Understand how habits and lifestyle directly affect heart health
“Did you have a heart attack in your 20s? But he isn’t old enough yet!” Young, without symptoms and apparently healthy. The time when episodes of heart attack were considered a problem only for those who had passed middle age. The fact is that it is more and more frequent to come across cases of victims of a myocardial infarction in their 20s, 30s or 40s. And this is very much related today to the lifestyle we lead.
We don’t even need to get to the question of the changes brought about by the arrival of the coronavirus and its consequences, but to factors that already influenced health even before the pandemic. Anxiety, excessive assignments and responsibilities are sufficient reasons to increase the incidence of stress in young adults and favor the occurrence of early infarctions.
In addition, we can mention the multiplication of unhealthy habits, such as poor diet and a unregulated diet, physical inactivity, unlimited self-medication, few hours of sleep, smoking, excessive alcohol and the consumption of illegal drugs, points that put the heart at risk and the lives of people in that age group.
There are also known factors that are responsible for the increase in statistics, such as obesity, diabetes, hypertension, high cholesterol levels and family history.
How to suspect the possibility of a heart attack?
First, let’s understand why the heart attack occurs. To maintain its function, the heart muscle needs a constant demand for blood. Infarction happens just when there is a blockage or a reduction in this blood circulation in the heart. This is due to the accumulation of fatty plaques in the coronary arteries, responsible for irrigating the organ – what we call coronary artery disease (CAD).
The problem arises especially in the presence of the factors already mentioned above, however, the degree of obstruction and the symptoms can vary according to each case. In general, coronary obstructions of more than 70% have angina (discomfort, pain and tightness in the chest) as main indication, but it is also possible to feel shortness of breath, fatigue, nausea, pain in the shoulder, arm or jaw and, in women, atypical chest pains.
The situation worsens, however, because few people notice or have these signs: estimates indicate that only about 2% of Brazilians know they are having a heart attack.
A worrying point is that CAD can develop progressively and silently, without showing any evidence, increasing the chances of a fulminant attack in individuals of any age. This happens when there is already a complete blockage of the coronary artery by the formation of a clot on the fatty plaque. At this point, the acute myocardial infarction begins and the heart muscle necrosis process begins.
The dangers of today’s life
When it comes to lifestyle, one of the main villains is stress. Estimates indicate that approximately 15% of infarction cases are linked to stress crises, capable of triggering pressure spikes and the collapse of the heart muscle.
In addition, in general, young people are increasingly sedentary: today there is a greater reliance on the car for mobility, jobs and leisure activities that require less physical activity and more time spent in front of screens and in the digital world. The direct consequence is obesity.
To get an idea of the severity, obesity affects 20% of Brazilians (data from the Ministry of Health in 2018). In the last decade, the index has almost doubled between 18 and 44 years old.
And in 30 years, it has practically tripled in schoolchildren, also causing an increase in the diagnosis of high cholesterol. Since obese children are more likely to be obese adults, preventing or treating the problem in childhood can reduce the risks of heart disease, diabetes and other related issues in the future.
Research also points to the growth in the number of diabetic people. According to the International Diabetes Federation, by 2030, there will be more than 500 million diabetics in the world. The consumption of processed foods, with high caloric content and excess of sugars, is the main responsible for the disease in the youngest, thus increasing the risk of early death from infarction.
The number of Brazilians with arterial hypertension is also growing and worrying. According to the Ministry of Health, one in four people claims to have the diagnosis. Among children and adolescents, there are already more than 3.5 million hypertensive patients. High blood pressure is a serious condition in childhood and often goes unnoticed because it does not cause symptoms.
Cigarette and other drugs
Another warning point is smoking. Between 2016 and 2017, the rate of smokers between 18 and 24 years of age increased from 7.4% to 8.5% (Ministry of Health). Addiction, when acquired in youth, extends the period of exposure of the body to cigarettes, further increasing the chances of the onset of early cardiovascular diseases, such as infarction.
Research indicates that smoking increases the heart rate, stimulates the contraction of arteries and can create irregularities in the heartbeat, which makes the organ work harder. Cigarettes also increase the chances of the accumulation of fatty plaques in the arteries, affect the levels of cholesterol and fibrinogen, which increases the chances of a blood clot and, consequently, of a heart attack.
Finally, we can not fail to mention illicit drugs, mainly cocaine and its synthetic variations, which have a relevant role in increasing the incidence of heart attacks in young people, even without associated risk factors.
Heart attacks can happen to anyone, but the risk is especially high when it comes to genetics. It is estimated, for example, that children of hypertensive parents or those who have already had a stroke are 50% more likely to suffer an early heart attack.
Heredity can also interfere with cholesterol. In some cases, high cholesterol is related to what is called familial hypercholesterolemia. About 1% to 2% of children have this condition, and they should have their cholesterol levels monitored before they are even five years old.
Studies reveal that the accumulation of fatty plaques in the body’s arteries, especially in the coronary arteries, begins in childhood and progresses to adulthood. With time and lack of care, coronary artery disease can develop.
Therefore, in addition to the factors that can interfere, it is also essential to consider family history in cases of infarction in young people. Investigation and follow-up, when there are records of cases of parents and close relatives, are extremely important. Without prior knowledge, cardiovascular impairment is often revealed only at the time of the infarction itself. Thus, the faster the probability of the disease is identified, the better.
Are young people less likely to resist heart attacks?
You may have heard that infarction in young people is more serious and fatal than in older people. What many say is that over time the heart is better prepared for future problems. This whole story has different opinions and it is not so simple.
But the question revolves around what we call collateral circulation, that is, a network of blood vessels that develops around the heart muscle over the years or for those who have faced a heart attack throughout their lives. A kind of natural protection, an alternative route if an artery is blocked, ensuring that the blood reaches the heart muscle.
Thus, even if young people have more physical strength to endure a heart attack, the problem among older people would be less intense and slower because of this compensation.
What has been studied, however, is that collateral circulation may, indeed, be decisive for the outcome of a heart attack, but age would not have an influence on this phenomenon, since there are indications that it is not higher or lower in the young, but genetically determined.
The fact is that there is still no consensus on the degree of mortality to have or not to do with age, however, in relation to the sequels everyone agrees: in this case, age is not the main determining factor, but the speed of First aid.
The faster medical care is started, the less time it takes to restore blood flow, as well as damage to myocardium and heart muscle cells, with the possibility of complete recovery.
Therefore, it is no longer possible to determine an age at risk for a heart attack. The idea that prevention should start at age 40 is a thing of the past. Care must begin before birth and extend throughout life. This is because, as we have seen, the problem is directly linked to exposure to risk factors, in addition to the genetic issue.
For this reason, much more than just understanding the symptoms and seeking help when any signs appear, it is very important to give due attention to the heart and keep the cardiac check-up up to date, even in the absence of symptoms. Many factors can be controlled with medical monitoring, changes in habits and lifestyle, reducing the chances of heart attack and other heart diseases throughout life.