Population Health

Young Adult Risks Factors Predict CVD Tsunami

Among all the ACC presentations that addressed cardiovascular disease prevention, one particularly alarming study underscored how crucial those preventative actions might be if we’re going to avoid a “tsunami of cardiovascular disease over the long-term.”

The JAMA-published serial cross-sectional study (n=12,924) revealed an alarmingly high and rapidly increasing prevalence of major CVD risk factors among young adult Americans (20-44yrs).

Their comparison of the 2009-2010 and 2017-2020 periods revealed that:

  • Diabetes jumped from 3.0% to 4.1%
  • Obesity increased from 32.7% to 40.9%
  • Hypertension rates rose from 9.3% to 11.5% (not statistically significant)
  • Only hyperlipidemia fell 40.5% to 36.1%
  • And smoking rates stayed stable and high (40% w/ smoking history)

Racial minorities were among the most affected, as Black young adults had the highest rates of hypertension (1 in 5, 2x higher than any other group), while Mexican American and other Hispanic adults saw notable increases in hypertension and diabetes. 

Treatments rates and effectiveness didn’t keep up with these increases:

  • Only 55% with hypertension were receiving treatment in both periods
  • The percentage treated for hypertension who achieved blood pressure control didn’t significantly change (65% to 74.8%)
  • Diabetes treatment rates stayed low (62.4% to 54.5%)
  • Glycemic control among those who received diabetes treatment “remained suboptimal” (45.5% to 56.6%).

Considering that this data is from 22 to 44 year-olds, just about everyone who saw these results were alarmed about future rates of cardiovascular disease and death. 

So what can we do about it? The authors urged expanding risk factor screening and public health efforts, specifically targeting earlier age ranges and at-risk minority groups.


Cardiovascular-related deaths have been on the decline for quite a while, but that progress stagnated during the past decade, and the “smoldering public health crisis” exposed by this data suggests that increasing CVD rates and worsening outcomes could be on the way without action.

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