Until a few years ago, the term "heart attack" typically brought to mind older adults. However, reports of sudden deaths among young people circulating on social media and a rise in vascular diseases and collapses during exercise among those in their 20s, are fueling concerns that heart attacks are striking at younger ages. According to experts, this is partly due to increased awareness, but changes in young people's lifestyles and habits are placing a significant strain on heart health.

Dr. Enes Çelik, a cardiologist at Bilecik Şeyh Edebali University, said heart attacks in young people usually refer to men under 45 and women under 55, but in recent years, he has observed a concerning rise in serious vascular diseases among people in their 20s and 30s.

Lifestyle shift

"Biological age and vascular age are now diverging," said Çelik, attributing this largely to modern lifestyles.

Drawing attention to the effects of the inactive lifestyle that has become widespread following the COVID-19 pandemic, Çelik said, "With the 'stay-at-home' period, people began walking less and sitting for longer periods. Comfort increased, but physical activity decreased dramatically."

Emphasizing that the cardiovascular system requires movement, Çelik said that sitting at a desk all day and remaining physically inactive in front of a screen significantly increases the risk of weight gain, insulin resistance, hypertension and arterial stiffness.

"A significant portion of the metabolic issues we see in the younger age group today are related to this sedentary lifestyle," he said.

Stress, sleepless nights

Experts also consider extended screen time and disrupted sleep patterns as key risk factors. Noting that exposure to phones, tablets, or computers late into the night suppresses melatonin secretion, Çelik explained that this affects sleep quality as well as the vascular system and metabolism.

"Melatonin is not just a sleep hormone. It is also a biological regulator that influences the vascular system, blood pressure balance and metabolism," he said, adding that exposure to bright screen light throughout the night keeps the body in a constant state of alert.

Çelik said that hypertension, arrhythmia, obesity and diabetes are more common in individuals with irregular sleep patterns. Heart rhythm problems and blood pressure fluctuations are now increasingly observed in young people who stay up until 2 or 3 a.m. staring at screens, he added.

Noting that the psychological pressure created by social media use also directly affects heart health, Çelik said, "The constant need to be online, the fear of missing out and mental fatigue create chronic stress. When the brain can’t rest, the heart can’t rest either."

New-generation risk factors

Noting that dietary habits also worsen the situation, Çelik explained that ultra-processed foods, excessive salt and sugar intake, as well as a fast-food culture, can damage vascular health.

He also emphasized that the perception, particularly common among young people, that "being thin means being healthy" is misleading. "A person may be thin, but their vascular structure could be impaired, their cholesterol levels high and they could be at metabolic risk," he said.

In recent years, energy drinks and e-cigarettes have also been among the topics drawing experts’ attention. Çelik explained that energy drinks, which contain high amounts of caffeine and stimulants, can accelerate the heart rate, raise blood pressure and trigger arrhythmias, especially when consumed before exercise.

"We are seeing cases of sudden arrhythmias and even heart attacks in some young people," says Çelik, noting that e-cigarettes are not as harmless as commonly believed. "There is still a perception in society that they are 'safer than regular cigarettes,' but this is not scientifically accurate," he adds.

Çelik noted that e-cigarettes can damage the inner lining of blood vessels and accelerate atherosclerosis, while pointing out that their long-term effects are still not fully understood.

Silent warning signs

The symptoms of a heart attack in young people do not always appear with the classic picture. Instead of severe chest pain, symptoms such as shortness of breath, sudden palpitations, unexplained fatigue, chest pressure mistaken for heartburn, pain radiating to the back or jaw, and cold sweating may go unnoticed.

Çelik said that especially chest tightness or a fainting sensation that occurs during exercise must be taken seriously and noted that heart attacks in young people can sometimes progress more aggressively.

"In older adults, collateral vessels that develop over the years create a protective mechanism; however, young blood vessels are unprepared," he said.

According to experts, one of the most dangerous mindsets is the belief that "I’m young; nothing will happen to me." Çelik noted that young people often dismiss symptoms by saying, "I exercised, that’s why it hurts," or "I drank too much coffee, that’s why."

"Cardiovascular diseases often progress silently for a long time," he said, adding that individuals with a family history of risk should have their blood pressure checked regularly and monitor their cholesterol and blood sugar levels.

According to Çelik, the most important message for young people is quite clear: "Heart disease doesn’t appear suddenly. It develops silently over the years."

He noted that regular sleep, a smoke-free, active lifestyle, healthy eating and stress management – though they may seem like small decisions today – determine life expectancy years down the line.

"A heart attack is no longer just a disease of the elderly. Being young does not mean you are safe," said Çelik.