Alarming Rise in CAD Among Youngsters: Causes and Preventions

Heart disease is now a serious worry for younger individuals as well, with more cardiac-related deaths happening in people under the age of 50. Therefore, it is vital to comprehend the causes of the rise in heart illness in this age group as well as the specific cardiac issues that are plaguing them.

What is CAD?

CAD stands for “Coronary Artery Disease,” a condition where the arteries supplying blood to the heart become narrowed or blocked, potentially leading to heart problems like chest pain and heart attacks.

The prevalence of coronary artery disease (CAD) has emerged as a concerning trend among youngsters who possess risk factors such as age, family history, high blood pressure, high cholesterol levels, smoking, obesity, and a sedentary lifestyle.

Major Risk Factors for CAD in youngsters

• Smoking: Tobacco use remains a significant risk factor for CAD, even in youngsters. 
• Obesity: The prevalence of obesity among youngsters is a growing concern, as it contributes to conditions like hypertension, dyslipidemia, and insulin resistance, which elevate the risk of artery disease.
• Physical Inactivity: Sedentary behavior, which is prevalent in youngsters, puts the cardiovascular system at serious risk, necessitating frequent exercise for better heart health.
• Dyslipidemia (Abnormal Cholesterol): youngsters with unhealthy cholesterol profiles, including low HDL levels and high triglycerides (TGL), are at an increased risk of developing atheromatous CAD.
• Unhealthy Eating Patterns: Poor dietary choices, such as consuming excessive saturated fats, processed foods, and refined sugars, play a significant role in the development of youngsters.
• Hypertension: High blood pressure affects individuals of all ages. youngsters with uncontrolled hypertension are at a higher risk.
• Muscle Enhancing Supplements and Food Junking: The use of muscle-enhancing supplements and frequent indulgence in junk food can exacerbate the risk of CAD among youngsters.

Are you aware that youngsters are increasingly at risk of Coronary Artery Disease ?

Types of CAD vary among youngsters

• Males-Atheromatous CAD: This form of CAD is more common in young millennials and is characterized by the buildup of atherosclerotic plaques in the coronary arteries, leading to reduced blood flow. Risk factors like smoking, obesity, and dyslipidemia are closely associated with this type of CAD. Also the increased HDL, triglycerides, and lipoprotein(a) levels heighten the risk of atherosclerosis, leading to acute coronary syndrome (ACS). Meanwhile, hyperhomocysteinemia is associated with vascular diseases such as stroke and coronary artery disease (CAD), especially in young individuals, particularly those with a genetic predisposition known as familial hypercholesterolemia.

• Young Men- Non Atheromatous CAD: Youngsters may develop CAD due to congenital abnormalities of the coronary arteries, valvular diseases, myocardial bridging, or coronary compression. Illicit drug abuse, especially cocaine, can also lead to coronary spasms and increased coagulability.
• Young Women-Specific Conditions: Young women may face unique CAD risks, such as spontaneous coronary artery dissection, coronary vasculitis, coronary ectasia, coronary fibromuscular dysplasia, and increased risks due to long-term use of oral contraceptives.
• Syndromes and Conditions: Certain medical conditions like antiphospholipid syndrome, nephrotic syndrome, and Factor V Leiden mutations can predispose youngsters to CAD.

Solutions to Combat CAD

Prevention and early Diagnosis  are crucial in addressing this alarming trend of CAD in youngsters. Here are some solutions:

• DASH Diet: Adopting the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, lean protein, and low-fat dairy, can help reduce CAD risk.
• Physical Activity: Engaging in at least 30 minutes of moderate-intensity exercise on most days or breaking it into three 10-minute blocks can promote cardiovascular health.
• Smoking Cessation: Quitting smoking is one of the most effective ways to reduce CAD risk.
• Limit Alcohol Consumption: Moderation in alcohol consumption is advisable.
• Quality Sleep: Ensure you get sufficient, good-quality sleep to support overall health.

Screening Tests for CAD

Regular screening can aid in early detection and risk assessment. Consider the following tests:

• Complete Blood Panel (CBP): To monitor blood parameters and detect abnormalities.
• Lipid Panel: To measure cholesterol levels and assess cardiovascular risk.
• Homocysteine Levels (S. Homocysteine): Elevated homocysteine levels are associated with CAD risk.
• HbA1c: A measure of long-term blood sugar control, important for diabetes assessment.
• Fibrinogen Levels: Elevated fibrinogen is linked to increased CAD risk.
• TBH Levels: Total Body Homocysteine levels can provide additional insights into CAD risk.
• MPO Antibody Test (pANCA): To evaluate markers of inflammation associated with CAD.
• Vitamin D Levels: Low levels of vitamin D have been associated with increased CAD risk.
• ASCVD Risk Calculator: Use an atherosclerotic cardiovascular disease (ASCVD) risk calculator to assess your individual risk profile. The ASCVD Risk Calculator Categories:
• <5%: Low risk
• 5-7.5%: Header line risk
• 7.5%-20%: High risk
• >20%: Very high risk

If your risk exceeds 7.5%, your healthcare provider may recommend high-intensity statin therapy.

Youth, let’s win the battle against CAD!

The alarming rise of CAD in youngsters is a public health concern that demands attention. Addressing risk factors through lifestyle changes, early screening, and appropriate medical management can help curb this trend. It is essential for both individuals and healthcare providers to be proactive in preventing and detecting CAD in youngsters, as this can ultimately save lives and improve the quality of life for the younger generation.

References:

• NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5183972/
• JACC: https://www.jacc.org/doi/10.1016/j.jacc.2019.08.1023
• Wolters kluwer: https://www.uptodate.com/contents/coronary-artery-disease-and-myocardial-infarction-in-young-people
• Harvard Health https://www.health.harvard.edu/heart-health/premature-heart-disease
• Narayana Health: https://www.narayanahealth.org/blog/cad-heart-disease-in-young-people/