Life expectancy in the US is now the lowest it has been since 1996, with young- and middle-aged adults seeing the most rapid declines. These declines began in 2014 and have accelerated over the past 3 years of the pandemic. While COVID-19 represents a significant proportion, increases in heart disease between 2020 and 2021 explain more than 4% of the most recent shortening in life expectancy. These increases in cardiovascular mortality reflect recent disturbing trends in cardiovascular risk determinants and events in younger adults. Although overall cardiovascular disease mortality declined until 2020, hospitalization and death rates flattened or in some cases increased among specific racial and ethnic subgroups of young adults during this time. In particular, hypertensive heart disease, heart failure, and endocarditis have increased in young adults, particularly among Black individuals, through 2018. Consequently, young adults make up a growing proportion of cardiovascular disease events, with the proportion of premature myocardial infarction among adults younger than 40 years increasing by 2% every year. The increasing event rates observed among younger adults can be attributed to the increasing prevalence and onset of risk factors such as obesity and hypertension at younger ages, which exacerbate cumulative exposure and cardiovascular disease risk over near- and long-term time horizons.
Source: JAMA Online First