Heart disease in young peopleNews /
Coronary disease in middle age and the elderly is the greatest health burden we face today, but let’s not forget it affects young people too.
The raw numbers hide a host of personal and family stories. Those presenting with heart failure, stroke or arrhythmia include the relatively new phenomenon of people who have had surgery for severe congenital heart conditions in childhood.
Figures from the National Health Survey show that between 2014 and 2015, there were 12,000 people between the ages of 18 to 40 with ischaemic heart disease and another 12,000 with other forms of heart disease including heart failure. In addition, 80,000 have an irregular or abnormal heart rhythm and 11,500 have cerebrovascular disease.
For hospitalisations in the 2013 and 2014 financial year, for those aged 20 to 40:
- 2,100 hospitalised due to ischaemic heart disease
- 1,045 hospitalised for heart attack
- 570 hospitalised for heart failure
- 3,900 hospitalised for an arrhythmia
- 1,370 hospitalised for stroke.
Genes also play their part. Arrhythmias and even sudden cardiac death can be due to rare inherited conditions. These include diseases that affect people from families with familial hypertrophic or dilated cardiomyopathy; an inherited condition where the heart muscle is thickened, and a weakening of the heart’s main pumping chamber, respectively. Young aboriginal people can suffer rheumatic heart disease and young mothers can develop pulmonary hypertension or eclampsia (high blood pressure) at the time of pregnancy.
After the age of 30 but, occasionally earlier, coronary heart disease affects a surprisingly large number of people. Many will have familial hypercholesterolemia (FH). FH is one of the most common, potentially fatal inherited conditions. When FH is present, the body does not remove enough cholesterol from the blood. This causes high blood cholesterol levels and early heart disease in some families.
This affects 1 in 200-250 Australians so there are about 100,000 people in Australia with FH facing a twenty-fold risk of coronary disease at a young age. It is unrecognised and underestimated .
But every week new understanding of the underlying causes of these conditions is emerging from genetic studies, bringing hope to many families. Through better detection, modern treatments and research, many young Australians suffering heart disease can lead long and productive lives.
 Vickery and Watts , Heart, Lung & Circulation (2016) 25:1045-1047