Taking care of your heart should start young

“One of the biggest misconceptions about heart disease is that it only affects the elderly,” says Professor Juhani Junttila, who researches sudden cardiac deaths in the Fibrobesity research programme at the University of Oulu. According to him, it’s important to understand that taking preventive care of your heart is worthwhile — rather than assuming you can deal with any issues once you’re older.

“Strain on the heart and blood vessels can begin already in childhood and develop gradually from there. Even in their twenties or thirties, people might think, ‘I can live recklessly for another 15 years — medicine will fix me later.’”

“Young people often don’t realise that cardiovascular diseases are chronic conditions — you’ll have them for the rest of your life,” Junttila reminds.

New risk factors in youth

Junttila is not trying to frighten young people, but in his clinical work he observes new risk factors that may endanger heart health. “Nicotine pouches, which are popular among young people, can contain much higher nicotine levels than traditional snus or cigarettes. Users may not realise the long-term effects these can have.”

High doses of nicotine constrict blood vessels and increase the risk of arrhythmias and blood clots. Nicotine absorbed from pouches puts strain on the entire circulatory system for a longer time than smoking does, as users often swallow the liquid that seeps from the pouch, meaning the nicotine is also absorbed through the gut.

In fact, the harmful mechanism of nicotine pouches on the heart is similar to that of cocaine. “Cocaine is, of course, a much stronger risk factor, with a high risk of overdose. An overdose of nicotine is harder to reach, but coronary artery disease develops over time,” Junttila notes.

Anabolic steroids, familiar from bodybuilding circles, have also found their way into the hands of increasingly younger users. “We see patients who have damaged their hearts with steroids while still young. People under 40 suffering from heart failure whose heart muscles have thickened abnormally as a result of steroid use.”

Low-carb, high-fat ketogenic diets, popularised through social media, are also beginning to show up in patient statistics. “We’ve had a few patients who otherwise took good care of themselves, but had consumed so much fat over the past six months that they ended up with a coronary event.”

“A ketogenic diet may be suitable as a weight management tool for people with significant obesity, but it can also do a lot of harm in a fairly short time,” Junttila explains.

Fortunately, the basics of heart care are simple. Avoiding tobacco and alcohol already goes a long way, but Junttila has further recommendations.

“Measuring your blood pressure is probably the easiest preventive step. It’s important to know your blood pressure by the age of 30 at the latest. Cholesterol should also be checked at the same time, as it contributes to plaque build-up in the coronary arteries.”

Wiring and plumbing of the heart

Junttila likes to think of the heart in terms of house construction: the electrical wiring and plumbing must be in good working order. The “pipes” are the coronary arteries, which are at risk of becoming blocked, and the heart muscle needs functioning electrical pathways in order to beat.

“For example, high blood pressure increases the resistance against which the heart has to pump, meaning the heart muscle has to work harder,” Junttila explains. The heart muscle essentially overtrains and grows larger, causing connective tissue — known as fibrosis — to form between the muscle fibres.

“Connective tissue doesn’t conduct electricity, so the heart’s usual, reliable electrical routes stop working and it begins to search for new ones. In the worst case, electrical signals reach different parts of the heart at different times because of the fibrosis, creating a sort of fatal short circuit.”

In coronary artery disease, plaque builds up in the artery-like vessels that carry blood to the heart, narrowing the flow. As a result, the heart doesn’t get enough oxygen. “When the heart has to operate in a low-oxygen environment for long enough, it starts to develop harmful fibrosis. A ruptured plaque can also lead to a blockage that causes a heart attack.”

Original text (in Finnish) and photos: Juho Karjalainen

Read more (in Finnish): Sydänperäisiin äkkikuolemiin selvyyttä maailman parhaasta kuolinsyyaineistosta