Heart Disease. A condition often associated with aging is now becoming a concern in younger populations. Heart disease has become the leading cause of death in people living in the United States as one person dies every 33 seconds from cardiovascular issues. However, while older adults remain at higher risk, alarming trends are showing rising cases of heart disease among the young.
Heart Disease Facts
It is crucial to understand the overall importance of cardiovascular disease in general and its effects on the country.
- 1 out 5 people (695,000) died from heart disease in 2021.
- Between 2018 to 2019 heart disease costs the United States about $239.9 billion each year which includes health care services and medicines.
- Coronary artery disease is the most common type of heart disease as 1 in 20 people have this condition. It has also killed over 375,000 people in 2021.
- Over 800,000 people in the U.S. have heart attacks, with 1 of 5 being considered “silent” where the person is not aware of it.
Causes of Heart Disease in Young People
There are a variety of risk factors that can cause heart disease in young people.
Diabetes
In general, people with diabetes are twice as likely to develop heart disease than people who do not have diabetes. This has increased substantially in those ages 20 to 44 years from 2009 to 2020. Having high blood glucose damages blood vessels resulting in more fat buildup in the arteries thus causing atherosclerosis.
Obesity
Obesity has become another huge factor in young people developing heart disease (from 32.7% of those from 20-44 in 2009 to 40.9% in 2020). Carrying extra weight puts more strain on the heart to have to work harder and puts more people at a significant risk for heart disease. Furthermore it leads to other chronic conditions such as hypertension, high cholesterol and diabetes.
Smoking cigarettes and vaping
Smoking cigarettes is one of the top risk factors of developing heart disease. In fact, the risk of heart attacks doubles in those that smoke one or more packs of cigarettes a day compared to nonsmokers.
However, cigarettes are not the only things that put you at risk of heart attacks, E-cigarettes or vapes (which are used more in young adults and in 1 in 20 Americans), can also put those in risk of developing a heart attack. The nicotine content accelerates the heart rate and can raise blood pressure as well leading to heart disease. In addition, some vape juices contain Vitamin E acetate, an oily chemical which helps to dilute or thicken vape liquids, that can cause lung related illnesses.
Substance abuse
Illicit drugs such as cocaine or methamphetamine can raise your heart rate and increase your chances of developing a heart attack. Although marijuana is still being researched, daily use may raise the risk of developing heart failure, stroke or heart attacks.
Stress
Between increasing demands of work, events happening both nationally and globally, and other stressors of life, it is no coincidence that stress has a huge impact on the heart. Chronic stress and anxiety elevates blood pressure further contributing to heart disease. It also increases inflammation throughout the body which leads to other chronic conditions such as certain skin, joint and nerve diseases.
Genetics
Although not talked about often, family history plays a big role in developing heart disease. About one-third to one-half chances of developing heart conditions, specifically coronary heart disease, is rooted in the genes.
In fact, in 2022, a large-scale genome study of heart disease used a quarter million cases from a variety of participants that were white, Black or Hispanic. This research showed the region of DNA where the “heart attack” region was located. However, further research to determine its effects on various populations is needed to determine a solid conclusion of the genes found.
Unhealthy lifestyle
Poor dietary habits, a sedentary lifestyle, excessive alcohol use can also contribute to early onset of heart disease.
Complications that often results from heart disease, especially in young people tend to be premature deaths (as death is the first indication of heart problems); reduced quality of life (can limit ability to enjoy experiences and daily life); and financial burden that can take a toll due to medical expenses, lifestyle adjustments and if severe enough, lacking the ability to work.
Why are Healthy Young People getting heart disease?
Sometimes it might be easy to see a young person that is overweight with high blood pressure and diabetes and not be surprised if they develop heart disease. But when it occurs suddenly in a young person who is seemingly healthy, it often leaves a lot of people stunned, especially since it happens without warning.
Sudden cardiac death used to occur mainly in older adults, but these days it is becoming increasingly seen in young adults especially those who are athletes. It is estimated that 1 in 50,000 to 1 in 80,000 young athletes die of sudden cardiac death each year. This is mainly seen the most in black male athletes.
There are a few heart conditions that can contribute to death in this population.
- Thickened heart muscle (hypertrophic cardiomyopathy)
- Heart rhythm disorders: QT prolongation is a common one that can cause sudden heart death.
- Blunt chest injury or trauma: Sometimes a hard hit to the chest causes sudden cardiac death which can change the signaling of the heart.
