Although many consider heart attacks an “old man’s disease,” they commonly affect young adults. Certain risk factors, such as smoking cigarettes and substance misuse, increase the likelihood in young people.

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The Atherosclerosis Risk in Communities (ARIC) Study, which started in 1987, found an increase in the incidence of heart attacks in young people. They noted an increase in young women in particular.

A 2021 study reported that while the number of heart attacks in the general population has significantly decreased, this is not necessarily the case among younger people.

The researchers noted the different risk factors affecting young adults. Additionally, young people may be less likely to receive preventive therapy because doctors consider them to be at low risk for heart attacks.

Read on to learn about the causes and risk factors for heart attacks in young people.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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People with diabetes have a higher chance of developing heart disease than people without diabetes. They are also more likely to have high blood pressure or high cholesterol, which elevates a person’s chances of having a heart attack.

Estimates suggest 526,000 young people will have one form of diabetes by 2060. This is a significant increase compared with 213,000 people in 2017.

The Centers for Disease Control and Prevention (CDC) measured data from over 12,000 young people ages 12–19 between 2001 and 2016. They found that more than 1 in 7 young people had high or elevated blood pressure between 2013 and 2016.

The 2017 AAP Guideline introduced a lower threshold for diagnosing high blood pressure — and notably, almost half of the reclassified young people had obesity.

Young people with high blood pressure, in addition to obesity and diabetes, have an increased chance of carrying these risk factors into adulthood. This knock-on effect increases their risk for heart disease and stroke.

A 2018 study published in Circulation found that people with higher BMIs, including young people, were more likely to have worse cardiovascular health. This was especially true of high blood pressure and left ventricular mass index, a measure that predicts sudden cardiac death.

Heart damage that begins in childhood can lead to a heart attack in adulthood.

The 2018 study showed that every additional unit of BMI was associated with higher blood pressure. It was also associated with increased thickness and size of the left ventricle, one of the lower heart chambers responsible for pumping blood around the body.

Smoking triples a person’s risk of dying early due to heart disease and stroke compared to not smoking. Additionally, people who start smoking before age 15 are at the greatest risk.

The data showed that study participants who started smoking between ages 10–14 had a higher risk of dying prematurely from heart disease or stroke. However, the data also showed that if a person quit smoking by age 40, the increased risk of premature death was reduced by around 90%.

While the British Heart Foundation says e-cigarettes are less harmful than smoking tobacco, this does not mean that they are safe. Researchers do not yet know the long-term impacts on the heart and other areas of health.

One 2022 study noted that long-term vaping had a damaging effect on the endothelium, the inner lining of the blood vessels that keeps blood flowing smoothly.

Misusing substances can increase a young person’s chances of developing heart disease sooner than they otherwise would.

A 2021 study investigated the relationship between recreational substance use and premature development of atherosclerotic (plaque buildup) cardiovascular disease (ASCVD). It found that people with premature ASCVD used more:

  • tobacco (62.9% vs. 40.6%)
  • alcohol (31.8% vs. 14.8%)
  • cocaine (12.9% vs. 2.5%)
  • amphetamine (2.9% vs. 0.5%)
  • cannabis (12.5% vs. 2.7%)

The researchers also found that females had the highest risk.

Some people inherit genetic heart problems from their parents. For instance, around 1 in 250 people have familial hypercholesterolemia, a genetic disorder that increases a person’s chances of developing coronary heart disease at a younger age.

Other heart conditions a person may be born with include:

  • Familial cardiomyopathies: These diseases make it harder for the heart to pump blood around the body.
  • Familial arrhythmias: These are irregular heart rhythms.
  • Marfan syndrome: This is a disease of the connective tissue, including muscles such as the heart.
  • Sudden arrhythmic death syndrome (SADS): This is an unexplained underlying familial heart rhythm only found during an investigation into the cause of a person’s death.

The American Heart Association (AHA) offers advice for preventing heart disease throughout life. In particular, young people can:

  • have regular wellness checks with a doctor
  • learn their family history of heart health to understand their risk
  • stay physically active
  • avoid smoking and second-hand smoke
  • limit stress wherever possible
  • develop heart-healthy habits, such as daily walks or planting a vegetable garden

Learn more about heart disease prevention.

If a person shows warning signs of a heart attack, call 911. This is usually the quickest way for a person to receive the lifesaving treatment they need.

It is important to note that besides chest pain, women may experience symptoms like shortness of breath, nausea or vomiting, and back or jaw pain.

Heart attacks in young people happen due to an interruption in blood supply to the heart.

Young people can develop heart disease for a range of reasons, including:

  • having diabetes
  • high blood pressure
  • obesity
  • genetic heart problem
  • smoking
  • misusing other substances

A young person can avoid having a heart attack by understanding their family history, eating well, exercising, and having regular health checks with a doctor.