Doctors Identify "Really Unfortunate" Heart Attack Trends for Under-40s

With the health risks of vaping and the bleak future of the planet’s climate to grapple with, heart disease might not be the first thing on most 20-year-olds’ minds. However, research that will be presented at the American College of Cardiology’s 68th Scientific Session suggests it’s time for younger people to take notice of their heart health. The doctors behind this research have data showing that the number of heart attacks in very young people has been steadily rising for a decade.

When it comes to heart attacks, “very young” typically refers to someone under the age of 40. But Dr. Ron Blankstein, the study’s senior author and an associate physician at Brigham and Women’s Hospital in Boston, says that people in their 20s and 30s should still take his data to heart. His team reports that one in every five people who suffers from a heart attack is 40 years old or younger, and overall, the average rate of heart attacks in that age group has increased at the rate of 2 percent per year between 2006 and 2016. He will present his findings on March 17 at the ACC meeting in New Orleans.

"Young patients tend to do just as bad as their counterparts who are 10 years older.

“As a country we need to do more to prevent these myocardial infarctions from happening in the first place,” Blankstein tells Inverse, using the clinical term for a heart attack. “I think it’s a really unfortunate statistic that we’re seeing more myocardial infarction in young patients, especially since the majority of myocardial infarctions can be prevented.”

Blankstein’s study specifically looked at lifestyle data and angiograms taken from the hearts of 2,097 “young” patients (under the age of 50), all of whom confirmed they have had at least one heart attack. Then he compared the lifestyle data of the “young patients” to that of the “very young patients” (under 40) and analyzed how well each group was faring after their first heart attack. First of all, he noted that the young patients didn’t actually fare any better than the older group. They were just as likely to die after their heart attacks, either from other conditions (all-cause mortality) or from another heart attack. Blankstein explains that this actually goes against traditional thinking that young people who have heart attacks may be able to recover from them more effectively than older people.

“Young patients tend to do just as bad as their counterparts who are 10 years older,” he says. “Usually age is a very strong predictor of cardiovascular events in every study. This suggests that despite being 10 years younger, they have excess risk relative to their age.”

The question, he adds, is what might contribute to that “excess” risk. On that front, the new study points to a few factors.

For one, the younger patients had some of the most common risk factors for heart attack — high blood pressure, obesity, and diabetes, for instance — at similar rates to the older group. But there was one thing unique about the “very young” group. That group showed significantly higher rates of substance abuse — in the case of his analysis, cocaine or marijuana use. 19.1 percent of very young people who had a heart attack reported abusing cocaine or marijuana, compared to 9.3 percent of the young group.

"The fact that you’re young doesn’t protect you once you’ve had a heart attack.

If you’re wondering why he picked those drugs — and didn’t investigate alcohol use or prescription drug abuse — he explains that cocaine and marijuana have a checkered past when it comes to heart health.

“Both of them have been found to be associated with cardiovascular events,” he explains. “I think maybe it’s more recognized that cocaine is harmful. Marijuana isn’t usually as well recognized as being associated with a high risk of cardiovascular events.”

Blankstein’s study doesn’t prove that substance abuse can cause heart attacks, but it illustrates yet another factor that might explain the rising number of heart attacks amongst younger people. He hopes that his findings will inspire physicians to take heart attacks in young people a bit more seriously — especially if they have other risk factors.

“I think one of the bottom lines from this is that we can’t as physicians say, ‘Well you had a heart attack but you’re really young, so you’re going to do just fine’,” Blankstein says. “The fact that you’re young doesn’t protect you once you’ve had a heart attack.”