Cardiac aging in the young: Why millennials and Gen Z are facing heart disease earlier

For decades, cardiovascular disease had been regarded as an old and middle-aged person' s disease, something that usually emerged after the age of 50. However, cardiologists are now observing a concerning trend.

More and more millennials, and even Gen Z adults—in their twenties, thirties and early forties—are showing up with ailments previously linked to older age. The phenomenon, termed as cardiac aging, indicates that the heart is biologically older than the individual's real years.Aging of the heart reflects the divergence between chronological age—the age we mark on our birthdays—and biological age, which relies on how healthy the heart and blood vessels really are.

Risk factors like blood pressure, cholesterol, blood sugar, weight, and kidney function all contribute to this. Data indicate that most young adults have hearts that are 10 to 20 years than their birthday age. One sophisticated imaging test even discovered that individuals with obesity, hypertension or diabetes might have hearts that are working up to 45 years older than their actual age (EatingWell).

The causes behind this movement are multifaceted, but lifestyle is at the heart.

Sedentary lifestyles, augmented by lengthy workdays, screen addiction, and minimal physical exertion, have propelled obesity, type 2 diabetes and high blood cholesterol into young adults (Priority Health). Poor food choices, excess sugar and salt consumption, poor eating habits, alcohol, and not enough sleep further promote metabolic load on the heart (OnlyMyHealth).But lifestyle isn't all about diet and fitness—it's about daily stress and work burnout.

The younger generation workforce is dealing with endless deadlines, long hours stuck in traffic, nighttime emails, and feeling pressure to constantly deliver in a high-stakes environment. Couple this with the round-the-clock use of social media, and the brain never has a moment to relax. This is a perpetual state of wakefulness that thrusts the body into fight-or-flight mode, speeding up heart rate and blood pressure, and pumping in stress hormones.

Continued for months and years, it takes a serious toll on the cardiovascular system. Physicians note that burnout characterized by exhaustion, detachment, and helplessness does not only relate to mental well-being; it is increasingly being directly associated with increased risks forhypertension, arrhythmias, and premature myocardial infarctions. This interaction between stress and the heart is partially explained by what researchers refer to as inflammaging. With chronic stress, inflammatory mediators like IL-6 and TNF-α increase in the blood. At low levels, this inflammation is asymptomatic, but chronically it hastens arterialstiffness, injures heart muscle, and leads to premature atherosclerosis (Wikipedia).

Research has further indicated that millennials are also more likely to experience depression, hypertension, and diabetes compared to Gen X at the same age, demonstrating how psychosocial determinants are fueling biology (Cardiovascular Business).The seeds of future heart disease are frequently planted in childhood. The seminal Bogalusa Heart Study tracked children over decades and showed that school-year obesity, high blood pressure and cholesterol can strongly track into adult life, setting the stage for premature cardiovascular disease (Wikipedia).

A lot of today's young adults carry this silent baggage.

Others have genetic threats—such as hypertrophic cardiomyopathy that can go unnoticed during childhood and adolescence but appear suddenly with arrhythmias or heart failure in the thirties. Clinicians are seeing more young patients with symptoms such as palpitations, fatigue, or heaviness over the chest—often attributed to stress or acidity. But additional tests confirm narrowing arteries or early cardiac dysfunction.

Molecular marker studies also indicate that high triglycerides, low HDL cholesterol, and abnormal DNA methylation patterns are associated with the accelerated epigenetic aging of the heart (Clinical Epigenetics). Essentially, the pressures of contemporary life are inscribing biological wounds long prior to overt disease. The encouraging part of this tale is that premature aging of the heart is reversible. Heart resilience can be regained through lifestyle change. The American Heart Association "Life's Essential 8" focuses on healthy diet, regular exercise, weight control, good sleep, not smoking, limiting alcohol, and keeping blood pressure, cholesterol, and blood glucose in check. Adhering to these guidelines can make the heart between two and six years younger biologically(EatingWell). Equally vital is taking care of mental health—establishing boundaries in theworkplace, putting sleep and rest first, going to therapy when necessary, and developing copingskills to buffer against stress.

Millennial and Gen Z cardiac aging isn't just a healthcare problem; it is a social and generational issue. The everyday task of work, perpetual connection, and lifestyle hacks are pulling heart health forward earlier than ever. But awareness presents the chance to do something about it. By altering their way of life in their 20s and 30s, young adults not only can shield themselves from early disease but also can give their hearts the opportunity to really beat strong fordecades to come.Dr Brajesh Kunwar, Sr. Consultant Interventional Cardiologist, Apollo Hospitals Navi Mumbai.