blacks were also more likely to experience silent heart attacks but since the sample size of blacks is small, the finding may be nonsignificant.

Regardless of sex or race, individuals who experience heart attacks have an increased risk for coronary heart disease.

"Women with a silent heart attack appear to fare worse than men," said Soliman.

Researchers said that their study is more inclusive than most studies, but since the comparison studies they used have small sample sizes, the findings reflect only the incidence of heart attacks and not disease prognosis.

Soliman said that the studies lack proper long-term follow-up to determine the term of prognosis. He added that specific studies cannot properly monitor individuals with silent heart attacks, making it difficult to establish whether they have better or worse disease progression than those who suffered clinical heart attacks.

Still, they believe that their study underlines the need for proper and early detection and prevention methods across sexes and different races.

Soliman went on to explain that gaps in knowledge about silent heart attacks must be addressed by conducting a more diverse sample size. Future studies should encompass all factors that might contribute to the occurrence of heart attacks, including access to health care, adherence to medication, emerging risk factors, genetic background and awareness.

Soliman pointed out that silent and clinical heart attacks have one thing in common - their modifiable risk factors. Doctors with patients who have had silent heart attacks must advise on weight management, smoking cessation, cholesterol control, blood pressure monitoring and more physical activity.

A recent report highlighted that more than 30,000 deaths from heart attack could have been prevented had doctors followed the National Health Service guidelines on correct patient treatment.

The study was published in Circulation on May 16.

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