Heart attacks in young people are rare — but rates are rising. Experts point to 4 possible reasons.
When paramedics responded to a 911 call from the mother of Raquel Hutt, they saw a slender, scared 24-year-old and assumed that the “crazy shooting pains” down her left arm were the result of a panic attack. Hutt didn’t look like a typical heart attack patient. But after Hutt’s mother, Jenny, insisted her daughter be taken to the hospital, doctors confirmed that that’s exactly what Hutt was: a 24-year-old heart attack patient. “It really shocked me how the EMT just looked at me — because of my age and because of my body type and because of the history I was explaining — like I was perfectly healthy,” Hutt told Today.
It’s true that heart attacks rarely strike young adults — but it’s becoming more common. Read on for why experts think this is happening and what you can do to help prevent a heart attack at any age.
The young adult heart attack rate has risen by 2/3rds in 4 years
In 2019, only 0.3% of U.S. adults between ages 18 and 44 had suffered a heart attack, according to data from the National Center for Health Statistics. That figure went up to 0.5% last year. So while heart attacks in this age group are still rare, that’s an increase of more than 66% over the past four years.
While heart attacks are far more common among older people overall, NCHS data shows that rates in every other adult age group have actually declined since 2019. Doctors and scientists are still trying to work out what is driving up heart attacks among young adults — a group historically less at risk for acute cardiovascular events — but several parallel trends are likely at play.
1. Obesity rates continue to rise
Adults under 50 are by no means the only age group affected by the so-called obesity epidemic, but experts suspect their cardiovascular health may be impacted more dramatically than that of older generations. “Even though obesity has increased in every age group, the slope of increase is much steeper in young adults than older adults,” Dr. Andrew Moran, a Columbia University preventive cardiologist and epidemiologist, tells Yahoo Life.
That may be, in part, because “nutrition habits are pretty well-formed in childhood,” Cedars-Sinai cardiology professor Dr. Noel Bairey Merz tells Yahoo Life. “I still eat pretty much the way I was raised” in the 1950s and 1960s, she says. “This was before fast food, before all the highly processed and snacking foods,” she explains. Fast food became widely available following World War II, and by 2010, the share of meals that people eat out had eclipsed the proportion cooked at home. Younger patients — those now in their 40s and below — developed their eating habits in the heyday of McDonald’s, Doritos, snack bars and Big Gulps. Bairey Merz suspects that younger adults who were raised with a diet full of these high-calorie, low-nutrient foods are still eating them out of habits formed in childhood.
Low-quality diets and more sedentary lifestyles have contributed to the development of what Bairey Merz calls the “diabesity epidemic,” referring to the coinciding increases in obesity and diabetes rates. Obesity and diabetes are major risk factors for high blood pressure. And all three are risk factors for cardiovascular disease and heart attacks because they can damage blood vessels and put a strain on your heart.
2. COVID may have fueled a further increase in premature heart attacks
We now know that COVID-19 can damage the heart and cardiovascular system, in some cases causing a dangerous form of heart inflammation called myocarditis, as well as attacking the lungs. Severe infections are relatively rare among young people. But when they happen, it’s often to young adults with risk factors for heart attacks, including obesity, says Moran. “The virus’s effect on the heart muscle has led to acute cardiovascular events related to COVID,” he explains.
During the first two years of the COVID pandemic, there were 30% more heart attack deaths than would be expected among people between ages 25 and 44, one study found. Another study estimated that 4 out of every 100 people in the U.S. develop some heart-related symptom in the year after they recover from COVID. “We have to look at the traditional risk factors like obesity and hypertension,” which we know are rising among young adults, Cleveland Clinic cardiologist Dr. Ashish Sarraju tells Yahoo Life. “But it’s hard to ignore that the COVID-19 pandemic happened at the same time, and the virus affects the heart in a number of different ways that we’re still trying to understand, so we need to look at nontraditional factors as well.”
3. Younger men are ‘lost to the health care system’
Men of all ages are more likely than women to suffer heart attacks. But young men — more of whom are now obese, diabetic or both — with warning signs may slip more easily through the cracks, says Moran. “A proportion of young women will end up in the medical system because they see a gynecologist,” which is recommended annually, he explains. “But young adult men are basically lost to the health care system ... they don’t know if they have high blood pressure or diabetes until they wind up in the hospital.”
4. Smoking, diabetes, periods and stress: Unique risk factors for younger women
The rise in heart attack rates has been steepest among young women, some research suggests. From 1995 to 2014, hospitalizations for heart attacks in women between ages 35 and 54 rose from 21% to 31%, according to one study. Bairey Merz is among those trying to find out why the rate is spiking among young women, and she has several theories. For one, “the ‘diabesity’ epidemic is clearly contributing to a rising rate of heart disease,” she says. “And diabetes is a stronger risk factor [for cardiovascular problems] for women than for men, but we don’t know why.”
There’s also the problem of smoking and vaping, both of which increase the risk of a heart attack. “We clearly are seeing a demographic of college-educated women who are more likely to start smoking when they go away to college ... for what they say is weight management,” Bairey Merz says. She adds that e-cigarettes are a big part of this problem and are likely just as bad for cardiovascular health as traditional cigarettes.
Finally, the relationship between stress, periods and hormones may pose a unique heart attack risk to women. This is an emerging area of research, says Bairey Merz. “But it’s becoming pretty clear in research that younger women are facing more stress, anxiety and pressure, and a lot of this is related to social media.” High levels of stress can disrupt menstrual cycles; specifically, it can lead to missed periods. “When you’re not ovulating each month, your estrogen levels are very low and this is a contributing factor to heart disease” and, consequently, heart attacks, Bairey Merz explains.
What you can do to reduce your risks
Some good news: There’s a lot you can do to reduce your heart attack risks, starting now.
Eat better: “Consume fresh food, including fruits and vegetables, and minimize the amount of packaged food you eat,” Moran advises. “If you follow that basic advice, you’re going to have a much lower-sodium diet,” which is crucial for heart disease prevention.
Be more active: “Do something that’s sustainable for you,” like getting the recommended two and a half hours of moderate physical activity per week, or getting in 7,000 steps a day.
Quit tobacco: “Don’t smoke; e-cigarettes are the same, vaping is the same, smoking cannabis is the same,” says Bairey Merz. “There is no safe tobacco or cannabis” smoke.
Get healthy sleep: Sarraju says many young adults may be unaware of how important “sleep quality and sleep quantity” are for heart health. The AHA recommends seven to nine hours of sleep each night for adults.
Drink less alcohol: A glass of red wine was once thought of as heart-healthy. But recent research has debunked that myth (and others) about alcohol consumption. In fact, drinking any amount of alcohol has now been linked to greater heart disease risks.
Manage weight: Talk to your health care provider about what a healthy weight for you would be, and manage it with “nutrition and daily activity,” says Bairey Merz.
Get cholesterol, blood sugar and blood pressure checked: Find out what your blood pressure is along with your cholesterol and blood sugar levels. “There’s a short list of tests that everyone should have done,” says Moran. He recommends asking for these checks, talking to your health care provider about your family history and finding out what steps to take to get any high levels under control.