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Salon
Salon
Science
Matthew Rozsa

Why youth heart attack rates are rising

When Buffalo Bills safety Damar Hamlin suffered cardiac arrest during a live game earlier this year, many spectators commented that it seemed bizarre for a 24-year-old to experience a near-fatal heart-related incident. Yet even before that infamous game against the Cincinnati Bengals, experts had been raising alarms about the COVID-19 pandemic, which is demonstrably linked to heart disease. More recently a national survey by The Ohio State University Wexner Medical Center revealed that young people remain largely unconcerned about their risk of heart disease even though experts continue to warn about the disturbing trends.

"We are in a society now that people are less physically active. There is more use of screen time in general and less activity for a lot of people for their job. They sit all day."

As it turns out, the growing epidemic of youth heart disease precedes the Hamlin incident, and may ultimately have deadly consequences. In the words of Dr. Ron Blankstein — a preventive cardiologist and professor of medicine at Harvard Medical School — "It's never too early to start thinking about prevention of heart disease," in no small part because of the growing obesity epidemic, and additionally because "cardiovascular disease among young people has been increasing since before COVID-19."

"The main reasons [for the spike in youth heart disease] have been increases in obesity and diabetes," Blankstein told Salon. He added that young people dealing with mental health issues are also turning increasingly to substances like marijuana, alcohol, cocaine and nicotine, all of which are also linked to heart disease. Beyond what they put into their bodies, however, modern American young people are also simply not moving enough to stay fit.

"We are in a society now that people are less physically active," Blankstein explained. "There is more use of screen time in general and less activity for a lot of people for their job. They sit all day." Americans have been trending toward increasingly sedentary lifestyles for decades, as more and more jobs do not require sustained physical labor, and the foods fueling people sap rather than restore their energy. Indeed, the term "food desert" exists today because there are so many places — including in the United States — where the food options available to the average consumer are nutritionally inadequate and bad for your heart.

"When we talk about diet choices and diet availability, we're in a society where there is a large consumption of processed foods that are readily available, fast food that at times is cheaper and more readily available and more accessible than healthier options like fruits and vegetables and whole grains and food that is not processed," Blankstein pointed out. Compounding the damage from regularly consuming heart-unhealthy foods, low-income Americans also lack access to the type of regular health care that could help them stay on top of potential heart problems.

"Although observed rates of myocarditis were higher than expected, the benefits of vaccination against SARS-CoV-2 in reducing the severity of COVID-19, hospital admission and deaths far outweigh the risk of developing myocarditis."

"Addressing heart disease risk factors at a young age is important because when conditions are treated at an earlier age, you can slow the progression or onset of developing heart disease," explained Dr. Laxmi Mehta, director of Preventative Cardiology and Women's Cardiovascular Health at The Ohio State Wexner Medical Center, in a statement after Ohio State University released a study on youth cardiac disease. Yet because so many young people dismiss heart disease as a problem exclusive to the middle-aged and elderly, detectable and thus avoidable diseases are often missed.

For those who do not have access to a robust personal health care plan, there are other ways to protect yourself. The American Heart Association (AHA) has a list of the so-called "Essential Eight" — that is, eight things that any person should do to maintain good heart health regardless of their age. In addition to eating well, avoiding nicotine and exercising more, the AHA urges people to watch their weight, maintain their cholesterol, manage their blood sugar, manage their blood pressure and get seven to nine hours of sleep.

Finally, it is especially important for young people to receive COVID-19 vaccinations. Patients infected with the SARS-CoV-2 virus (which causes COVID-19) often have damaged cardiac muscle as a result. Although anti-vaccine advocates have argued that COVID-19 vaccines are heart-dangerous, the same studies that identify a slightly increased risk of myocarditis linked to vaccines also emphasized that there are far greater health perils involved with not being inoculated. 

"Although observed rates of myocarditis were higher than expected, the benefits of vaccination against SARS-CoV-2 in reducing the severity of COVID-19, hospital admission and deaths far outweigh the risk of developing myocarditis," explained the Canadian Medical Association Journal (CMAJ) at the time. Blankstein elaborated on the heart-COVID connection.

"There is a lot you can do to lower your risk of heart disease. It's never too late to start some of these preventive efforts."

"There are various reasons why COVID-19 in general has increased cardiovascular disease," Blankstein explained, including many related to the unique way in which the virus infects the body.

"That's one reason why there is a higher risk of a stroke or heart attack. There is also the systemic inflammation that is associated with having a viral illness like COVID-19, and we know inflammation is a factor that can accelerate coronary disease and lead to more events. In addition to that — and these are a direct effect of the virus on the body — there is the stress of both the pandemic in general and stress of individuals who are sick, who may sometimes have a prolonged illness, and we know that contributes as well." As any casual perusal of TikTok demonstrates, a lot of people have gained weight and become more sedentary during the pandemic.

"I think that heart disease is mostly preventable, so I think it's important for people to know that nobody is doomed to have heart disease," Blankstein explained. "There is a lot you can do to lower your risk of heart disease. It's never too late to start some of these preventive efforts. But in generally, the earlier we start, the better, because when people have heart disease and it's diagnosed in their 30s or 40s, it's usually been building up over decades. It's never too early to start thinking about prevention of heart disease."

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