In your 20s and 30s, heart disease can seem like a far-off concern. It’s more common among people 75 or older than in any other age group.
But there’s good reason to think about your heart health decades earlier: “While young adults often associate heart disease with people in their parents’ and grandparents’ ages, it’s never too early to start prevention,” says Dr. Nieca Goldberg, a cardiologist, author, and clinical associate professor at NYU Grossman School of Medicine. “In fact, 80% of heart disease is preventable.”
If there’s just one thing you do for your heart when you’re young, it should be increasing your physical activity, experts agree. “Exercise is the foundation of heart-disease prevention, and combining aerobic exercise with resistance training has been shown to have the greatest impact on preventing and managing heart disease,” Goldberg says. That’s because physical activity taxes your heart and lungs, helping them to adapt to the stress and grow stronger over time.
Getting regular exercise is also a step in the American Heart Association’s (AHA) Life’s Essential 8, a list of eight crucial health behaviors for maintaining optimal cardiovascular health. Aside from staying active, the list also includes eating a nutritious diet; managing your blood pressure, cholesterol, and blood sugar; maintaining a healthy weight; quitting tobacco; and getting plenty of sleep.
Starting with physical activity will likely trickle down to these other arenas, says Dr. Keith Churchwell, president of the AHA. “If you stay active, it probably will help your sleep, it’ll probably help you in terms of thinking about your diet appropriately. It’ll help in terms of reducing your blood pressure, controlling your lipid status, your weight…and hopefully keep you away from other issues, like tobacco use.”
How to get (even just a little) more exercise
You don’t have to suddenly become a runner or join a gym if that’s not your style. You can focus on simply moving more throughout the day to start, Churchwell says. Take an extra stroll with your dog, meet a friend for a walk instead of a drink, finally give pickleball a try, or sign up for a dance class. Even just 20 more minutes of activity a day is a great benchmark to aim for, he says.
It’s important not to go too hard, too fast. “The idea here is you want to establish lifestyle changes that are truly going to last you a lifetime,” says Dr. Nishant Shah, a preventive cardiologist and assistant professor at Duke University School of Medicine and the Duke Cardiometabolic Prevention Clinic. “Whatever you decide to do now, don’t do it with the intention of stopping it six months later.”
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Establishing a lifelong fitness plan means identifying forms of exercise you actually like; it’s fine if CrossFit isn’t your thing. “Spend time to find activities that you enjoy so it doesn’t feel like a chore,” Goldberg says.
Gradually build up to at least 150 minutes of moderate or 75 minutes of vigorous cardio activity, plus two strength-training sessions a week. That’s the general AHA recommendation for overall health and wellbeing.
You can modify and tailor your exercise program to your specific needs, abilities, interests, and fitness level, Goldberg says. If you’re not sure how to get started, speak with your doctor or a certified fitness professional who can guide you. “Start small and build from there: Consistency is key, so it’s important to ensure your routine is manageable based on your current lifestyle and commitments,” she says.
It can get harder to start a physical activity routine as you get older, so it may be easier to maintain for your entire life if you make it a habit in your 20s or 30s. “When you maintain a habit of exercising at an earlier age, it’s just normal for you,” Shah says.
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Finding the time can be tough, though, he admits. Try blocking off 30 to 60 minutes of your day for exercise just like you would for any other commitment or meeting, and then stick to it, he says.
If you already exercise, keep building up your cardiovascular fitness and strength. There are even greater benefits of getting 300 (or more) minutes a week of physical activity.
Shah offers one caveat to the exercise-first mentality: If you use tobacco, the most important heart-health habit for you, no matter your age, is to stop. While only about 5 to 12% of Americans in their 20s and 30s smoke now, according to a 2023 report in JAMA Health Forum, it’s still the most important habit to quit for your heart and overall health, he says, even before picking up an exercise routine. Smoking is linked to about one-third of heart disease-related deaths.
And whether or not you’re ready to make some heart-healthy changes, talk with your relatives about any heart-health concerns in your family tree—especially your first-degree relatives. “Oftentimes when I see patients in this age range, they are unaware of any conditions that run in the family,” says Dr. Maxim Olivier, a cardiologist at Orlando Health Heart and Vascular Institute. “A good family history is very important to determine if they are at an increased risk for premature coronary artery disease, heart disease, or even sudden cardiac death. Though the ramifications may seem far off, there are patients who can present with heart disease as early as 20s to 30s, and even younger, which is often a reflection of their genetic predisposition and/or lifestyle.”
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