‘I’m a Cardiologist, and This Is What People in Their 20s and 30s Get Wrong About Heart Health’

For most people, heart issues don’t start cropping up until one reaches their fifties or sixties. But that doesn’t mean you shouldn’t care about your heart health earlier in life. Heart disease is still the leading cause of death in the United States. Satjit Bhusri, MD, FACC, a New York City-based cardiologist, says the choices you make in your twenties and thirties largely impact your heart health as you get older.

“Heart disease is a slow, gradual accumulation of cholesterol and plaque in the arteries. Hypertension is a slow progression of hardening of the arteries,” says Dr. Bhursi, the founder of Upper East Side Cardiology. “It’s not something that all of a sudden happens when you hit 50. This is something that accumulated—you have to understand that it starts young.”

A 2019 Blue Cross Blue Shield report that shows that the health of millennials is declining faster than that of the previous generation. The report found that between 2014 and 2017, incidences of hypertension and high cholesterol increased by 16 and 12 percent, respectively, among millennials. High blood pressure awareness among Americans is also decreasing, following 15 years of increasing levels of awareness.

Dr. Bhusri explains that cardiology is focusing more on prevention and screening so doctors are catching warning signs before people develop issues like heart disease or have a heart attack.

“For people in their twenties and thirties, the real screening starts with a detailed family history,” says Dr. Bhursi. “The second thing is definitely a physical exam where we look for heart murmurs or irregular heartbeat. The third thing is examining symptoms.” If you are in you’re in your twenties and thirties and you’re passing out or having unexplained chest pain, he says those are important red flags.

Brian Lima, MD, a cardiac surgeon based on Long Island, NY, says if your doctors do spot that something is off, the earlier they catch it, the better.

“A good analogy is cigarette smoking. In the medical field, we always talk about ‘how many pack years does so-and-so have?’ Meaning how many years have they been smoking a pack per day,” says Dr. Lima, author of Heart to Beat ($14). The negative impacts of get worse the longer you’ve smoked. “The same applies for hypertension and high blood pressure. The longer you’ve subjected your body to increased tension in the blood vessels [and] increased blood pressure, more damage can accumulate over time.”

And if you’ve recovered from COVID-19, you’ll want to be even more careful when it comes to monitoring your heart health.

“In your twenties and thirties, if you did have COVID-19, that is a whole new ballgame because we’re seeing young populations who had COVID-19 coming in with a multiple increase in abnormal heartbeat, in heart failure, in inflammation of the heart,” says Dr. Bhusri.

Dr. Lima says that young people should consider how current lifestyle habits impact their heart health. He recommends living an active lifestyle. The American Heart Association recommends that adults get at least 150 minutes per week of moderate aerobic activity or 75 minutes of vigorous aerobic activity to promote a healthy heart. Additionally, you’ll want to make sure you’re maintaining strong mental health.

“There’s an all-time high in depression and things like that among the millennial population,” says Dr. Lima. “Mental health and heart health go hand in hand.” This 2011 review study shows that 20 to 40 percent of cardiac patients meet the criteria for major depressive disorder. And this 2020 review shows that by middle age, women who have clinical depression are twice as likely to have an incident cardiovascular disease (such as a stroke or heart disease) than those without.

Dr. Bhusri adds that young people should do what they can to avoid getting type II diabetes and becoming a heavy smoker. If you can decrease the risk associated with the modifying factors (factors you can control, like smoking) and screen for the non-modifiable factors (like family history), all the better. Visit your doctor for a checkup at least once a year, he says.

“With social media and Google and WebMD and all those things, I think many people think they don’t need to see a doctor on a regular basis,” says Dr. Lima. “That’s really the biggest mistake anybody could make. Like it or not, even if you think you’re doing the right thing from a health perspective, you can’t control your genes or your family history.”

If you’re interested in tracking your heart health, watch What the Wellness host Ella Dove try heart rate monitors: