Why Are More Young Adults Having Heart Attacks?

Despite medical advances and awareness campaigns, heart disease has remained the leading cause of death in the U.S. for the past century, according to a report from the American Heart Association. Each year, there are about 605,000 new heart attacks and 200,000 recurrent attacks, and 14 out of 100 people will die from these myocardial infarctions. That’s the bad news.

The good news is that survival rates after heart attacks are improving, and fewer older people are having — and dying from — heart attacks. However, those glad tidings don’t extend to the younger demographic. Recent research has shown that the frequency of heart attacks, as well as other forms of cardiovascular disease, is increasing in adults under 50. In addition, the prevalence of early onset heart attacks is worse among young women than young men, particularly Black young women.

This doesn’t come as a surprise to physicians like Beteal Ashinne, M.D., M.P.H., a preventative cardiologist with the University of Miami Health System. “A big contributing factor is our lifestyle,” she explains. “Our diet, our weight, our sedentary habits play a role in what we’re seeing [in younger adults.] Another factor is stress levels.”

Numbers underscore the cardiologists’ anecdotal observations. 

For instance, a 2019 study published in the American Journal of Medicine that examined more than 2,000 young adults hospitalized for heart attacks found that 20 percent of these patients were 40 years old or younger and, the proportion of this group has been increasing by 2% each year in the past decade.

In her clinical practice in Miami, Dr. Ashinne has seen more young people being referred because of their family history. 

“They’re being more proactive, which is encouraging,” she says. “We’re catching the risk factors earlier, even before the symptoms show up.”

That said, younger patients who eventually end up in the hospital because of a heart attack present with more severe disease. Myocardial infarctions are considered an older person’s health event — the average age at first heart attack is 65.6 years for men and 72.0 years for women. Consequently, the telltale symptoms are too often dismissed by younger patients.

“Younger patients come to the hospital later, and as a result, they can have worse outcomes,” Dr. Ashinne says. “Younger people are not expecting a heart attack. They think it’s heartburn or a muscle spasm. In contrast, a 75-year-old will go to the ER right away. They’re more aware of the signs.”

What’s more, the 2019 research revealed that younger patients, particularly women, also had a history of diabetes, high blood pressure, and chronic kidney disease — all factors that contribute to poor health in general.   

Unfortunately, COVID-19 appears to be contributing to the trend. A recent study, conducted in Cedars Sinai hospital in Los Angeles, found that in the first two years of the pandemic, heart attacks in the 25-to-44 age group shot up by 30% compared to the expected number. This held true even for those who didn’t have risk factors for heart disease. Physician-scientists theorize that the body’s hyper-inflammation response to the virus may be to blame.

This upward shift in heart attacks among younger adults is not irreversible, Dr. Ashinne points out.

“It comes down to prevention, and prevention starts now, not later. No one should wait until they’re in their 60s or 70s to make healthy choices.”

Here are her recommendations:

• Recognize the warning signs of a heart attack. These include chest pain or discomfort, jaw, neck, or back pain, shortness of breath, trouble breathing, pain in one or both arms, cold sweat, nausea, and lightheadedness or dizziness. If you experience any of these symptoms, immediately seek emergency care.
• Know your risk factors. If you have a family history of cardiovascular disease, ensure your doctor knows, even if your bloodwork and other health indicators appear normal.
• Keep track of your numbers. This includes blood pressure, blood sugar levels and cholesterol.
• Eat a healthy diet, with plenty of fruits and vegetables, nuts, seeds, and whole grains. Avoid packaged, ultra-processed foods.
• Get enough sleep, usually the recommended 7 to 8 hours a night.
• Manage your weight. The rise in obesity is a significant contributor to poor cardiovascular health and diabetes.
• Exercise. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity. Ideally, a person would combine both types throughout the week.
• Don’t smoke.

Prevention is like building a house. You need a strong foundation, and the time to build that strong foundation is when you’re young.

Dr. Beteal Ashinne

Ana Veciana-Suarez is a regular contributor to the University of Miami Health System. She is an acclaimed author and journalist who has worked at The Miami Herald, The Miami News, and The Palm Beach Post.

Tags: Dr. Beteal Ashinne, heart care in Miami, preventative cardiology, preventative heart care