Young Hearts: Understanding and Preventing Early Heart Disease

Read below to learn why heart disease is increasingly affecting younger adults and how simple lifestyle changes made today can help protect your heart in the future.

Most people assume being diagnosed with a heart condition or having a heart attack only happens to older adults. However, a troubling health trend has emerged in recent years: heart disease is increasingly affecting younger adults. Since 2019, there has been a startling increase in heart attack rates, up 66% among those aged 18 to 44. Every 33 seconds, someone in America dies of heart disease, according to the Centers for Disease Control and Prevention (CDC), making it the nation's leading cause of death—and increasingly, its victims are getting younger.

Dr. Ameera Ahmed, a Dignity Health interventional structural cardiologist, calls the trend "alarming." 

"It's a common misconception that if you're young, heart disease really isn't a problem for [you]," says Dr. Ahmed. "I've treated young patients with stents, as young as 26 when they've come in with plaque rupture or heart attacks, and you look at them, and you don't think they're going to have a real heart attack in the truest sense of the word." 

This surge in early-onset heart disease signals a critical need for younger generations to understand their cardiovascular health. "Heart disease doesn't happen overnight," explains Dr. Ahmed. "Things that we're doing in our 20s, 30s, and 40s really affect what our later life risk factors look like." 

The good news for younger adults is that through awareness, lifestyle changes, and preventive measures as simple as going to your yearly physical, you can reclaim your heart health.

Understanding How Heart Disease Develops

To grasp why heart disease is affecting younger people, it's crucial to understand how it develops. Dr. Ahmed explains that heart disease is a gradual process that begins years before symptoms appear. 

The heart's vital blood supply depends on three major coronary arteries, each surprisingly small—only 2.5 to 3.5 millimeters in diameter. "You're working with very little real estate," Dr. Ahmed notes, "and when you start to build up stuff, it happens very fast." 

The process often begins with inflammation throughout the body, which can be triggered by various factors, including smoking, stress, and poor diet. This inflammation damages the arterial walls, making them more susceptible to accumulating plaque—a mixture of cholesterol, calcium, and other substances. As Dr. Ahmed explains, "Think of a pipe that's accumulating gunk, and then something happens to kind of clog it up completely, like a blood clot." 

Dr. Ahmed encourages younger adults to be aware of the risk factors that accelerate this process in distinct ways: 

• Smoking accelerates atherosclerosis (plaque buildup) and makes blood more likely to clot 
• High blood pressure causes arteries to become stiffer and more damaged 
• Diabetes increases overall inflammation in the body 
• High cholesterol leads to faster deposit of fatty materials in the arteries

Modern Heart Disease Risk Factors and Landscape

Today's younger generations face unique challenges their parents didn't encounter. “We all live in a world where we don't have a lot of control over the factors that lead to general disease," Dr. Ahmed notes. Environmental factors like microplastics, which have been found in arterial plaques and ultra-processed foods high in sodium and saturated fats, contribute to increased cardiovascular risk. 

The obesity epidemic plays a significant role, with rates climbing from 30% to 40% among 18 to 45-year-olds in the past decade. Access to health care remains a critical issue, with Dr. Ahmed pointing out that “35 to 37 million Americans don't have access to insurance, 41 million are under-insured." 

Mental health has emerged as another crucial factor. Research shows people with depression have a 64% higher risk of developing coronary heart disease. “Our minds and bodies are connected in so many ways," Dr. Ahmed emphasizes. “Our bodies kind of carry the imprint of what's been going on with our mind, what we've been through, the traumas we've been through."

Taking Control of Your Heart Health

The good news is that young adults can take meaningful steps to protect their heart health. Dr. Ahmed advocates for sustainable lifestyle changes rather than dramatic transformations: "Making one small change and doing it in a sustainable fashion is the way to go. Big life changes, like 'I'm no longer eating any sugar,' are often not sustainable." 

