Heart Failure for People Under 65 Is Rising: How to Reduce Your Risk

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Diet, exercise, and a knowledge of your family medical history can all help you manage and lower your risk of heart failure. Getty Images
  • Heart failure, also called congestive heart failure, is when the heart doesn’t pump blood as well as it needs to.
  • Over the past decade, death rates from heart failure for adults between 35 and 64 years old have been increasing.
  • According to experts, this is partially due to a “clustering of risk factors” in young adults, such as hypertension, high blood pressure, rising rates of obesity, and coronary artery disease.
  • A healthy diet, regular exercise, and knowing your family history can help prevent and manage heart failure for those who are at risk.

It was just before the Fourth of July three years ago when John Sousa, 44, knew something was seriously wrong with his health.

For about a month, he had trouble breathing, which he initially passed off as part of his asthma symptoms from seasonal allergies. But this was different. His inhaler wasn’t working like it normally did.

Concerned, Sousa visited his doctor who treated him for an upper respiratory infection.

While some antibiotics and steroids improved his condition slightly, within 10 days, he was back at the doctor’s office. He was given another round of steroids and just days later was back. His breathing was worse.

“This time, the nurse asked me ‘weird questions’ like, ‘Did I have chest pains?’ Those kind of things. She was like, ‘I’m going to do an EKG’ (electrocardiogram), and the next thing I knew, I had an appointment to see a cardiologist the day before the Fourth of July,” Sousa told Healthline.

The results shocked him. Sousa was diagnosed with a chronic type of heart failure. He had no family history of heart disease.

“I couldn’t even wrap my brain around it,” he said of his diagnosis. “It was overwhelming. ‘I was going to die’ was the only thing I could think. I started Googling the survival rates and saw these terrible statistics. It took me probably about six months before I was able to wrap my brain around what heart failure was and that it was something that could be managed.”

Heart failure, also called congestive heart failure, is when the heart doesn’t pump blood as well as it needs to, according to the Mayo Clinic.

Related conditions, such as high blood pressure, might diminish the heart’s ability to pump blood effectively, and symptoms range from shortness of breath, swelling of the feet, ankles and legs, and fatigue, among others.

And it’s a condition that’s more common than many people realize.

A recent report published in the journal Circulation reveals an estimated 6.2 million adults in the United States lived with heart failure between the years 2013 and 2016. This is up from the 5.7 million adults with the chronic condition between 2009 and 2012.

One reason why heart failure didn’t occur right away to Sousa as a possibility for what was happening to him is the fact that it’s often associated with older adults.

Just in his early 40s, the father of two from Tennessee assumed he’d be too young for that kind of diagnosis. However, this is an assumption that’s beginning to shift for those who are under 65 years old.

An article recently published in the Journal of the American College of Cardiology highlights that heart failure is rising in people under the age of 65.

Over the past decade, death rates for adults between 35 and 64 years old have been increasing, something even more pronounced for African American adults. The article reveals that the heart failure-related death rates for young black men and women have been rising compared to their white counterparts.

Dr. Andrew T. Darlington, DO, a cardiologist who specializes in advanced heart failure at the Piedmont Heart Institute in the greater Atlanta area, told Healthline that more and more diagnoses of young adults are becoming all too common.

Darlington said there’s an increasing prevalence of a range of common risk factors for heart failure among young people in the United States. We’re seeing what he calls a “clustering of risk factors” in young adults, from hypertension to high blood pressure to rising rates of obesity and coronary artery disease.

Dr. Jerry Estep, who specializes in cardiovascular medicine at the Cleveland Clinic, told Healthline that he sees people of all ages from all kinds of backgrounds who have heart failure diagnoses.

“Heart failure has many faces,” he said. “In the field, we certainly appreciate epidemiology-based studies, especially those that highlight that black men and women are at higher risk for having the disease and more adverse events related to heart failure syndrome.”

Estep said that it’s been shown that black men under 65 are more than twofold higher than white men to have heart failure-related death, with black women closer to threefold higher than white women.

This is partially due to higher rates of risk factors for heart failure, like diabetes, obesity, and hypertension, among people in the African American community.

Estep stressed that it’s crucial the medical community continues to carefully examine these kinds of trends, especially to make people aware of the risk factors and ways to manage them.

When Sousa received his diagnosis, he knew that it was crucial he make some adjustments in his life to manage his condition. A father of two young daughters who are 8 and 14 years, he’s been taking a daily medication called Entresto.

Beyond that, he’s made some significant lifestyle changes to maintain his health. He’s seriously reduced the amount of salt in his diet, and he’s been working with a nurse and a nutritionist to devise healthy recipes and make a meal plan to ensure he’s preparing heart-healthy meals.

Sousa has also increased his daily physical activity. He does a lot of walking — especially early morning walks with his dog — and he added that he’s lost some weight in the years since his diagnosis.

For anyone like him who’s trying to stay physically active during the warm summer months, he cautioned that it’s necessary to stay cool and hydrated.

“I do find even though my condition has improved, I’m pretty sensitive to being outside when it is really, really hot,” said Sousa, who works in marketing and lives in the greater Nashville, Tennessee area.

Sousa said it’s important to listen to your own body and learn that moderation is key.

“I want to express how important lifestyle modification is,” Darlington added. “Partly, how we achieve that is maintaining a healthy body weight, and obesity is one of the biggest drivers and risk factors. I always tell people who are overweight and want to manage obesity to maintain a healthy body weight with caloric restriction and daily exercise.”

Was it hard to make these adjustments? Sousa said he had a clear motivator to stay healthy.

“Not dying was a real motivator for me. Once I got through being overwhelmed and understood what I needed to do, I was able to make the right adjustments,” he said. “I’m lucky to have a great support system at home. My wife and kids are supportive of me, which makes it easier.”

Estep said that prevention is key. He said that people who do what Sousa did — making needed changes to their lifestyle — are on the correct path to staying healthy. Beyond this, those who don’t have a diagnosis should carry out the same behaviors to avoid the disease.

“Awareness and prevention are key,” he explained. “People positioning themselves to mitigate the potential to even develop the disease is crucial Prevention is a real need, and it’s tied to better exercise, diet, and knowing your family history. This all relates to heart disease in general, as well as heart failure. We can’t lose sight of the importance of prevention in managing one’s health.”

Sousa said it’s essential to always take your doctor’s advice. When it comes to his family, he sees a solid support system, but most importantly, a reason to get and stay healthy.

“I thought about my daughters a lot. I love my kids, I want to see what they do with their lives. It’s important that my wife and I model healthy behavior for them,” he said. “I don’t know at this point if it’s a genetic problem because I have no family history of it, but I know I don’t want my girls to go through this if it can be prevented. If I start being healthier, hopefully they’ll carry some of those habits, too.”



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