Death Rates Increasing for Younger Adults Due to Heart Disease

The face of heart disease is changing in the U.S. with death rates increasing for younger adults, and obesity and diabetes may be key factors.

Obesity and diabetes are increasing the risk of death from heart disease. A recent decline in heart failure-related deaths in the United States has reversed, and those types of deaths are now climbing nationwide, especially among adults ages 35 to 64. The trend, which also revealed some racial disparities, was found in a research paper published in the Journal of the American College of Cardiology. The paper points to an increase in the prevalence of obesity and diabetes as possibly driving a parallel rise in heart failure deaths.

“The research demonstrates that greater loss of life from heart failure is occurring, especially premature death in those under the age of 65,” said Dr. Sadiya Khan, an assistant professor of cardiology at Northwestern University’s Feinberg School of Medicine in Chicago, who was first author of the paper.

The paper doesn’t distinguish why this rise in heart failure deaths occurred — for instance, are more younger adults developing heart failure, or is heart failure more deadly now? “Our suspicion is that it is likely the former, because of the obesity, hypertension and diabetes epidemics,” Khan said.

About 5.7 million adults in the United States have heart failure, according to the US Centers for Disease Control and Prevention. Heart failure is more common in people who are obese or overweight, as excess weight can put strain on the heart, and those who have a history of heart attack, among other risk factors.

The rates of heart attacks are declining overall in the U.S. — but not among all groups of Americans. According to a new study, heart attack rates are increasing in what may seem like an unlikely group: adults in their 20s and 30s.  What’s more, despite their relatively young age, 20- and 30-somethings have the same rate of bad outcomes after a heart attack — including death — as those who are about 10 years older, the study found.

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.

In the study, researchers looked at data from about 2,100 heart attack patients age 50 and younger who were admitted to one of two large hospitals between 2000 and 2016.

Overall, about 1 in 5 patients, or 20 percent, were 40 or younger. But for the last 10 years of the study, the proportion of patients 40 and younger increased by about 2 percent each year, the researchers said.

In addition, patients 40 and younger were just as likely to die after their heart attack as those ages 41 to 50, meaning that a younger age isn’t necessarily protective after a heart attack. Even if you’re in your 20s or 30s, once you’ve had a heart attack, you’re at risk for more cardiovascular events, and you have just as much risk as someone who may be older than you

Both young and older age groups in the study had about the same rate of traditional risk factors for heart disease, including diabetes, high blood pressure, smoking and a family history of heart attack.

But compared with those ages 41 to 50, those age 40 and younger were more likely to report substance abuse, including marijuana and cocaine use. In particular, 18 percent of those in the younger group reported substance abuse, compared with 9 percent of those in the older group. This finding suggests that substance use may be contributing to the trend of heart attacks among young adults, but more research is needed to confirm this.

The new paper involved analyzing heart failure-related mortality data in the CDC’s Wide-Ranging Online Data for Epidemiologic Research database. The researchers took a close look at deaths between 1999 and 2017 among adults aged 35 to 84. Overall, the researchers found that rates for heart failure death dropped significantly from 1999 through 2012 but then increased through 2017. The researchers also found disparities by age and race. Black men had a 1.16-fold higher heart failure death rate than white men in 1999, compared with a 1.43-fold higher heart failure death rate in 2017. Meanwhile, black women had a 1.35-fold higher heart failure death rate than white women in 1999, compared with a 1.54-fold higher heart failure death rate in 2017, the data showed. Those disparities were more pronounced among adults 35 to 64 than those 65 to 84, according to the data. What the data is demonstrating is, for the first time that heart disease deaths from heart failure are increasing. We’re seeing more young people with high blood pressure because of the obesity and diabetes epidemic

Practice Pearls

• For the first time heart disease deaths from heart failure are increasing.
• Heart attack rates are increasing in what may seem like an unlikely group: adults in their 20s and 30s.
• Patients 40 and younger were just as likely to die after their heart attack as those ages 41 to 50.

Originally published on Live Science.