There’s good news and bad news. Although Americans are suffering fewer heart attacks as a whole, the rate of heart attacks for people under 40 is increasing.
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For the last several decades, aging has been established as one of the biggest risk factors for heart attacks, typically affecting men 50+ and women 65+. Now, people in their 20s, 30s and 40s are more often falling victim to these cardiovascular attacks.
Cause: lifestyle, diabetes
“There’s a few reasons why we’re seeing the rise of heart attacks in young people,” says cardiologist Luke Laffin, MD. “But one of the biggest risk factors is the increasing incident of type 2 diabetes.”
Contributors to type 2 diabetes include:
- Dietary choices such as exposure and access to ultra-processed food.
- Weight and obesity.
- Sedentary lifestyle and decreased physical activity.
“We’re now seeing heart attacks occurring in young men who are only 25 or 35,” says Dr. Laffin. “Twenty years ago this wasn’t the case and was rarely discussed in medical school.”
Dr. Laffin attributes this new development to the change in lifestyle over the past several decades. There’s been a shift in people’s day-to-day – too much Uber Eats and not enough cardio. Increased screen time has dramatically impacted how much we move as well. Even jobs are more sedentary and require less physical activity than in past decades.
So much, in fact, has shifted over the past several years that some experts aren’t surprised by the fact that heart attacks are climbing in young people.
“These bad habits are starting in early childhood now,” explains Dr. Laffin. “There needs to be attention brought to how important prevention and modification is.”
Primordial prevention: how early is early enough?
Heart experts always thought about primary and secondary prevention when it comes to heart attacks, Dr. Laffin says. That’s trying to prevent the first heart attack and then trying to prevent the second heart attack.
But recently, there’s been a shift to the idea of primordial prevention. This means trying to prevent the progression of the heart attack risk factors themselves. Dr. Laffin says it includes trying to change the social and environmental conditions that could develop and progress risk factors. These are things we have control over such as exercising, eating nutritious foods, not smoking, managing stress and blood pressure.
Primordial prevention also includes education about what behaviors put you at risk for cardiovascular disease. These include:
- Poor diet and lack of exercise.
- Type 2 diabetes.
- High blood pressure.
- High cholesterol.
- Family history of cardiovascular disease.
What if you’re at risk?
Heart attacks can happen to anyone – but the risk is especially high when genetics come into play. Primordial and primary prevention is crucial for those with a family history of heart disease.
Your hereditary risk of heart disease is defined by having a first-degree male relative (like your father, brother or son) under the age of 55 with heart attack or stroke history, or a first-degree female relative (like your mother, sister or daughter) under the age of 65 with heart attack or stroke history.
“When we’re talking about young people having heart attacks, it’s important to individualize the discussion based on risk factors,” says Dr. Laffin. “It’s about having an honest conversation and not pushing things off and saying ‘Oh, I’m too young,’ especially if you have symptoms.”
Guidelines recommend that people ages 20 to 39 without hereditary risk have their cardiovascular health assessed every four to six years.
For those that have a genetic risk, it’s critical to be engaged in your health and speak with your doctor early.
The biggest thing here? Prevention.
At the end of the day, it’s important to understand what your risk factors are – high blood pressure, waist circumference, unhealthy BMI – and work to correct them early.
“Whatever we can do early on, the better,” says Dr. Laffin. “We need to set good habits for ourselves and for our children, especially with how childhood obesity will come into play with this.”
The dramatic increase of young adults having heart attacks is evidence, he says, that our lifestyles need to change.
“Not enough young people take their risk factors seriously,” warns Dr. Laffin. “But we need to be aggressive about risk factor modification, or the heart attack rate in young people is going to keep climbing.”