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Heart Attack Rates Soar Among Young Adults: Experts Highlight Key Risk Factors
Contrary to common perception, heart attacks are increasingly affecting younger individuals in the United States. While typically associated with older demographics, new data reveals a concerning surge in heart attacks among young adults. In 2019, 0.3% of adults aged 18-44 experienced a myocardial infarction. By 2023, this figure climbed to 0.5%, representing a significant 66% increase within just four years. This escalation means that now, approximately one in five heart attack patients are under the age of 40, underscoring a critical shift in cardiovascular health trends and highlighting the urgent need to understand and address the contributing factors behind this alarming rise.
Possible Contributing Factors to Rising Heart Attacks in Younger People
While some theories have linked the increase to the COVID-19 pandemic’s impact on cardiovascular health and blood flow, and others have controversially, and without evidence, suggested a connection to COVID-19 vaccines, leading cardiology experts are pointing to other significant factors. Dr. Evan Levine, a leading cardiologist at Mount Sinai in New York, has identified four key elements, based on medical literature and clinical observations, that he believes are contributing to this disturbing trend.
Increase in Prescription Drug Abuse
Dr. Levine highlights the significant rise in prescription stimulant use, particularly among young adults. Prescriptions for Adderall and Ritalin witnessed a 14% surge during the pandemic. This spike is largely attributed to the expansion of telehealth services and relaxed regulations, which facilitated easier access to prescriptions through online consultations. Between 2019 and 2022, approximately 5.9 million new stimulant prescriptions were issued.
This increase was most pronounced among young adults aged 20 to 39, who experienced a 30% rise in Schedule II stimulant prescriptions during this period. Dr. Levine suggests this “dramatic spike” in stimulant usage has “undoubtedly played a role” in the observed increase in heart attacks within this age group.
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Adderall, a stimulant medication commonly prescribed for attention-deficit/hyperactivity disorder (ADHD), carries the risk of cardiovascular events, including heart attack, especially when misused, as cautioned by the American College of Cardiology.
This medication, used by over 16 million adults in the U.S., enhances focus and reduces hyperactivity in ADHD patients by elevating dopamine levels in the brain. Despite its therapeutic benefits, the Drug Enforcement Administration classifies Adderall as a Schedule II drug—akin to cocaine—due to its high potential for abuse.
The euphoric effects of Adderall can lead to tolerance and dependence, potentially prompting individuals to escalate dosages to achieve the desired effects, which can result in addiction. Signs of Adderall abuse may include elevated heart rate, increased respiratory rate, high blood pressure, excessive sweating, restlessness, and dilated pupils.
Furthermore, Adderall can constrict blood vessels and impede blood flow, consequently elevating heart rate and blood pressure and increasing the likelihood of a cardiac event. Excessive Adderall intake can heighten the risk of stroke or heart attack by pushing heart rate and blood pressure beyond healthy baselines.
Spontaneous Coronary Artery Dissection (SCAD)
Spontaneous coronary artery dissection, or SCAD, is a critical condition involving a tear in the wall of a coronary artery, which can precipitate a heart attack. Dr. Levine notes that SCAD is frequently observed in young women, particularly postpartum.
The precise cause of SCAD remains unclear; however, hormonal changes, inflammation, and underlying conditions such as fibromuscular dysplasia are considered potential factors. SCAD is becoming increasingly recognized, especially among younger individuals and women, although the reasons for this rise are still under investigation.
Over the past quarter-century, research has indicated a clear increase in SCAD cases, both in absolute numbers and as a proportion of acute coronary syndrome (ACS) diagnoses.
A tear in the artery wall allows blood to accumulate between the layers, obstructing blood flow to the heart. This disruption in blood supply can deprive heart muscles of oxygen and vital nutrients, leading to damage and a heart attack.
Dr. Levine emphasizes the importance of developing “more sensitive methods” for detecting SCAD in young individuals to prevent potential heart attacks.
Stress Related to Crime
Stress is a significant determinant of overall health, impacting sleep patterns and elevating blood pressure, with insufficient sleep posing health risks. While occupational stress is often considered, Dr. Levine suggests that stress induced by crime concerns may be a substantial contributor to early-onset heart attacks.
Dr. Levine stated that societal anxieties related to crime are contributing to widespread stress, which detrimentally affects cardiovascular health. Although 2024 FBI data indicates a decrease in violent crimes, including murder and carjackings, a Statista study indicates that a significant majority of Americans perceive crime as being more prevalent now than in recent years.
Personal experiences and shared narratives of crime-related incidents can exert psychological, emotional, and physical effects, potentially triggering stress responses ranging from anxiety and fear to chronic conditions like depression, anxiety disorders, and post-traumatic stress disorder.
While stress is not a direct cause of heart attacks, it significantly increases the risk by elevating blood pressure and impairing blood flow, thereby posing a risk for both heart attack and stroke.
Obesity
Obesity affects over 100 million Americans, or 40.3% of the population. Studies estimate that excessive body weight is linked to over 370,000 deaths annually in the U.S. Obesity elevates cholesterol and blood pressure levels and increases the risk of type 2 diabetes—all significant risk factors for heart attacks.
Individuals with a BMI of 30 or higher require increased blood circulation to supply oxygen and nutrients, forcing the heart to pump more forcefully. Excess weight also increases body volume, creating resistance for the heart as it pumps blood.
This increased volume and resistance necessitate the heart working harder consistently. This added workload can cause pressure within the heart walls and elevate blood pressure. Elevated blood pressure is a primary cause of heart attack and a leading cause of mortality among obese individuals.
Recent research indicates that accumulating at least 150 minutes of moderate to vigorous physical activity over two days provides similar health benefits compared to distributing exercise throughout the week.
Individuals who exercised only two days per week experienced a 32% lower risk of all-cause mortality, a 31% reduced risk of cardiovascular death, and a 21% lower cancer mortality risk.
The American Heart Association advises adults to engage in at least 150 minutes of moderate-intensity aerobic activity weekly, 75 minutes of vigorous aerobic activity, or a combination, ideally spread throughout the week to promote optimal cardiovascular health.