“We are witnessing a simmering public health crisis,” Rishi K. Wadhera, an assistant professor of medicine at Harvard Medical School and one of the study’s authors, wrote in an email.
Deaths from heart attacks and other effects of cardiovascular disease has declined in the United States due to medical advances in prevention and treatment. This progress has stalled over the past decade.
Colon cancer burden shifting to young adults, study warns
The study, published in the Journal of the American Medical Association, aimed to examine whether young adults were increasingly at risk, using data between 2009 and 2020.
The results have been mixed. There has been an increase in obesity (from 33% to 41%) and diabetes (from 3% to 4%). Hypertension showed no significant improvement: it increased slightly from 9% to 11.5%, but the increase did not quite reach statistical significance.
Hyperlipidemia – high cholesterol or triglyceride levels – fell from 40.5% to 26%.
Young black adults are at greatest risk. Hypertension is twice as common among them as in other racial and ethnic groups. Diabetes and obesity are also more common.
The study authors identified structural racial inequalities in American society as a driver of the gaps.
“Black youth are more likely to live in low-income households that experience housing instability and food insecurity, as well as socio-economically disadvantaged neighborhoods,” Wadhera said. “Black people also disproportionately face difficulty accessing primary and preventive care, and are more likely to reside in ‘pharmaceutical deserts'” – a reference to areas where medicines are more difficult to access.
Hypertension is increasing among Hispanics, a trend not evident among other groups.
High-sodium diets and ultra-processed foods are among the factors behind the rise in hypertension among Hispanics, researchers say. They emphasized that it transcends life choices. When people struggle to pay their bills, they often turn to cheaper, less healthy foods. Fresh produce is more difficult to find in areas where there are few grocery stores.
Researchers suspect that the decline in young adults with high cholesterol is partly explained by greater regulation of trans fats in food.
The study did not identify a big difference in cardiovascular risk factors between men and women.
They also warned that it is unclear whether the trends have persisted since the start of the coronavirus pandemic, as the study only covered up to 2020.
Here are some of the ways the study authors suggest to address the disparities:
- Expand large-scale efforts to screen and treat young black adults with hypertension.
- Screen people with diabetes earlier in life, as current guidelines often apply to people 35 and older.
- Launched a public health campaign against the rise of diabetes among Mexican American adults, culturally competent and shaped by community leaders.
- Create more green spaces in communities that encourage exercise to counter sedentary lifestyles that contribute to rising obesity.
Without action to reverse the trends, the public health consequences could be disastrous, the study warned.
“The increasing burden of risk factors we have observed in young adults – particularly if these trends continue – could lead to a long-term tsunami of cardiovascular disease and ultimately an increase in cardiovascular mortality as the population America is getting old,” Wadhera said. .