- Congenital heart defect (CHDs): These are heart structure defects that are present at birth. Some can be mild and others can be severe (or critical). Critical CHDs occur in 1 in 4 babies with surgery being needed within the first year of their life.
What are some prevention strategies?
Although heart disease has been occurring suddenly in young people without warning, there can be preventative measures that can be taken to minimize the risks of serious complications.
Implementing a healthy lifestyle
Encouraging a balanced diet rich in vegetables, fruits, lean proteins and healthy fats along with physical activity can help reduce the risk of heart disease.
Getting regular checkups
Monitoring blood pressure, blood glucose, cholesterol levels and other risks factors that might be associated with heart disease is an important approach to preventing cardiac and other chronic conditions.
Reducing substance use
Steering clear of smoking, excessive alcohol consumption and illicit drug use is crucial for improving overall health.
Stress management
Implementing stress reduction techniques such as mindfulness, meditation and regular exercise can help lower the risk of heart disease.
How can pharmacists be more involved?
There is no doubt that pharmacists are one of the most trusted and easily accessible healthcare professionals. We play a crucial role in the medical system and can be involved in the care of young people.
Providing medication counseling on prescriptions and overall health education are important parts that can help patients understand their conditions and adhere to any medications they are taking. This leads to greater prevention of chronic conditions from forming or worsening over time.
Giving over-the-counter (OTC) medication recommendations that are safe and effective for these patients is also another service that can be provided in order to avoid potential drug interactions and give the best product advice for their current condition. We can also educate young people about risks associated with drug and alcohol use and provide resources for those that might be struggling.
Collaborative care is also a fundamental part of our profession as we can work together with other allied healthcare professionals to ensure coordinated and comprehensive care for young patients. This can involve medication therapy management (MTM), medication reconciliation, and follow up for optimizing treatment outcomes. Also another care we can provide as pharmacists can be conduct healthcare screenings that involves monitoring blood pressure, cholesterol and blood glucose.
Takeaway
Young patients might appear healthy on the surface, but these individuals can develop heart disease due to a combination of genetic predisposition, unhealthy life choices, underlying health conditions and other risk factors. It’s essential for young people to prioritize heart health by implementing regular exercise, a balanced diet, stress management and a healthy lifestyle.
Patients should also try to reduce their risks by knowing their birth and family history, if possible, and frequently obtaining checkups and screenings for heart disease. Utilizing pharmacists can also help them to manage any medications they are taking and allow them to get recommendations that will best support their overall health.
Heart disease in young people may not always be known or may come without warning, but there are approaches that can be taken now to prevent further cardiac damage and helping to reduce the risks of other chronic conditions can help them live a long, fulfilled life.
References:
- Centers for Disease Control and Prevention. (2023, May 15). Heart disease facts. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/facts.htm
- U.S. Department of Health and Human Services. (n.d.). Diabetes, heart disease, & stroke – NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke
- Aggarwal, R., Yeh, R. W., Joynt Maddox, K. E., & Wadhera, R. K. (2023). Cardiovascular risk factor prevalence, treatment, and control in US adults aged 20 to 44 years, 2009 to March 2020. JAMA, 329(11), 899. https://doi.org/10.1001/jama.2023.2307
- ScienceDaily. (2019, March 7). E-cigarettes linked to heart attacks, coronary artery disease and depression. ScienceDaily. https://www.sciencedaily.com/releases/2019/03/190307103111.htm
- Boudi, F. B., Patel, S., Boudi, A., & Chan, C. (2019). Vitamin E acetate as a plausible cause of acute vaping-related illness. Cureus. https://doi.org/10.7759/cureus.6350
- Marijuana use linked with increased risk of heart attack, heart failure. American Heart Association. (n.d.). https://newsroom.heart.org/news/marijuana-use-linked-with-increased-risk-of-heart-attack-heart-failure#:~:text=DALLAS%2C%20Nov.%206%2C%202023,at%20the%20American%20Heart%20Association%27s
- Genes involved in heart disease are similar across all populations, VA study finds. (2022, August 3). https://www.research.va.gov/currents/0822-Genes-involved-in-heart-disease-are-similar-across-all-populations-VA-study-finds.cfm#:~:text=The%20genes%20involved%20in%20coronary,are%20rooted%20in%20their%20genes
- Liu, B., & Quertermous, T. (2018). Genome-wide association studies for coronary artery disease risk. Science Trends. https://doi.org/10.31988/scitrends.40870
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