You’re Breaking Your Own Heart. No, Really.

Millennials are hopeful for the future. But if they don’t pay attention to their hearts, they might not be around to see it.

With a progressive outlook on climate change, equality, and social responsibility, millennials have been hailed as forward thinkers with an optimistic vision for the future. However, perhaps due to the relative health that comes with youth, studies show they just aren’t thinking much about how healthy they’ll be when that future is here, addressing only day-to-day health issues as they arise.

Yet experts estimate that nearly one in three of the 600,000 U.S. deaths caused by heart disease each year could have been prevented by taking action at a young age—much younger than most people realize. “It’s already been proven that heart disease starts at a very early age and only becomes evident to the patient later in life,” explains Dr. Maan Fares, M.D., a cardiologist at the Cleveland Clinic. “We need to start doing something about it as opposed to waiting for it to manifest itself.”

The American Heart Association (A.H.A.) recommends anyone over 20 years old get tested to check their blood pressure and cholesterol levels, to maintain heart health and prevent heart disease, a term that refers to several conditions affecting the cardiovascular system. The most common—and most preventable—is coronary artery disease, the culprit behind most heart attacks. The condition begins when a substance called plaque builds up in the walls of the arteries, a process known as atherosclerosis. Research suggests that early atherosclerosis, also described as “hardening of the arteries,” may occur in as many as 80 percent of young people ages 18 to 35.

For most of those young people, the condition won’t become life-threatening until they’re between 40 and 60 years of age; sometimes even later. But individuals with additional risk factors, like obesity or a genetic predisposition, could experience a heart attack as early as their 20s or 30s. The good news? There’s significant evidence that, even for those with a family history of the condition, adopting healthy habits reduces heart disease risk—and the younger, the better.

“There's this idea that it's an old person’s disease,” says Amy Doneen, D.N.P, A.R.N.P., medical director of the Heart Attack and Stroke Prevention Center in Spokane, Washington, and coauthor of the book Beat the Heart Attack Gene. “When you’re young is actually the best time to find out if you are predisposed to any risk factors.”

Genetic factors linked to heart disease are remarkably common, and Doneen suggests that no age is too young to consider genetic testing. Roughly 50 percent of people carry a gene called 9P21, which ups an individual’s risk by about 20 to 60 percent. But it doesn’t make heart disease inevitable.

“The younger we can catch somebody, even if they are vehemently genetically predisposed, we have the opportunity to stop the disease in its tracks,” says Doneen. She explains that healthy lifestyle changes can actually prevent plaque from developing in the arteries.

In November, new data from a long-term study called Coronary Artery Risk Development in Young Adults (C.A.R.D.I.A.)—which has been following more than 3,500 young adults aged 18-35 since the 1980s—revealed that every time participants added one of the following healthy habits during the study, they reduced their risk of artery damage by 15%:

Exercising regularly: This is often defined as meeting the A.H.A.’s exercise recommendations for adults, which include 30 minutes of moderate activity, like a brisk walk, five days per week, or 25 minutes of vigorous activity, like running, three days per week. The AHA also recommends two weekly weight-training sessions targeting major muscle groups.

Eating a healthy diet: Most experts agree that a healthy diet should include vegetables, fruits, lean proteins, and whole grains, with very low amounts of refined sugar, sodium, and fat (especially saturated and trans fat). The A.H.A. recommends enjoying two servings of fish per week. Some studies, not related to C.A.R.D.I.A. research, have also shown benefits from taking Omega-3 fish oil supplements, but it’s best to consult a doctor first.

Maintaining an average or below average weight: There are two guidelines for determining ideal weight. Body Mass Index is a calculation based on height and weight. The other is waist circumference; the risk of heart disease is higher in women with a waist size greater than 35 inches, and in men with a waist size greater than 40 inches.

Drinking moderate amounts alcohol: Recommendations concerning alcohol are complex, but a “moderate” level of drinking is generally acceptable, which usually means no more than one drink per day for women, and an average of one to two drinks per day for men.

Not smoking: Dr. Fares describes smoking as a direct cause of coronary artery disease. He explains, “Smoking damages the healthy layer of cells that protect the coronary arteries from forming plaque.” If you smoke, quitting is among the best thing you can do for your heart (not to mention your lungs).

At age 37, West Virginian Amanda Skeen truly appreciates the difference healthy choices can make—though, by some standards, she got a late start. Last February, tests revealed such severe narrowing in one of her coronary arteries that surgery was no longer an option. Though she knew her mother and grandmother suffered from heart disease, Skeen had no idea a blockage could start so young. “When they told me how bad it was, I was shocked."

However, in under a year, Skeen turned her health around—a change she credits to the Dr. Dean Ornish Program for Reversing Heart Disease, a lifestyle regimen covered by Medicare and other insurance providers. Skeen went from rarely exercising to doing a mix of cardio, strength training, and yoga every single day. Though she loved eating meat, she shifted her focus to meals that were almost entirely plant-based. Skeen has since dropped 30 pounds and reduced her cholesterol levels from high to average.

Despite her successes, Skeen still has to take medication and wishes she’d made these changes before her condition became so serious. “When you’re 20, you think you’re invincible,” she says wistfully, “but you’re not.”

An A.H.A. survey revealed that Skeen’s attitude was all too common, finding that nearly half of college-aged adults weren’t concerned about their risk of heart attack or stroke, and over a third didn’t think that their risky behaviors would make an impact later in life. However, when asked how long they hoped to live, the participants’ average answer was 98 years old.

For those striving to reach that ninety-eighth year, the best approach is to make healthy choices a part of your daily life: Exercise, eat right, don’t smoke, and watch how much you’re drinking. It also doesn’t hurt to learn more about your family history and see a doctor for basic screenings to see if you’re at risk for an early heart problem. No matter your age, being more mindful about your behaviors will improve your heart health—and your overall health, too.

Illustration by Tyler Hoehne

Photo by Casey Horner on Unsplash

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