Heart disease has been the leading cause of death in the United States for decades. Overall, the number of people dying from heart disease decreased from 2009 to 2019. But among the younger population, the number of people with heart disease has increased.
Even more troubling, heart attacks in young people are on the rise. Having a heart attack under 50 used to be uncommon. Now, the trends are moving the other way.
Why?
Doctors and scientists who study heart disease point to a variety of factors, from rising rates of diabetes to COVID-19 to family history.
Let’s review what a heart attack is, what the numbers say about who’s having them, and risk factors for young people.
What Is a Heart Attack?
A heart attack happens when there’s a clog in an artery, and blood can’t get to your heart. This lack of blood flow damages your heart. The official term is “myocardial infarction.”
A heart attack isn’t the same as sudden cardiac arrest (SCA). SCA is when your heart stops beating. It usually happens because something is wrong with the heart’s electrical system.
SCA can happen after a heart attack. However, in young people, SCA is usually related to an undiagnosed congenital condition. For example, the young athlete who collapses on the field with SCA isn’t usually related to a blocked artery.
This is an important distinction because we’re focusing on the risk factors that increase blocked arteries in young people.
How Common Are Heart Attacks Under 50?
Scientists who study heart disease trends have a lot of information about who is having them and who is dying.
According to the American Heart Association, the average age for men to have a heart attack is about 65. For women, it’s 72. But 1 in 5 heart attack deaths are people younger than age 64.
More telling: Between 2000 and 2016, the proportion of people under 50 having heart attacks rose by 2%. Not only that, 20% of people in the “under-50” heart attack category were actually 40 or younger.
The news doesn’t get better. People who have heart attacks in their 40s have the same rate of bad outcomes. That means their chance of dying from another heart attack is just as high as an older person who has a heart attack.
Why Are Heart Attacks in Young People on the Rise?
Age has always been one of the biggest risk factors for heart disease. But there are several reasons why more people under the age of 50 are having heart attacks.
COVID-19
A 2022 Journal of Virology study examined the link between COVID-19 and heart attacks. Researchers found that people ages 25 to 44 had about a 30% increase in heart attack deaths in the first two years of the pandemic. In fact, heart attack deaths rose most sharply in that age group compared to all other age groups.
Scientists know COVID-19 can impact your heart and lungs, but they’re still trying to understand the exact link. They suspect that COVID-19 increases the likelihood of blood clots, which can block arteries. They also know that COVID-19 can inflame the heart. It may also cause a rise in blood pressure.
Diabetes
Diabetes is on the rise in younger adults. A 2023 JAMA study found that the number of 20-to-44-year-olds with diabetes increased from 3% to 4% between 2009 and 2020.
Why is this a problem?
According to the Centers for Disease Control and Prevention (CDC), people with diabetes are twice as likely to have heart disease as people without diabetes. Diabetes is a key risk factor for having a heart attack because high blood sugar is bad for your blood vessels.
Having diabetes also makes you more likely to have high blood pressure and high cholesterol. These are both risk factors for having a heart attack.
Studying the data, researchers know that 1 in 5 people who have a heart attack under the age of 50 also have diabetes. A person with diabetes who has a heart attack is more likely to die. They’re also more likely to have another heart attack.
Family history
Your genes impact everything from your risk for diabetes to blood pressure and cholesterol. Some genetic conditions increase your risk even more.
Familial hypercholesterolemia (FH) is an inherited condition that causes people to have high cholesterol at a young age. Half of men with FH that’s untreated will have a heart attack before age 50. About one-third of women with untreated FH will have one before age 60.
The problem? Doctors only diagnose about 10% of all FH cases.
What Can Young People Do to Lower Their Risk of Having a Heart Attack?
The key is to focus on the factors that are in your control. That includes:
- Eating healthy — Diet plays a major role in heart health. A heart-healthy diet should include plenty of whole grains, lean proteins, fruits and vegetables, and low-fat or fat-free dairy. Avoid food and drinks high in saturated fats, sodium, and added sugars.
- Getting regular exercise — If you don’t have an exercise program already, start with the basics. Aim for at least 150 minutes of mild intensity a week (that’s 30 minutes of walking, five days a week).
- Knowing your family history — Heart attacks can happen to people with no family history, but family history makes them more likely.
- Paying attention to mental health — Depression and anxiety release stress hormones and chemicals that can actually affect your blood vessels. Depression can also make it hard to exercise and eat healthy. This is one reason why the American Heart Association recommends monitoring teens who have depression for early disease.
- Scheduling regular visits with your doctor — Getting well checks every year means your doctor can track your metrics. They can spot high cholesterol, high blood pressure, and pre-diabetes. If you don’t have a primary care provider (PCP), you can find one at UPMC and schedule a visit today.
- Quitting smoking — Smoking greatly increases your risk of having a heart attack.
- Trying to manage your stress — Stress, in general, is a risk factor for heart disease. Try to manage your stress through relaxation techniques, calming activities, and more.