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Why Millennials Need To Care About Heart Health

Kelsey Tyler

On a sunny January day in 2008, as Jenny Petz nursed her eight-day-old son, she felt a strange tingling in her left arm. As it went numb, she stood, called for help — and collapsed on the floor. After being rushed to the hospital, she learned she’d experienced a rare type of heart attack called a spontaneous coronary artery dissection (SCAD), which occurs when a tear forms a blood vessel in the heart.

In the aftermath, she discovered that she had been unknowingly living with hereditary high cholesterol. In fact, before the heart attack, one of her arteries had been 98% blocked by cholesterol. Doctors theorized the extra pressure of her recent pregnancy had pushed things over the edge. “I was completely caught off guard,” says Petz. “I had lived a pretty darned healthy life.” 

It’s true, Petz had none of the obvious risk factors for cardiovascular disease: she maintained a healthy weight, exercised regularly, didn’t smoke, ate a healthy diet — plus, she was only 32.  And while what happened to Petz is rare, her story shines a light on the fact that heart issues aren’t reserved for senior citizens.  


Heart disease is the leading cause of death in the U.S.; Nearly half of US adults suffer from a cardiovascular issue. Most heart attacks happen in older populations, and the risk for cardiovascular disease increases as you age — nearly half of all adults with cardiovascular disease are over 60. 

However, the number of young people with heart disease has been steadily increasing. One in five heart attack patients is now younger than 40, and the proportion of people in their 20s and 30s having heart attacks has increased by 2% each year for the past decade. “Shockingly, about half of all heart attacks happen in people younger than 50 years of age,” says Dr. Nicole Harkin, a Member of the American Society for Preventive Cardiology. “And for many people, the first sign of heart disease is death.”

These earlier heart attacks are particularly concerning for women, who not only account for the largest increase in young heart attacks, but also tend to have greater mortality rates than young men.

Explainers

Can Bad Dental Habits Cause Heart Disease?

While it’s not completely clear what’s behind the uptick in heart disease in younger people, many experts believe people are beginning to experience risk factors, that could lead to heart disease, earlier in life. More and more folks are developing diabetes, hypertension, and obesity, driven by more sedentary lifestyles and processed foods. 

“Although improvements have been made in acute cardiovascular care, they’ve been offset by unhealthy lifestyle habits,” says Dr. Dapo Iluyomade, a Board Member of the American College of Cardiology. 

Lifestyle vs. genetics

Many of us have internalized the idea that your risk of heart disease is directly tied to your genes. In other words, some think if your family has a history of heart disease, you should be worried; if not, you’re good.

While there is some truth to this, it’s more nuanced than that; it’s important to understand the contours. For Petz, genetic risk was the sole cause of her heart attack. After surgery, in which three stents were used to reopen her coronary artery, she learned that her maternal grandmother was also diagnosed with high cholesterol as a young woman. In fact, when Petz was 13 years old, she was told that she had high cholesterol, but her family never followed up for additional testing. In her adult years, her doctors didn’t express concern — she was trim and fit, the picture of heart health. Though Petz had done everything “right,” lifestyle-wise, she wasn’t able to counteract her hereditary disposition without pharmaceutical intervention. 

“My body just can’t do it on its own,” she says. “I’ve learned to live with the fact that I’ll need medication for the rest of my life.”

Indeed, one study found that having at least one parent with cardiovascular disease doubles the eight-year risk of heart disease for men and increases it by 70% for women. That’s not nothing — but it’s also not everything.

While genetic disposition plays a role, a large body of research supports the idea that lifestyle factors are a stronger predictor of heart disease, and that making healthy choices can blunt hereditary risk.

For instance, positive lifestyle choices can offset family risk, with research showing that exercising, eating well, and maintaining a healthy weight can lower a person’s relative risk of heart disease by almost 50%. Others have also supported the notion that lifestyle plays a bigger role than genetics in causing heart disease in young patients. 

“Our individual family history is a non-modifiable risk factor — one you can’t change,” says Dr. Stacey Rosen, Professor of Cardiology at Zucker School of Medicine. “But the majority of our risk for developing heart disease is controllable.”

The key to your heart health

Whether or not you have a family risk of heart disease, experts agree that all young adults should be thinking about their heart health. “The opportunity to lower your lifetime risk for heart disease begins when we’re young,” says Rosen. Similarly, Iloyumade advises people to view heart disease prevention as a marathon rather than a sprint. 

For those with genetic risk, it’s even more important to start thinking about heart health early. “If you’re a young person who has a family history of heart disease, it’s really important to take a proactive approach,” says Harkin, explaining that this often means “taking a good, hard look at lifestyle factors and trying to optimize those.”

The key to avoiding heart disease long-term is focusing on what’s called primordial prevention, or preventing risk factors from forming. This means you should:

Know your numbers. “I see my cardiologist once a year and get my cholesterol checked often,” says Petz. Experts recommend getting your cholesterol checked every five years starting at age 20 for those without risk factors, and more frequently for those with family risk or comorbidities like diabetes or obesity. Harkin also recommends that children get their cholesterol checked at least once, as genetically high cholesterol often shows up quite early (the American Heart Association recommends children get tested between ages 9 and 11). Blood pressure is already one of the four vital signs, so it’s automatically monitored whenever you visit a care provider. Screening recommendations for diabetes vary from population to population, but it generally begins at 45 for those without risk factors, and earlier for those with. 

Stay physically active. There’s a reason it’s called “cardio.” To keep your heart healthy, you should aim to get 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise per week, and avoid long periods of sitting. According to the CDC, only 50% of adults get this amount of exercise. Adequate physical activity could prevent 1 in 15 cases of heart disease. And this doesn’t have to mean endlessly running on the treadmill — things like tennis, swimming, and hiking count as vigorous activity, while brisk walking and leisurely biking count as moderate activity.  

Eat a healthy diet. Processed foods, excess sugar or sodium, trans fats, and excessive alcohol can all contribute to your risk of heart disease, whereas a diet that emphasizes fruits, vegetables, whole grains, and fish can help ward it off. Research shows that the Mediterranean diet, the DASH diet (which, fittingly, stands for Dietary Approaches to Stop Hypertension), and a vegetarian diet are the best choices for heart health. 

Don’t smoke. Nicotine has a number of adverse affects on your heart health, including increasing blood pressure and heart rate and decreasing blood flow. It can also cause the walls of your arteries to harden, setting you up for a future heart attack. 

Manage stress. Stress can lead to high blood pressure, a major risk factor for heart issues. It can also cause a domino effect — making you more likely to drink alcohol, smoke, or skip your workout. 

Maintain a healthy weight. “Obesity is arguably the largest contributor to poor heart health among 21st century populations in the developed world,” says Iluyomade, explaining that our leaner hunter-gatherer ancestors had a much lower risk for heart disease. While the BMI metric has its issues, it’s the barometer that most doctors still use to assess “normal” weight, and research shows that for every 5-point increase in BMI, risk of heart disease rises by 32%. Another way to assess your weight vis-a-vis your risk of heart disease is by measuring your waist circumference

Assemble the right team. While everyone should have a primary care doctor they see for regular check-ups, those who are high-risk may also need to see specialists. This could include a prevention-focused cardiologist, endocrinologist (if you suspect you may be at-risk of developing diabetes) or a registered dietician.


While heart disease mostly affects older people, what you do now will affect whether or not you’re one of those older people. So next time you think about protecting your heart, remember that this means more than deleting that dating app. As she’s gotten her heath back in order, Petz says, “Life is good. I love getting the message out to all young women: know your numbers!” 


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