Trends in Risk Factor Prevalence and Incidence of Acute Myocardial Infarction in Young Adults (JACC: Advances September 2025)-Article: Trends in Risk Factor Prevalence and Incidence of Acute Myocardial Infarction in Young Adults

Article: Trends in Risk Factor Prevalence and Incidence of Acute Myocardial Infarction in Young Adults

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This large U.S. study analyzed 4.4 million acute myocardial infarction (AMI) hospitalizations from 2011-2021, focusing on traditional and nontraditional risk factors (RFs) in young adults (aged 18–54) compared to older adults (≥55). Nearly 22% of incident AMI cases occurred in young adults, a sizable and concerning proportion.<br /><br />Among young adults with AMI, hypertension (64.8%), tobacco use (57.8%), and dyslipidemia (57.5%) were the most prevalent traditional risk factors. Tobacco smoking and obesity were significantly higher in young adults than older adults, while hypertension and dyslipidemia were more common in the older group. Nontraditional RFs—including low income, family history of ischemic heart disease (IHD), and psychiatric disorders—were also more prevalent in young adults. Notably, 96.1% of young adults had at least one RF, and nearly 25% had five or more RFs. Young women and non-White groups, especially Blacks and Hispanics, bore a disproportionate burden of both traditional and nontraditional RFs.<br /><br />Over the decade, AMI hospitalization rates declined overall but less so in young adults, with smaller decreases among young women and non-Whites. Simultaneously, the prevalence of most traditional and nontraditional RFs increased significantly in young adults, with obesity showing the largest absolute rise (annual increase ~1.3%) across all subgroups. Dyslipidemia increased since 2017, reversing prior downward trends. Tobacco use remained high in young adults, although a decline was seen in young women after 2017. Nontraditional RFs like psychiatric disorders and socioeconomic disadvantage also increased, especially among young women and racial minorities.<br /><br />The study highlights that young adults with AMI carry a distinct and rising burden of both traditional (e.g., hypertension, smoking, obesity) and nontraditional (e.g., poverty, mental health) risk factors, with marked disparities by sex and race/ethnicity. These findings stress the urgent need for tailored primary prevention strategies that address both medical and social determinants of health to reduce AMI incidence in young populations. Enhanced screening, risk stratification including family history and psychosocial risks, and equitable access to prevention programs are essential to improve cardiovascular outcomes in young adults.

Keywords

acute myocardial infarction

young adults

traditional risk factors

nontraditional risk factors

hypertension

tobacco use

obesity

racial disparities

psychiatric disorders

primary prevention