What’s behind rising heart attack rates in younger adults
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Deaths from heart attacks have been in decline for decades, thanks to improved diagnosis and treatments. But, among younger adults under 50 and those from communities that have been marginalized, the trend has reversed.
More young people have suffered heart attacks each year since the 2000s—and the reasons why aren’t always clear.
Here’s what you need to know about heart attack trends in younger adults.
Heart attack deaths began declining in the 1980s
Heart disease has been a leading cause of death in the United States for more than a century, but rates have declined for decades as diagnosis and treatments improved. In the 1950s, half of all Americans who had heart attacks died, compared to one in eight today.
A 2023 study found that heart attack deaths declined 4 percent a year between 1999 and 2020.
The downward trend plateaued in the 2000s as heart attacks in young adults rose
In 2012, the decline in heart disease deaths in the U.S. began to slow. A 2018 study revealed that a growing number of younger adults were suffering heart attacks, with women more affected than men. Additionally, younger adults made up one-third of heart attack hospitalizations, with one in five heart attack patients being under 40.
The following year, data showed that heart attack rates among adults under 40 had increased steadily since 2006. Even more troubling, young patients were just as likely to die from heart attacks as patients more than a decade older.
Why are more younger adults having heart attacks?
Heart attacks have historically been viewed as a condition that primarily affects older adults. So, what has changed in recent decades that puts younger adults at higher risk?
Higher rates of obesity, diabetes, and high blood pressure
Several leading risk factors for heart attacks are rising among younger adults.
Between 2009 and 2020, diabetes and obesity rates increased in Americans ages 20 to 44.
During the same period, hypertension, or high blood pressure, rates did not improve in younger adults overall and worsened in young Hispanic people. Notably, young Black adults had hypertension rates nearly twice as high as the general population.
Hypertension significantly increases the risk of heart attack and cardiovascular death in young adults.
Increased substance use
Substance use of all kinds increases the risk of cardiovascular issues, including heart attacks. A recent study found that cardiovascular deaths associated with substance use increased by 4 percent annually between 1999 and 2019.
The rise in substance use-related deaths has accelerated since 2012 and was particularly pronounced among women, younger adults (25-39), American Indians and Alaska Natives, and those in rural areas.
Alcohol was linked to 65 percent of the deaths, but stimulants (like methamphetamine) and cannabis were the substances associated with the greatest increase in cardiovascular deaths during the study period.
Poor mental health
Depression and poor mental health have been linked to cardiovascular issues in young adults. A 2023 study of nearly 600,000 adults under 50 found that depression and self-reported poor mental health are a risk factor for heart disease, regardless of socioeconomic or other cardiovascular risk factors.
Adults under 50 years consistently report mental health conditions at around twice the rate of older adults. Additionally, U.S. depression rates have trended up and reached an all-time high in 2023, when 17.8 percent of adults reported having depression.
Depression rates are rising fastest among women, adults under 44, and Black and Hispanic populations.
COVID-19
COVID-19 can cause real, lasting damage to the heart, increasing the risk of certain cardiovascular diseases for up to a year after infection. Vaccination reduces the risk of heart attack and other cardiovascular events caused by COVID-19 infection.
The first year of the pandemic marked the largest single-year spike in heart-related deaths in five years, including a 14 percent increase in heart attacks. In the second year of the pandemic, heart attacks in young adults increased by 30 percent.
Heart attack prevention
Not every heart attack is preventable, but everyone can take steps to reduce their risks. The American Heart Association recommends managing health conditions that increase heart disease risk, including diabetes, obesity, and high blood pressure.
Lifestyle changes like improving diet, reducing substance use, and increasing physical activity can also help reduce heart attack risk.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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An RSV vaccine has been approved for people over 60. But what about young children?
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The Therapeutic Goods Administration (TGA) has approved a vaccine against respiratory syncytial virus (RSV) in Australia for the first time. The shot, called Arexvy and manufactured by GSK, will be available by prescription to adults over 60.
RSV is a contagious respiratory virus which causes an illness similar to influenza, most notably in babies and older adults.
So while it will be good to have an RSV vaccine available for older people, where is protection up to for the youngest children?
A bit about RSV
RSV was discovered in chimpanzees with respiratory illness in 1956, and was soon found to be a common cause of illness in humans.
There are two key groups of people we would like to protect from RSV: babies (up to about one year old) and people older than 60.
Babies tend to fill up hospitals during the RSV season in late spring and winter in large numbers, but severe infection requiring admission to intensive care is less common.
In babies and younger children, RSV generally causes a wheezing asthma-like illness (bronchiolitis), but can also cause pneumonia and croup.
Although there are far fewer hospital admissions among older people, they can develop severe disease and die from an infection.
Babies account for the majority of hospitalisations with RSV.
