Your twenties can make or break your heart health

Many teens enter adulthood already carrying risk factors for heart disease. According to a new American Heart Association (AHA) scientific statement, this transition phase – from 18 to the late twenties – is critical for protecting heart health.

During this time, the brain and decision-making abilities are still developing. At the same time, independence increases, and life takes on many new forms.

The research, published in the Journal of the American Heart Association, urges better support for young adults. Their routines change, their responsibilities grow, but health often takes a backseat.

Recognizing this period as an opportunity to build strong habits can shift the outlook of cardiovascular wellness for life.

Loss of structure can hurt heart health

When children grow up, their regular health checkups often disappear.

Adolescents see doctors for vaccines or school-related check-ins. Those visits vanish once high school ends. Without these routine appointments, early signs of heart disease can go unnoticed.

“We may miss the opportunity to let them know that they are in the elevated blood pressure range and ways they can take action,” said Dr. Jewel Scott, an assistant professor of biobehavioral health and nursing science in the College of Nursing at the University of South Carolina in Columbia.

Emerging adults often eat more processed foods and exercise less. The habits of high school sports fade, replaced by sedentary days and fast food. Sleep also suffers due to work, studies or parenting. All of these changes increase cardiovascular risk.

Vaping surge among young adults

Historically, smoking began in high school. But now, people are picking up tobacco products later. Between 2002 and 2018, tobacco use among 18 to 23-year-olds doubled.

E-cigarettes are now the most used product in this age group. The long-term effects of vaping on heart health remain unclear, which worries researchers.

Cost and coverage: Health care barriers

Emerging adults make up the biggest group among the 27 million uninsured in the U.S. Insurance often vanishes at 19 or 26, depending on state rules or family plans under the Affordable Care Act.

Students in community colleges are at greater risk. About 40% of college students attend these institutions, which often lack health services. Similarly, those in trade programs or apprenticeships may not have access to care.

Even those with insurance don’t always visit the doctor. Less than 40% of insured emerging adults use their benefits. Some avoid care due to bad experiences, long waits or confusion about where to go.

Social conditions affect heart health

The AHA statement highlights how education, neighborhoods and income shape health. People with higher education often have better heart health. Those in segregated or resource-poor areas see worse outcomes.

Neighborhoods without clean air or safe green spaces leave kids inactive and stressed. These effects follow them into adulthood. The statement calls for changes that improve access to healthy environments.

Strong friendships and emotional support also help. On the flip side, isolation, especially after the COVID-19 pandemic, can hurt heart health. The statement urges finding and helping at-risk youth – especially those with a history of trauma or abuse.

“We highlight some of the populations that need extra effort or attention tailored to their unique circumstances,” said Dr. Scott.

Addressing heart health

The AHA statement calls for policy changes that close coverage gaps. But having insurance isn’t enough. Young adults need help navigating the system, and providers must use every opportunity to talk about heart health.

Pregnancy adds another layer of concern. Poor heart health can lead to problems like gestational diabetes or preeclampsia. These can affect both mother and child, even years later.

Clinicians must address heart risks before pregnancy. This means bringing cardiovascular conversations into regular care.

Supporting young adults with technology

Technology offers new ways to engage. Telehealth and mobile tools can help. The statement also pushes for social media campaigns to share heart health messages with young people.

Places like community colleges, the military and hospitality industries offer untapped potential. These are spaces where many young adults work and study. Using these channels could improve outreach and awareness.

The statement encourages partnerships across health systems, education and employers. These joint efforts can support emerging adults as they take on the challenges of growing up – while keeping their hearts healthy.

The scientific statement was prepared by a volunteer writing group for the AHA Prevention Science Committee and other councils. It aims to raise awareness and spark better decisions around heart health.

It does not offer treatment advice but summarizes what’s known and what needs more research. Contributors include medical experts and researchers from across the U.S.

The study is published in the Journal of the American Heart Association.

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