Cardiovascular mortality rates in the U.S. had been declining, but they have slowed over the past decade. This may be a result of cardiovascular risk factors, such as obesity, diabetes and hypertension, that have risen, particularly among young adults, putting them at increased risk of heart disease and premature death.
An increase in the onset of cardiovascular risk factors in young adults could have significant public health implications as the U.S. population ages, according to a new study. The researchers, led by a team at Harvard Medical School, found that rates of cardiovascular risk factors among young adults are high and continue to increase, particularly among those who are Black and Latinx.
“Most prior work has focused on the older U.S. population, and young adults have been left out,” researcher Rishi Wadhera told TheDoctor. Because of this, he and his team wanted to better understand how rates in cardiovascular risk factors among young adults were changing. As they suspected, it wasn’t good.
The rate of obesity among young adults has increased by about eight percent.
The rate of hypertension among participants increased by a little more than two percent during the study period, and the rate of diabetes increased about one percent. Obesity also significantly rose by about eight percent. Hyperlipidemia decreased by more than four percent.
Among young adults who were treated for hypertension, the rate of blood pressure control did not change significantly during the study period. Rates of glycemic control in those with diabetes remained below the desired treatment goals.
Trends in cardiovascular risk factors were mostly the same for women and men, however, there were disparities among racial and ethnic groups.
Compared to other groups, young Black adults had the highest rates of hypertension, which increased more than four percent during the study period. Mexican American and other Hispanic adults had significant increases in rates of hypertension of three percent and six percent, respectively. Mexican American adults also had a significant increase in the rate of diabetes of a little more than three percent.
Young adults of color also face more challenges in accessing primary and preventive care and preventive health screenings in part because they are more likely to be uninsured. Going forward, Wadhera and his colleagues want to see if strategies to expand insurance coverage to young adults could address disparities in cardiovascular health outcomes. He said Medicaid expansion under the Affordable Care Act led to many low-income young adults getting insurance coverage. “Expanding Medicaid in states that have yet to do so might address some of the concerning trends in cardiovascular risk factors among young adults.”
“Make the healthy choice the easy choice.”
Some work has been done to develop community-based interventions, such as through community health educators and barbershops for Black men. Programs run at local churches have also been able to improve cardiovascular risk factors among members of the community. “We must work with these communities to identify opportunities to educate them about these risk factors,” Norrina Allen, co-author of a related editorial, told TheDoctor.
Programs supporting a healthy diet, such as policy changes through WIC, the federal supplementary nutrition program, are also important. As Allen, an associate professor of epidemiology and pediatrics at the Feinberg School of Medicine in Chicago, put it, “Make the healthy choice the easy choice.”