While heart attack rates in the U.S. have decreased, these life-threatening heart events are steadily rising in young adults under 40, shows recent study at Brigham and Women’s Hospital. Findings were presented at the American College of Cardiology’s 68th Annual Scientific Session and suggest that drug use may to blame for this alarming trend.
Using data from the YOUNG-MI Registry, this study looked at heart attack rates among adults under 50 years old. It included 2,097 patients treated for heart attack in two large U.S. hospitals between 2000 and 2016. The study is the first of its kind to compare heart attack rates among young and very young adults.
Heart attack, also called a myocardial infarction, occurs when blood flow to the heart is blocked. It affects an estimated 790,000 Americans each year.
Findings showed that 1 in 5 heart attack survivors were 40 or younger—an age range defined as “very young” in this study.
When comparing imaging results, people in the very young heart attack group were more likely to have disease in only one vessel. According to authors, that suggests heart disease was still early and confined, yet they had the same rate of bad outcomes. The very young group also had more spontaneous coronary artery dissection—a tear in the vessel wall—which, while rare, tends to be more common in women, especially during pregnancy.
Analysis also showed that the proportion of very young people having a heart attack has increased by two percent each year for the past decade. Despite being 10 years younger on average than those having heart attacks in their 40s, very young patients have the same rate of adverse outcomes, including dying from another heart attack, stroke or any other reason.
“It used to be incredibly rare to see anyone under age 40 come in with a heart attack—and some of these people are now in their 20s and early 30s,” said Ron Blankstein, MD, a preventive cardiologist at Brigham and Women’s Hospital, associate professor at Harvard Medical School in Boston and the study’s senior author. “Based on what we are seeing, it seems that we are moving in the wrong direction.”
A related study by Blankstein showed that 1 in 5 patients who suffer a heart attack at a young age have diabetes. Unfortunately, these patients with diabetes were more likely to die and have repeat events than heart attack survivors without diabetes.
Findings highlight the importance of prevention, according to authors. “Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors,” Blankstein said. “My best advice is to avoid tobacco, get regular exercise, eat a heart-healthy diet, lose weight if you need to, manage your blood pressure and cholesterol, avoid diabetes if you can.”
Blankstein also advises that patients stay away from cocaine and marijuana because they can have negative effects on the heart. In this study, the youngest patients were nearly twice as likely to report substance abuse compared to patients between 41 and 50 years old. It’s possible that drug use plays some role in rising heart attack rates in very young adults.