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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    Intermittent fasting has become a popular dietary approach to help people lose or manage their weight. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and improve overall health.

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    The brain accounts for about 20% of the body’s energy consumption.

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  • How Are You?

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    Answering The Most Difficult Question: How Are You?

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    • “I have so many emotions that I don’t always know what to do with them”
    • “What is an emotion, really? I think I felt one some time ago”

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    Alexithymia

    Alexi who? Alexithymia is an umbrella term for various kinds of problems with feeling emotions.

    That could be “problems feeling emotions” as in “I am unable to feel emotions” or “problems feeling emotions” as in “feeling these emotions is a problem for me”.

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    A somatic start

    Because a good level of self-awareness is critical for healthy emotional regulation, let’s start there. We’ll write this in the first person, but you can use it to help a loved one too, just switching to second person:

    Simplest level first:

    Are my most basic needs met right now? Is this room a good temperature? Am I comfortable dressed the way I am? Am I in good physical health? Am I well-rested? Have I been fed and watered recently? Does my body feel clean? Have I taken any meds I should be taking?

    Note: If the answer is “no”, then maybe there’s something you can do to fix that first. If the answer is “no” and also you can’t fix the thing for some reason, then that’s unfortunate, but just recognize it anyway for now. It doesn’t mean the thing in question is necessarily responsible for how you feel, but it’s good to check off this list as a matter of good practice.

    Bonus question: it’s cliché, but if applicable… What time of the month is it? Because while hormonal mood swings won’t create moods out of nothing, they sure aren’t irrelevant either and should be listened to too.

    Bodyscanning next

    What do you feel in each part of your body? Are you clenching your jaw? Are your shoulders tense? Do you have a knot in your stomach? What are your hands doing? How’s your posture? What’s your breathing like? How about your heart? What are your eyes doing?

    Your observations at this point should be neutral, by the way. Not “my posture is terrible”, but “my posture is stooped”, etc. Much like in mindfulness meditation, this is a time for observing, not for judging.

    Narrowing it down

    Now, like a good scientist, you have assembled data. But what does the data mean for your emotions? You may have to conduct some experiments to find out.

    Thought experiments: what calls to you? What do you feel like doing? Do you feel like curling up in a ball? Breaking something? Taking a bath? Crying?

    Maybe what calls to you, or what you feel like doing, isn’t something that’s possible for you to do. This is often the case with anxiety, for example, and perhaps also guilt. But whatever calls to you, notice it, reflect on it, and if it’s something that your conscious mind considers reasonable and safe for you to do, you can even try doing it.

    Your body is trying to help you here, by the way! It will try (and usually succeed) to give you a little dopamine spike when you anticipate doing the thing it wants you to do. Warning: it won’t always be right about what’s best for you, so do still make your own decisions about whether it is a good idea to safely do it.

    Practical experiments: whether you have a theory or just a hypothesis (if you have neither make up a hypothesis; that is also what scientists do), you can also test it:

    If in the previous step you identified something you’d like to do and are able to safely do it, now is the time to try it. If not…

    • Find something that is likely to (safely) tip you into emotional expression, ideally, in a cathartic way. But, whatever you can get is good.
      • Music is great for this. What songs (or even non-lyrical musical works) make you sad, happy, angry, energized? Try them.
      • Literature and film can be good too, albeit they take more time. Grab that tear-jerker or angsty rage-fest, and see if it feels right.
      • Other media, again, can be completely unrelated to the situation at hand, but if it evokes the same emotion, it’ll help you figure out “yes, this is it”.
        • It could be a love letter or a tax letter, it could be an outrage-provoking news piece or some nostalgic thing you own.

    Ride it out, wherever it takes you (safely)

    Feelings feel better felt. It doesn’t always seem that way! But, really, they are.

    Emotions, just like physical sensations, are messengers. And when a feeling/sensation is troublesome, one of the best ways to get past it is to first fully listen to it and respond accordingly.

    • If your body tells you something, then it’s good to acknowledge that and give it some reassurance by taking some action to appease it.
    • If your emotions are telling you something, then it’s good to acknowledge that and similarly take some action to appease it.

    There is a reason people feel better after “having a good cry”, or “pounding it out” against a punchbag. Even stress can be dealt with by physically deliberately tensing up and then relaxing that tension, so the body thinks that you had a fight and won and can relax now.

    And when someone is in a certain (not happy) mood and takes (sometimes baffling!) actions to stay in that mood rather than “snap out of it”, it’s probably because there’s more feeling to be done before the body feels heard. Hence the “ride it out if you safely can” idea.

    How much feeling is too much?

    While this is in large part a subjective matter, clinically speaking the key question is generally: is it adversely affecting daily life to the point of being a problem?

    For example, if you have to spend half an hour every day actively managing a certain emotion, that’s probably indicative of something unusual, but “unusual” is not inherently pathological. If you’re managing it safely and in a way that doesn’t negatively affect the rest of your life, then that is generally considered fine, unless you feel otherwise about it.

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    Take care!

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  • Breathe; Don’t Vent (At Least In The Moment)

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    Zen And The Art Of Breaking Things

    We’ve talked before about identifying emotions and the importance of being able to express them:

    Answering The Most Difficult Question: How Are You?

    However, there can be a difference between “expressing how we feel” and “being possessed by how we feel and bulldozing everything in our path”

    …which is, of course, primarily a problem in the case of anger—and by extension, emotions that are often contemporaneous with anger, such as jealousy, shame, fear, etc.

    How much feeling is too much?

    While this is in large part a subjective matter, clinically speaking the key question is generally: is it adversely affecting daily life to the point of being a problem?

    For example, if you have to spend half an hour every day actively managing a certain emotion, that’s probably indicative of something unusual, but “unusual” is not inherently bad. If you’re managing it safely and in a way that doesn’t negatively affect the rest of your life, then that is generally considered fine, unless you feel otherwise about it.

    A good example of this is complicated grief and/or prolonged grief.

    But what about when it comes to anger? How much is ok?

    When it comes to those around you, any amount of anger can seem like too much. Anger often makes us short-tempered even with people who are not the object of our anger, and it rarely brings out the best in us.

    We can express our feelings in non-aggressive ways, for example:

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    Sometimes, there’s another way though…

    Breathe; don’t vent

    That’s a great headline, but we can’t take the credit for it, because it came from:

    Breathe, don’t vent: turning down the heat is key to managing anger

    …in which it was found that, by all available metrics, the popular wisdom of “getting it off your chest” doesn’t necessarily stand up to scrutiny, at least in the short term:

    ❝The work was inspired in part by the rising popularity of rage rooms that promote smashing things (such as glass, plates and electronics) to work through angry feelings.

    I wanted to debunk the whole theory of expressing anger as a way of coping with it,” she said. “We wanted to show that reducing arousal, and actually the physiological aspect of it, is really important.❞

    ~ Dr. Brad Bushman

    And indeed, he and his team did find that various arousal-increasing activities (such as hitting a punchbag, breaking things, doing vigorous exercise) did not help as much as arousal-decreasing activities, such as mindfulness-based relaxation techniques.

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    Caveat!

    Did you notice the small gap between their results and their conclusion?

    In a lab or similar short-term observational setting, their recommendation is clearly correct.

    However, if the source of your anger is something chronic and persistent, it could well be that calming down without addressing the actual cause is just “kicking the can down the road”, and will still have to actually be dealt with eventually.

    So, while “here be science”, it’s not a mandate for necessarily suffering in silence. It’s more about being mindful about how we go about tackling our anger.

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    Take care!

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