HealthDay News — As many as half of all myocardial infarctions (MIs) may be silent, according to a study published online in Circulation.

Elsayed Soliman, MD, director of the epidemiological cardiology research center at the Wake Forest School of Medicine in Winston-Salem, NC, and colleagues collected data on middle-aged men and women who took part in a study assessing the causes and outcomes of atherosclerosis.

Among 9,498 Americans included in the study, 45% of all incident MIs were silent. Over roughly 9 years of follow-up, 317 participants had silent MIs and 386 had MIs with classic symptoms. Deaths were tracked for more than 20 years. The researchers accounted for factors such as smoking, weight, diabetes, hypertension, and cholesterol. They also took into account income and education, which could affect access to care. The investigators found that risk of death from all causes increased 34% after a silent MI.

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Andrew Freeman, MD, director of clinical cardiology at National Jewish Health in Denver, and spokesman for the American College of Cardiology, suggested that doctors need to put more effort into prevention. “Doctors spend very little time talking to patients about diet and exercise,” he told HealthDay. “Every doctor visit should have some component of prevention.”


  1. Zhang Z-M, Rautaharju PM, Prineas RJ, et al. Race and Sex Differences in the Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2016; doi: 10.1161/circulationaha.115.021.177