Young and at risk: Why heart disease is no longer just a problem for elderly

For decades, heart attacks and other serious heart conditions were thought to be the fate of the aging. They were illnesses we associated with retirement, old age, and decades of unhealthy living.

But that image is changing—and fast. More and more young people are now facing heart disease, with doctors across Kenya sounding the alarm.

Acute Coronary Syndrome (ACS), the umbrella term used to describe situations where the blood supplied to the heart muscle is suddenly blocked, is no longer just a problem for people in their 60s and 70s.

Increasingly, it is being diagnosed in people under 50—and even some in their 30s.

This shift is deeply troubling and reflects changing lifestyles, environmental pressures, and, in many cases, preventable habits that have taken root among Kenya’s youth.

Not just "old people's disease"

I recall, when a 38-year-old patient of mine walked into the emergency room with chest pain and shortness of breath, heart disease was the last thing on his mind. He was relatively fit, lived in Nairobi, and had a busy life as a sales manager.

But what he didn’t know was that his risk had been building silently: he smoked socially, used shisha at parties, had a family history of heart disease, and worked long hours with little exercise or rest.

Stories like his are becoming common. According to recent clinical research conducted at the Aga Khan University Hospital, nearly one in three patients admitted with ACS was under the age of 50. This isn't an isolated case or a small number—it represents a major shift in how cardiovascular disease is affecting Kenyan society.

So, what’s driving the rise?

There’s no single cause, but several key risk factors are emerging.

Smoking remains the biggest and most direct threat. Over 50 percent of the younger patients in the study were active smokers. But smoking in Kenya today doesn’t just mean cigarettes.

The increasing use of vapes, shisha (hookah), and e-cigarettes has created a new pathway to addiction and cardiovascular damage. These products are often marketed as cleaner or safer, but the truth is, they are still harmful.

Vapes, for example, contain nicotine and other chemicals that cause blood vessels to constrict, raising blood pressure and increasing the risk of clot formation—both of which can lead to heart attacks. Shisha, often smoked in social settings, has become particularly trendy among youth in urban areas. Despite the government’s ban on its use in 2017, enforcement remains patchy.

Many clubs and lounges continue to offer it. Health experts warn that a one-hour shisha session can deliver the same amount of toxic smoke as smoking 100 cigarettes.

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Another less-discussed but increasingly relevant factor is the use of miraa (also known as khat)—a plant chewed for its stimulant effects. While miraa is deeply rooted in cultural and social traditions, its impact on cardiovascular health cannot be ignored.

The stimulant compounds in miraa raise heart rate and blood pressure, mimicking some of the effects of other known cardiovascular risk factors.

While there’s not yet a definitive study linking miraa use directly to heart attacks, many cardiologists suspect it may play a hidden role, particularly when combined with other stressors like poor diet, sleep deprivation, and smoking.

The hidden risk of family history

Perhaps the most underestimated risk factor among the youth is family history. If you have a parent or sibling who had heart disease early in life (before age 55 for men or 65 for women), your own risk doubles or even triples.

In the Kenyan study, more than half of the young patients admitted with ACS had a family history of premature cardiovascular disease. This suggests that genetics may quietly be at work even when outward symptoms are not yet visible.

But family history isn’t a death sentence—it’s a warning sign. And it’s one that should prompt young people to take preventive steps early: getting regular check-ups, avoiding smoking and unhealthy foods, staying physically active, and managing stress.

A wake-up call to act early

There’s a troubling perception among many young people that they are immune to lifestyle diseases. After all, they feel fine, they’re busy, and health seems like a problem for “future me.” But the reality says otherwise.

Stress—especially work-related and financial stress—is another major factor. Long hours, traffic, irregular meals, poor sleep, and pressure to perform create a perfect storm for heart disease. Combined with unhealthy habits, it’s no surprise younger people are falling ill.

The good news is that ACS is preventable in many cases. The body gives warnings—chest discomfort, breathlessness, fatigue. But often, these are ignored or misattributed to indigestion or exhaustion. By the time most young people seek help, the damage is already done.

What the data says

The most in-depth recent study on this issue was conducted at Aga Khan University Hospital in Nairobi. The research, published in BMC Cardiovascular Disorders, analysed 506 patients with ACS.

Strikingly, 138 of them were aged 50 or younger—a proportion that we describe as alarmingly high. Many had already been diagnosed with conditions like high blood pressure, and over half were smokers. Almost a third had previously been prescribed medications to manage cholesterol, indicating that the warning signs were present well before their heart event.

Moving forward, what can be done?

First, awareness must improve. Schools, universities, and workplaces need to start incorporating heart health education into their wellness programmes. Medical check-ups should start early—especially for those with family histories or who smoke.

Second, regulatory enforcement on banned substances like shisha needs to be strengthened. The rise in vape use among teenagers and young adults should be treated with urgency by both parents and policymakers.

Third, public health campaigns must reach beyond the urban elite and into rural and peri-urban areas where misinformation and lack of access to health services remain a problem.

And finally, individuals must take responsibility. It’s time to de-glamorise smoking, question social habits, and normalise early health checks.

We only have one heart. Young or old, it deserves our care and attention—now more than ever.

The writer is a Cardiology Fellow at Aga Khan University Hospital, Nairobi