Fewer and fewer people have heart attacks in the US thanks to improved lifestyle factors, such as a general reduction in smoking, and the usage of medicines like statins. But in one group, it’s increasing- and not where you might expect. Heart attacks among those under 40 are becoming more and more common.
For the study, researchers from the American College of Cardiology examined data from 2,097 people under 50 who were admitted for a heart attack in two large hospitals. Those aged between 41 and 50 were classified as ‘young’ patients while those under 40, 20% of the patients, were ‘very young’. The researchers then compared angiograms between the patients, a procedure that uses X-rays to see the blood vessels and arteries in the heart.
Collecting data over a 16-year period between 2000 and 2016, they found that the proportion of ‘very young’ people having a heart attack increased by 2% each year between 2006 and 2016. They also found that those under 40 who had heart attacks were more likely to have the disease in one vessel than those in the older group, meaning that their condition was still at an early stage. They nevertheless had the same rate of negative outcomes such as dying from another heart attack or stroke. People in this demographic also had higher rates of spontaneous coronary artery dissection, a rare condition characterized by a tear in the vessel wall that is more common in pregnant women.
"It used to be incredibly rare to see anyone under age 40 come in with a heart attack - and some of these people are now in their 20s and early 30s," says Ron Blankstein, MD, a preventive cardiologist at Brigham and Women's Hospital and the study's senior author. "Based on what we are seeing, it seems that we are moving in the wrong direction."
The researchers sought to understand why this is the case. Lifestyle factors such smoking are known to hasten the onset of cardiovascular disease and events, alongside other conditions such as diabetes, high blood pressure and a family history of early heart attacks and high cholesterol. Seen in both the ‘young’ and ‘very young’ groups, the researchers also noted that the youngest patients tended to report more substance abuse. While 17.9% used marijuana, 9.3% reported using cocaine.
"It all comes back to prevention," says Blankstein. "Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors. My best advice is to avoid tobacco, get regular exercise, eat a heart healthy diet, lose weight if you need to, manage your blood pressure and cholesterol, avoid diabetes if you can, and stay away from cocaine and marijuana because they're not necessarily good for your heart."