Here are key preventive measures:

1. Regular Screening: Going to regular doctor's appointments, getting your cholesterol screenings every year, and making sure that someone checks your blood pressure can help catch problems early. This is true even if you haven't had issues in the past. On average, we increase our blood pressure one point every year, so as a result, hypertension is common even in someone who's maintained normal blood pressure throughout their life. Here are some screenings to keep in mind:
   - Annual cholesterol screenings
   - Regular blood pressure checks
   - Diabetes screening (hemoglobin A1C tests)
   - For those with a family history of early heart disease, consider a coronary calcium score test
   - Women with history of preeclampsia should ensure it's noted in their medical records, as it's "an under-recognized cardiovascular risk factor"
2. Movement Matters: For desk workers, Dr. Ahmed recommends using a standing desk or taking five to ten-minute walks every hour. Aim for 30 to 40 minutes of meaningful exercise four to five times per week. Consistency matters more than intensity. “I would rather you move somewhat than nothing at all," says Dr. Ahmed. "Remember, benefits accumulate even with short periods of activity."
3. Mindful Eating: Focus on whole foods and fresh produce. "It's true, you are what you eat," Dr. Ahmed confirms. "If most of your plate is full of fresh fruits and vegetables and you're eating at home, you're eating real food ... you're already winning."
   Here are some winning strategies:
   - Fill most of your plate with fresh fruits and vegetables
   - Choose whole foods over processed options
   - Include lean proteins, like white fish, Greek yogurt, eggs, and beans
   - Cook at home more often
   - Make sustainable changes rather than following fad diets
   - Remember that going vegan doesn't necessarily make you healthier ... being mindful of what goes in your body is what matters
4. Stress Management: The American Heart Association categorizes stress as a risk factor for heart disease. Regular meditation, stretching, or restorative yoga can help regulate your nervous system and reduce stress levels. These mindful practices work by activating the parasympathetic nervous system—often called the “rest and digest" mode—which maintains daily functions like resting heart rate, breathing rate, and metabolism. When practiced consistently, even just 10 to 15 minutes daily, these techniques can help lower cortisol levels, reduce muscle tension, and improve sleep quality. Together, these practices create a foundation for better stress resilience and emotional regulation throughout your day, which in turn eases hypertension.

Heart Disease Symptoms That Differ from the "Textbook"

Unlike older adults, younger people with heart problems might experience different symptoms. Dr. Ahmed emphasizes that "not everyone's heart disease will look like a textbook," particularly for women, who often have atypical presentations. 

Watch for: 

• Decreased exercise capacity or unexplained fatigue 
• Shortness of breath during normal activities 
• Recurring "heartburn" during exercise 
• Jaw pain or neck pain that extends to the arm 
• Regular headaches or pressure in the temples 
• Feeling your heartbeat in your ears 
• Unexplained changes in energy levels

Looking Forward

For young adults diagnosed with heart disease, the outlook isn't all dire. Dr. Ahmed explains that younger patients typically have blockages in just one artery, compared to older patients who often have multiple blocked vessels. However, this makes early intervention and lifestyle changes even more crucial. 

The ultimate message is one of empowerment rather than fear. As Dr. Ahmed puts it, "You get to take care of your body to live your best life ... If you think about it not as 'I can't eat this' or 'I have to do this,' but as 'I'm just taking care of me and my body,' that makes it a lot easier." 

By understanding these risks and taking proactive steps, young adults can protect their heart health and set themselves up for a healthier future. The key is making small, sustainable changes and staying attentive to your body's signals. As Dr. Ahmed emphasizes, “I would rather you do whatever you can. It's not all or nothing. You still get the benefits of things, even if you do them for a shorter amount of time." 

Concerned about your heart health? Talk to your doctor about your risk factors and any symptoms you may be experiencing. If it's recommended that you see a cardiologist, ask for a referral to Dignity Health. Find a Dignity Health cardiologist near you.

Copyrighted material adapted with permission from Hearst StoryStudio.