November 23, 2020 by Peter B. Laird
More Adults Under 45 Facing Early-Stage Heart Disease
There are studies and healthcare trends that point to an increase in early-stage heart disease among younger adults, or those under 45, which is considered the age at which people normally start seeing signs of plaque buildup in arteries, or high cholesterol.
A new study, published in the Journal of the American College of Cardiology, indicates that damage done to arteries early in life – even during late teens and the 20s – from high LDL levels (low-density lipoprotein or the “bad cholesterol”) can be irreversible and cumulative — meaning that it will likely increase the risk of developing heart disease during middle age.
“Generally, above that age (45) is considered normal age,” explains Tarak Rambhatla, M.D., cardiologist with Miami Cardiac & Vascular Institute. “Now, in that young population, people still develop atherosclerosis, the development of cholesterol plaque in the arteries. And that plaque gradually builds until the time that it blocks and causes angina. It can also be smaller, be unstable, rupture and cause a heart attack.”
The risk of having a heart attack seems to be on the rise in young women, ages 35 to 54, according to a major study published last year. Between 1995 and 1999, 27 percent of those hospitalized for heart attacks were between the ages of 35 and 54, the study found. Between 2010 and 2014, that figure climbed to 32 percent. Heart attacks in women showed the biggest increase, jumping from 21 to 31 percent. During those same time periods, admissions for heart attacks among men increased less, from 30 percent to 33 percent, researchers said.
Heart disease remains the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. But the nation’s obesity epidemic is also playing a major role in the rising prevalence of heart disease in younger adults.
“The risk factors that cause heart attack, stroke and cholesterol buildup in adults still apply to younger people,” said Dr. Rambhatla. “But nowadays, those risk factors are starting to show up at earlier ages — contributors include the obesity epidemic, smoking, cholesterol, diabetes, and sedentary lifestyles. Those all contribute to developing cholesterol plaque and now it tends to be affecting younger people.”
Dr. Rambhatla stresses the American Heart Association’s so-called: “Life’s Simple 7” plan, especially for adults who are showing signs of early heart disease. It covers the seven key areas of heart disease prevention: Managing blood pressure, controlling cholesterol, reducing blood sugar, exercising regularly, healthy eating, weight management and not smoking
But in younger adults, he says knowing your medical family history is as important as knowing your key numbers, including blood pressure, lipid panel (blood cholesterol), hemoglobin A1c (blood sugar), and BMI (body mass index).
“Family history is one of the most important risk factors for premature or heart disease in young people,” Dr. Rambhatla. “There’s the genetic component of having a decreased cholesterol metabolism, or having blood vessels that are more prone to developing plaque.”
But family history goes beyond the pure genetics, he adds. Picking up poor lifestyle choices, including unhealthy diets, lack of exercise and weight gain that is ignored.
“There also tends to be a nurture issue with that too,” says Dr. Rambhatla. “If someone already has those diseases in their adult years, then they have certain lifestyles that often get passed down to the kids and the next generation. So, they tend to develop that disease earlier.”