Prostock-studio/ShutterstockRSV vaccines for older people
For older adults, there are actually several RSV vaccines in the pipeline. The recent Australian TGA approval of Arexvy is likely to be the first of several, with other vaccines from Pfizer and Moderna currently in development.
The GSK and Pfizer RSV vaccines are similar. They both contain a small component of the virus, called the pre-fusion protein, that the immune system can recognise.
Both vaccines have been shown to reduce illness from RSV by more than 80% in the first season after vaccination.
In older adults, side effects following Arexvy appear to be similar to other vaccines, with a sore arm and generalised aches and fatigue frequently reported.
Unlike influenza vaccines which are given each year, it is anticipated the RSV vaccine would be a one-off dose, at least at this stage.
Protecting young children from RSV
Younger babies don’t tend to respond well to some vaccines due to their immature immune system. To prevent other diseases, this can be overcome by giving multiple vaccine doses over time. But the highest risk group for RSV are those in the first few months of life.
To protect this youngest age group from the virus, there are two potential strategies available instead of vaccinating the child directly.
The first is to give a vaccine to the mother and rely on the protective antibodies passing to the infant through the placenta. This is similar to how we protect babies by vaccinating pregnant women against influenza and pertussis (whooping cough).
The second is to give antibodies directly to the baby as an injection. With both these strategies, the protection provided is only temporary as antibodies wane over time, but this is sufficient to protect infants through their highest risk period.
Women could be vaccinated during pregnancy to protect their baby in its first months of life.
Image Point Fr/ShutterstockAbrysvo, the Pfizer RSV vaccine, has been trialled in pregnant women. In clinical trials, this vaccine has been shown to reduce illness in infants for up to six months. It has been approved in pregnant women in the United States, but is not yet approved in Australia.
An antibody product called palivizumab has been available for many years, but is only partially effective and extremely expensive, so has only been given to a small number of children at very high risk.
A newer antibody product, nirsevimab, has been shown to be effective in reducing infections and hospitalisations in infants. It was approved by the TGA in November, but it isn’t yet clear how this would be accessed in Australia.
What now?
RSV, like influenza, is a major cause of respiratory illness, and the development of effective vaccines represents a major advance.
While the approval of the first vaccine for older people is an important step, many details are yet to be made available, including the cost and the timing of availability. GSK has indicated its vaccine should be available soon. While the vaccine will initially only be available on private prescription (with the costs paid by the consumer), GSK has applied for it to be made free under the National Immunisation Program.
In the near future, we expect to hear further news about the other vaccines and antibodies to protect those at higher risk from RSV disease, including young children.
Allen Cheng, Professor of Infectious Diseases, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Pine Nuts vs Pecans – Which is Healthier?
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Our Verdict
When comparing pine nuts to pecans, we picked the pine nuts.
Why?
Both have their merits!
In terms of macros, pine nuts have more protein while pecans have more fiber. They’re about equal on fats, although pine nuts have more polyunsaturated fat and pecans have more monounsaturated fat, of which, both are healthy. They’re also about equal on carbs. So really it comes down to the subjective choice between prioritizing protein and prioritizing fiber. On principle, we pick fiber, which gives the win to pecans, but your preference in this regard may differ; prioritizing the protein would give the win to pine nuts.
In the category of vitamins, pine nuts have more of vitamins B2, B3, B9, E, K, and choline, while pecans have more of vitamins A, B1, B5, B6, and C. Thus, a 6:5 marginal win for pine nuts.
Looking at the minerals, pine nuts have more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while pecans have more calcium and selenium. An easy win for pine nuts this time.
Adding up the sections makes for a win for pine nuts, but of course, enjoy either or (preferably) both; diversity is good!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Enjoy!
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The Biological Mind – by Dr. Alan Jasanoff
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How special is our brain? According to Dr. Alan Jasanoff, it’s not nearly as special as we think it is.
In this work, he outlines the case for how we have collectively overstated the brain’s importance. That it’s just another organ like a heart or a kidney, and that who we are is as much a matter of other factors, as what goes on in our brain.
In this reviewer’s opinion, he overcorrects a bit. The heart and kidneys are very simple organs, as organs go. The brain is not. And while everything from our gut microbiota to our environment to our hormones may indeed contribute to what is us, our brain is one thing that can’t just be swapped out.
Nevertheless, this very well-written book can teach us a lot about everything else that makes us us, including many biological factors that many people don’t know about or consider.
Towards the end of the book, he switches into futurist speculation, and his speculation can be summed up as “we cannot achieve anything worthwhile in the future”.
Bottom line: if you’ve an interest in such things as how transplanting glial cells can give a 30% cognitive enhancement, and how a brain transplant wouldn’t result in the same us in a different body, this is the book for you.
Click here to check out The Biological Mind, and learn about yours!
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What should I do if I can’t see a psychiatrist?
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People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.
But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.
