AHA Tackles Need for Increased CV Prevention in Emerging Adults

As the prevalence of cardiovascular disease rises in young adults, clinicians need to shift their focus toward more intentional prevention efforts in those emerging from adolescence, according to a scientific statement from the American Heart Association.

“We’re seeing more chronic conditions manifest in younger populations,” writing committee chair Jewel Scott, PhD, RN (University of South Carolina, Columbia), told TCTMD. “We also know that there are a lot of struggles that emerging adults face that can also intersect with their cardiovascular health, such as mental health struggles, substance use, [and] being able to access the healthcare system.”

As such, “prevention has to begin earlier,” she stressed. “It should start in childhood and adolescence, but there’s something about that transition to fuller independence when we have an opportunity to really home in and motivate people to maintain their cardiovascular health.”

In their paper, published online last month in the Journal of the American Heart Association, Scott and colleagues define emerging adulthood as between ages 18 and 25 years, and sometimes up to age 29. For many, this is an intense time of transition, when health may not be at the forefront.

The authors outline some of the major health challenges for this population, including lifestyle changes related to living away from home for the first time, coming off parental health insurance, the potential for substance abuse, and detrimental effects of social media. There are population-level risk factors that begin to emerge during this transition, they add, such as early-onset hypertension in African Americans, as seen in the longitudinal CARDIA study.

Risk factor screening protocols are not universally agreed upon, but the paper suggests metrics for investigating for hypertension, obesity, hyperlipidemia, and diabetes based on current prevalence. It also emphasizes the importance of diet, physical activity, tobacco use, and sleep and how to put these lifestyle factors into context based on social and developmental factors, as well as the potential barriers, for those emerging from adolescence.

For those who do make it in to see the doctor, Scott noted that “cardiovascular health at this age is often overlooked.” She’d like to see change in this regard, as well as the creation of new public health programs to help address this treatment gap.

One idea would be to make sure that their health insurance includes telehealth, Scott suggested. “Being able to take healthcare to them could be really meaningful,” she said.

Additionally, Scott would like to see more large campaigns designed to increase physical activity, which naturally tends to drop off after adolescence, and expand access to healthy food. Improving preconception health will also have ripple effects to future generations, she added.

“There are opportunities to create some really innovative healthcare delivery models that would focus on emerging adults,” Scott said.