Heart disease, which is on the rise among young people (and is not as benign as previously thought)

Atrial fibrillation (AF), the most common arrhythmia in older people, is increasingly occurring in younger people, where it can also cause serious consequences. This is confirmed by the experience of cardiologists and confirmed by a recent study conducted in the USA.

This cardiovascular disease, which increases the risk of heart disease, has become the most treatable type of arrhythmia in Spanish hospitals and is growing beyond all expectations. “There is talk that a real epidemic of AF may occur within 10 or 20 years,” says Ignasi Angera, director of the arrhythmia department at Bellwitge Hospital.

Ignasi Angera: “AF may become a real epidemic in 10–20 years”

AF is an arrhythmia, that is, a change in heart rhythm. This condition, which increases the risk of heart failure and stroke, has historically been associated with age and was not thought to be a factor in the development of other pathologies in younger patients. A study conducted by the University of Pittsburgh Medical Center with data from more than 67,000 people treated, a quarter of whom were under 65 years of age, concluded that these patients had a significantly higher risk of hospitalization for heart failure, stroke and myocardial infarction than women without it. . atrial fibrillation.

The results are alarming, as cases of AF are becoming more and more common in all age groups, especially among young people, confirms Ivo Roca, head of the arrhythmia department at the Barcelona Hospital Clinic. In his opinion, this expansion is explained by several factors: “First of all, arrhythmia is being detected more and more carefully, because what was considered a benign arrhythmia is now considered serious. Since we have new detection tools, every day we make scanning in younger patients. They are no longer there, of course, but we discovered it earlier.”

On the other hand, AF is part of a group of diseases caused, to a certain extent, by cardiovascular risk factors. “This diet has led to an increase in obesity in our community, as happened many years ago in the United States among young people,” says the cardiologist.

According to experts, another phenomenon that explains the increase in the prevalence of AF among young people is smart watches that can accurately perform electrocardiograms and sound the alarm. Thus, many cases of asymptomatic AF or cases with mild symptoms such as palpitations or rapid heartbeat have been identified.

According to Dr. Angera, a characteristic detail is the fact that AF affects a subgroup of young patients without other heart disease (isolated atrial fibrillation). The increase in the number of cases is due to the ease of identification and the presence of very pronounced precipitating factors: high blood pressure, excessive alcohol consumption, sleep apnea, obesity or a sedentary lifestyle. Just a few years ago, other arrhythmias were more common; now AF is in first place and is growing without inhibition. “Increase in incidence always exceeds expectations, every time forecasts exceed forecasts for the number of patients we care for. They say that in 10–20 years this could become a real epidemic,” says the cardiologist.

Diet, hypertension, sedentary lifestyle, sleep apnea or alcohol, trigger factors

Exercise has been shown to have cardioprotective effects. Although, paradoxically, if practiced excessively, this can become a trigger for AF, and such excess is usually committed by young people. “There is a subgroup of people who perform high-intensity exercise for many hours in training and competition,” Angera says. This practice causes the heart rate to increase, which causes problems with the heart muscle (fibrosis) and, over time, significantly increases the likelihood of developing an arrhythmia.

Given the rise in cases and the realization that they can also cause serious consequences in young people, Angera calls for prevention: “This is important because young people tend to think that they are free from cardiovascular risks and there is a certain laziness. They need to have their hypertension well controlled, exercise moderately to regularly, control their weight, and treat their sleep apnea. It’s hard for young people to take responsibility, but they have to do it.”

There is a solution: prevention and early detection

The positive thing about the dynamics of the growth and spread of joint fibrillation is that it clearly responds to prevention, and treatment is highly effective if carried out in the initial stages, hence the importance of early detection. Prevention according to cardiovascular health: healthy lifestyle, Mediterranean diet, regular and moderate exercise, control of obesity, hypertension and sleep apnea. “If you have doubts, consult your doctor in advance,” advises Ivo Roca: “If we leave AF untreated, it can develop into heart failure or cerebral stroke. If it is detected, preventive treatment is carried out – cardiac ablation with catheters – a minimally invasive procedure that eliminates the source of arrhythmia. If you do this early, your long-term success rate is 80%.

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