More young adults are developing serious heart conditions – including heart failure – not just heart attacks, according to Illinois doctors who say the trend has quietly been growing for years.

According to the American College of Cardiology, the heart attack rate in adults younger than 40 grew by almost 2% each year during a 16-year study from 2000 to 2016 in the U.S.

In a study published by Northwestern Medicine in January, about one in five heart attacks occurs in people younger than 40. This represents a significant shift from decades ago, when heart attacks were rare in younger populations.

While heart disease is not the leading cause of death among younger adults, doctors and public health officials in Illinois say the trend is concerning yet largely preventable.

“The prevalence of heart disease in the under-40 population has essentially doubled in the last 10 years,” said Dr. Merrick Donenberg, cardiologist with OSF HealthCare. “The causes of early heart disease are present as early as the teenage years and 20s, but they’re largely preventable.”

At the state level, the data paints a more nuanced picture. Dr. Arti Barnes, chief medical advisor for the Illinois Department of Public Health, said the leading cause of death among adults ages 25 to 44 remains unintentional injuries, including overdoses and motor vehicle crashes. However, she acknowledged that heart disease has been a concern for years.

“We have started noticing this trend for a [few] years now,” Barnes said. “It’s going up – but it’s still unclear what’s driving it at a population level, but we do know that contributors like diabetes and obesity have not improved and likely play a role.”

Donenberg, who works directly with younger patients, firmly believes obesity is correlated with the heart problems young people are experiencing.

“It’s no secret that obesity is still on the rise in this country, and especially among young people,” Donenberg said. “I think what we’re seeing with heart disease is one of the many real health impacts that come with carrying that extra weight. It is ultimately the driver of high blood pressure and impaired glucose handling, which later manifests as diabetes.”

“Those conditions then go on to drive much of the heart disease that we’re seeing more and more of. So, when you’re talking about young patients developing heart problems, in many cases it starts with weight and the metabolic changes that come with it.”

Barnes echoed the same sentiment, noting how obesity rates have contributed to heart problems and rising rates of other chronic conditions.

“We are seeing more younger people being diagnosed with diabetes and obesity,” she said. “It’s not the same for every case, but we can safely say that those are the key drivers of heart disease.”

Smoking remains another major risk factor, particularly in younger patients experiencing heart attacks.

“When I see heart attacks in people under 40, the vast majority are ongoing tobacco users,” Donenberg said.

Although cigarette smoking has declined overall, vaping has risen significantly among younger adults. Donenberg cautioned against the practice.

“Vaping should never be introduced to someone who doesn’t already use nicotine,” he said. “It’s still a harmful, addictive substance.”

Heart failure vs. heart attack

While heart attacks often dominate public perception, Donenberg said a different condition is driving much of the increase in younger patients.

“The biggest rise in young people isn’t heart attacks- it’s congestive heart failure,” Donenberg said. “That goes back to the extra strain on the heart from conditions like obesity.”

Heart failure and heart attacks are different conditions with common causes. Heart attacks happen suddenly when an artery becomes blocked, cutting off blood flow to the heart muscle. Heart failure develops gradually as the heart muscle weakens and struggles to pump blood effectively to nourish the body’s cells. While heart failure is a chronic condition that worsens over time, medications can help patients live longer and better with it.

Donenberg mentioned that symptoms can sometimes be overlooked in younger patients, both by individuals and sometimes by providers.

“If chest discomfort gets worse with physical activity and goes away with rest, that’s a red flag – even in younger patients,” he said. “I think sometimes older physicians might overlook certain symptoms because when they were in medical school decades ago, it wasn’t very normal for someone so young to have heart problems.”

Donenberg said symptoms aren’t always limited to classic chest pain and can sometimes appear in the jaw. Regardless, any pain in either area should be a concern if it worsens with physical activity and goes away with rest.

Prevention strategies

Donenberg recommends focusing on whole, unprocessed foods and maintaining regular physical activity.

“If your food still looks like how it started in nature, you’re generally in a good spot,” he said. “Carbs aren’t the problem – processed carbs are.”

He also advises caution with heavily marketed products like energy drinks.

“We occasionally see very young people hospitalized after drinking multiple energy drinks in a short time,” Donenberg said. “I’ll always advise people to stick to coffee, water, or tea. We know those are well studied and safe, and people have been drinking them for centuries.”

At the public health level, Barnes said the state continues to invest in programs to prevent chronic disease, though funding can be inconsistent.

“We do have outreach programs focused on heart disease, diabetes,, and cholesterol management,” she said. “But sustained progress depends on consistent resources and community engagement.”

Ultimately, both experts stressed that early awareness and early action can make a real difference.

“The foundations of heart health start young,” Donenberg said. “And the earlier we address them, the better the outcomes will be.”

“Sometimes, I see patients whose hearts are in bad condition and I think to myself, ‘If only I saw you 10 or 20 years earlier, we could have intervened, addressed the risk factors and prevented this from happening.’”