If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.
Why do people see a psychiatrist?
Psychiatrists are doctors who specialise in mental health and can prescribe medication.
People seek or require psychiatry support for many reasons. These may include:
- severe depression, including suicidal thoughts or behaviours
- severe anxiety, panic attacks or phobias
- post-traumatic stress disorder (PTSD)
- eating disorders, such as anorexia or bulimia
- attention deficit hyperactivity disorder (ADHD).
Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.
Can my GP help?
Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.
GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.
The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.
It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.
What about psychologists, counsellors or community services?
Your GP should also be aware of supports available locally and online.
For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.
Medicare Mental Health Centres provide in-person care and are expanding across Australia.
There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.
Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.
How about if I’m rural or regional?
Accessing support in rural or regional areas is particularly tough.
Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.
Should I go to emergency?
As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.
But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.
Managing suicide-related distress
With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.
Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.
Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.
Safety planning is a popular suicide prevention strategy to help you stay safe.
What is a safety plan?
This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.
You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.
Safety plans usually include:
- recognising personal warning signs of a crisis (for example, feeling like a burden)
- identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
- seeking social supports for distraction (for example, visiting your local library)
- letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
- knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
- making the environment safer by removing or limiting access to lethal means
- identifying specific and personalised reasons for living.
Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.
Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.
Sharing your safety plan with loved ones may help understand warning signs of a crisis. Dragana Gordic/Shutterstock Are there helplines I can call?
There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):
Suicide helplines:
- Lifeline 13 11 14
- Suicide Call Back Service 1300 659 467
There is also specialised support:
- for men: MensLine Australia 1300 78 99 78
- children and young people: Kids’ Helpline 1800 55 1800
- Aboriginal and Torres Strait Islander people: 13YARN 13 92 76
- veterans and their families: Open Arms 1800 011 046
- LGBTQIA+ community: QLife 1300 184 527
- new and expecting parents: PANDA 1300 726 306
- people experiencing eating disorders: Butterfly Foundation 1800 33 4673.
Additionally, each state and territory will have its own list of mental health resources.
With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.
Monika Ferguson, Senior Lecturer in Mental Health, University of South Australia and Nicholas Procter, Professor and Chair: Mental Health Nursing, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Kiwi Fruit vs Pineapple – Which is Healthier?
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Our Verdict
When comparing kiwi fruit to pineapple, we picked the kiwi.
Why?
In terms of macros, they’re mostly quite comparable, being fruits made of mostly water, and a similar carb count (slightly different proportions of sugar types, but nothing that throws out the end result, and the GI is low for both). Technically kiwi has twice the protein, but they are fruits and “twice the protein” means “0.5g difference per 100g”. Aside from that, and more meaningfully, kiwi also has twice the fiber.
When it comes to vitamins, kiwi has more of vitamins A, B9, C, E, K, and choline, while pineapple has more of vitamins B1, B2, B3, B5, and B6. This would be a marginal (6:5) win for kiwi, but kiwi’s margins of difference are greater per vitamin, including 72x more vitamin E (with a cupful giving 29% of the RDA, vs a cupful of pineapple giving 0.4% of the RDA) and 57x more vitamin K (with a cupful giving a day’s RDA, vs a cupful of pineapple giving a little under 2% of the RDA). So, this is a fair win for kiwi.
In the category of minerals, things are clear: kiwi has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while pineapple has more manganese. An overwhelming win for kiwi.
Looking at their respective anti-inflammatory powers, pineapple has its special bromelain enzymes, which is a point in its favour, but when it comes to actual polyphenols, the two fruits are quite balanced, with kiwi’s flavonoids vs pineapple’s lignans.
Adding up the sections, it’s a clear win for kiwi—but pineapple is a very respectable fruit too (especially because of its bromelain content), so do enjoy both!
Want to learn more?
You might like to read:
Bromelain vs Inflammation & Much More
Take care!
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Dopamine Nation – by Dr. Anna Lembke
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We live in an age of abundance, though it often doesn’t feel like it. Some of that is due to artificial scarcity, but a lot of it is due to effectively whiting out our dopamine circuitry through chronic overuse.
Psychiatrist Dr. Anna Lembke explores the neurophysiology of pleasure and pain, and how each can (and does) lead to the other. Is the answer to lead a life of extreme neutrality? Not quite.
Rather, simply by being more mindful of how we seek each (yes, both pleasure and pain), we can leverage our neurophysiology to live a better, healthier life—and break/avoid compulsive habits, while we’re at it.
That said, the book itself is quite compelling reading, but as Dr. Lembke shows us, that certainly doesn’t have to be a bad thing.
Bottom line: if you sometimes find yourself restlessly cycling through the same few apps (or TV channels) looking for dopamine that you’re not going to find there, this is the book for you.
Click here to check out Dopamine Nation, and get a handle on yours!
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