Heart disease is something we think primarily affects older adults. For decades, our prevention campaigns focused on middle-aged and senior populations. But in recent years, doctors have been seeing a troubling shift as more young adults are being diagnosed with cardiovascular disease, sometimes in their 20s and 30s.

The reasons behind this trend are complex, but the warning is clear: heart health isn’t something you can put off until later in life. It matters now.

A Changing Landscape of Risk
Medical records and national health surveys show that the rates of obesity, high blood pressure, and type 2 diabetes have risen sharply among people under 40. Many of these conditions were once rare in this age group. Today, they’re far more common and set the stage for earlier development of heart disease.

Lifestyle factors are also playing a role. Sedentary work, long hours of screen time, diets high in processed foods, chronic stress, and poor sleep habits all contribute to cardiovascular strain. Add in the fact that vaping and smoking rates remain significant among young adults, and the heart faces more threats at an earlier age than in past generations.

“Heart disease doesn’t happen overnight, it’s the result of changes in health that can start years, even decades, before symptoms appear,” says Dr. Eduardo Hernandez, cardiologist at The Texas Heart Institute Center for Cardiovascular Care. “We are seeing patients in their 30s with advanced plaque buildup in their arteries, something we used to see mostly in their parents’ generation.”

Why Prevention Can’t Wait
The problem with early-onset heart disease is that it doesn’t just shorten life expectancy, but it can significantly impact quality of life for decades. A heart attack or heart failure at a young age can limit physical activity, increase medical costs, and cause emotional stress that affects work, relationships, and mental health.

The good news is that most of the risk factors for cardiovascular disease are preventable or manageable. Regular physical activity, a diet rich in fruits, vegetables, and whole grains, not smoking, maintaining a healthy weight, and managing stress can all dramatically lower risk. Importantly, regular checkups and blood pressure, cholesterol, and blood sugar screenings should begin earlier than many young adults realize—often by the mid-20s, especially for those with a family history of heart disease.

Young adults should know that the decisions they make today will shape their heart health decades from now. As Dr. Hernandez notes, “The earlier we act, including efforts such improving our diet, exercising more, or getting screened, the better chance we have to prevent disease before it starts.”

Heart health is a lifelong journey. For young adults, the time to start is today.