Study Finds Many Younger Adults Face Hidden Long-Term Risk of Heart Disease

Doctors are urged to look beyond short-term risk as heart disease is projected to surge over the next 25 years among younger Americans.

Chest pain may be the result of a heart condition or a lung-related issue. Andrey Mihaylov/Shutterstock

A new study shows that millions of adults in their 30s, 40s, and 50s could be on track to develop serious heart problems, even if their short-term health appears fine today, Northwestern University said in an April 25 statement.

Research from the university’s School of Medicine, published in JAMA, found that about one in seven adults between the ages of 30 and 59 has a high 30-year risk for cardiovascular disease. Yet most would not be flagged during a typical checkup because their short-term, 10-year risk appears low.

“While short-term or 10-year risk has been our standard of care, this analysis reflects an important shift in preventive cardiology and helps to raise public awareness that risk for heart disease can be detected even in young adults,” said Dr. Sadiya Khan, senior author of the study and professor of cardiovascular epidemiology at Northwestern.

The research used a new tool developed by the American Heart Association to assess both short- and long-term risk. It analyzed data from more than 9,700 adults who had no signs of existing heart disease, representing about 101 million people nationwide. While the majority showed low short-term risk, around one in seven were found to have high risk over a 30-year period.

The report said that kind of risk often goes unnoticed in primary care, where doctors rely heavily on 10-year risk models to guide treatment decisions.

“This helps demonstrate the importance of calculating both long-term and short-term risk when seeing a patient in primary care to communicate a more comprehensive assessment of a person’s risk of developing heart disease,” Khan said in the statement.

“If a younger person has a higher-risk 30-year [cardiovascular disease risk] score, earlier interventions and emphasis on preventive measures should be considered to potentially improve [cardiovascular disease risk score] outcomes.”

The findings come at a time when the overall burden of heart disease in the United States is expected to increase sharply. Researchers cited a forecast from the American Heart Association last year, which projects that more than 184 million adults—more than 60 percent of the population—will have some form of cardiovascular disease or high blood pressure by 2050.

Rising rates of hypertension (high blood pressure), obesity, diabetes, and an aging population are expected to drive much of the increase. The forecast estimates that hypertension will affect 61 percent of adults by 2050, diabetes will grow to nearly 27 percent, and obesity will reach more than 60 percent.

While smoking rates and physical inactivity are expected to decline, problems such as poor sleep and rising blood pressure are expected to worsen, according to the AHA forecast cited by the researchers.

Heart-related conditions such as coronary disease, heart failure, stroke, and atrial fibrillation are also projected to increase across the country, especially among younger and middle-aged adults. Researchers noted that after decades of progress, rates of heart disease and stroke have begun rising again in recent years.

Khan said identifying long-term risks in younger adults can help target early interventions, such as diet changes, increased physical activity, and blood pressure management, that could prevent serious health problems later in life.

“These individuals represent a group who may benefit from more intensive preventative efforts (eg, intensive lifestyle intervention, earlier initiation of statin or antihypertensive therapies),” the report said.

Experts say doctors should begin using both 10- and 30-year heart-risk calculators in checkups to better inform patients and guide prevention strategies, especially as new treatments for obesity and diabetes become more widely available.

Without broader changes, researchers warn that the United States will face a growing wave of heart disease that could overwhelm the health system in the future and shorten lives.